“Stops walking when talking” as a predictor of falls in elderly people

摘要: It was our clinical experience that some frail elderly patients stop walking when they start a conversation with companion, presumably because demands attention and are expected to do two things at once. We therefore investigated the usefulness of sign “stops talking” in predicting falls. 58 residents sheltered accommodation Umea, Sweden, were included. All able walk or without aids follow simple instructions (mean age [SD] 80·1 [6·1] years; 72% women). The most common diagnoses (some had more than one) dementia (n=26), depression (25), previous stroke (20). median score (inter-quartile range) Mini-Mental State Examination 1 21·5 (18‐26) activities daily living 17 (14‐19) as measured by Barthel Index. 2 Participants observed physiotherapist while accompanied from their home an assessment room, whether not stopped started recorded. Furthermore, ability safely rated basic functional mobility measured. 3 staff registered falls indoors during followup 6 months. Neither participants nor aware physiotherapist’s observations. 12 people ten them fell 6-month follow-up. 21 least Kaplan-Meier distributions differed significantly between those who continued (figure, log-rank test 17·46, p0·001). positive predictive value 83% (10/12) negative 76% (35/46). specificity high (95%; 35/37) but sensitivity low (48%; 10/21). Those less safe gait (p<0·001), Myocardial contrast