Falls and falls efficacy: the role of sustained attention in older adults

BMC Geriatrics

Research Article

Chie Wei Fan¹  Rose Anne Kenny²  Aisling M O'Halloran³  Alessandra Galli⁴  Ian H Robertson⁴  Nils Pénard⁴ 

[1] TRIL (Technology Research for Independent Living) Centre, St. James's Hospital, Dublin, Ireland;Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland;TRIL (Technology Research for Independent Living) Centre, St. James's Hospital, Dublin, Ireland;Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland;Department of Medical Gerontology, Trinity College, Dublin, Ireland;TRIL (Technology Research for Independent Living) Centre, St. James's Hospital, Dublin, Ireland;Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland;TRIL (Technology Research for Independent Living) Centre, Trinity College, Dublin, Ireland;Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland;

关键词: Sustained Attention;    Commission Error;    Omission Error;    Fast Fourier Transform Analysis;    Reaction Time Variability;   

DOI  :  10.1186/1471-2318-11-85

 received in 2011-07-25, accepted in 2011-12-19,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPrevious evidence indicates that older people allocate more of their attentional resources toward their gait and that the attention-related changes that occur during aging increase the risk of falls. The aim of this study was to investigate whether performance and variability in sustained attention is associated with falls and falls efficacy in older adults.Methods458 community-dwelling adults aged ≥ 60 years underwent a comprehensive geriatric assessment. Mean and variability of reaction time (RT), commission errors and omission errors were recorded during a fixed version of the Sustained Attention to Response Task (SART). RT variability was decomposed using the Fast Fourier Transform (FFT) procedure, to help characterise variability associated with the arousal and vigilance aspects of sustained attention.The number of self-reported falls in the previous twelve months, and falls efficacy (Modified Falls Efficacy Scale) were also recorded.ResultsSignificant increases in the mean and variability of reaction time on the SART were significantly associated with both falls (p < 0.01) and reduced falls efficacy (p < 0.05) in older adults. An increase in omission errors was also associated with falls (p < 0.01) and reduced falls efficacy (p < 0.05). Upon controlling for age and gender affects, logistic regression modelling revealed that increasing variability associated with the vigilance (top-down) aspect of sustained attention was a retrospective predictor of falling (p < 0.01, OR = 1.14, 95% CI: 1.03 - 1.26) in the previous year and was weakly correlated with reduced falls efficacy in non-fallers (p = 0.07).ConclusionsGreater variability in sustained attention is strongly correlated with retrospective falls and to a lesser degree with reduced falls efficacy. This cognitive measure may provide a novel and valuable biomarker for falls in older adults, potentially allowing for early detection and the implementation of preventative intervention strategies.

【 授权许可】

CC BY   
© O'Halloran et al; licensee BioMed Central Ltd. 2011