Walking while talking and falls in aging

Background: While divided attention tasks are recognized as predictors of falls in older adults, a comprehensive examination of this association is lacking. Objective: We examined the validity of a 'walking while talking' (WWT) task for predicting falls. Methods: We studied the associations of 8 selected gait markers measured during WWT (individually as well as domains derived by factor analysis) with incident falls in 646 adults (mean age 79.9 years; 61% women) enrolled in an aging study who received quantitative gait assessments. Cox regressions adjusted for multiple potential confounders and normal-pace walking were used to examine the associations. Results: Over a mean follow-up of 2.6 years, 337 participants (52%) fell. Step length was the only individual WWT parameter that predicted falls [hazard ratio (HR) 0.98; p = 0.034]. Factor analysis identified 3 gait domains, of which only the pace factor predicted falls (HR 1.31; p = 0.002). Results remained robust after adjusting for multiple potential confounders and accounting for normal-pace walking. Conclusions: WWT performance was a significant predictor of falls. Gait domains in WWT should be further studied to improve current fall risk assessments and to develop new interventions.