Department of Geriatrics, Angers University Hospital, France, FORMADEP, Korian, Paris, France, Department of Neurology, Geneva University Hospital, Switzerland, Department of Rehabilitation and Geriatrics, Geneva, University Hospital, France, Department of Geriatrics, Nantes University Hospital, France
Simple and efficient detection of the risk of falling in older adults is an objective yet to be reached. Twelve years ago, a study published by Lundin-Olsson et al., entitled «Stops walking when talking», showed that an interruption of walking while talking was a predictor of fall. Most of the subsequent studies using dual-task paradigm combining walking and attention-demanding tasks, have reported more dual-task related gait changes among fallers than non-fallers. But despite the development of dual-task-based fall risk assessment tests, the relationship between dual-task related gait changes and the risk of falling remain controversial. The divergence may be related to three main reasons. First of all, there was a lack of understanding of the theoretical models of dual-task interferences. Secondly, confusion factors such as a cognitive impairment or depressive symptoms were not taken into account. Thirdly, the analysis of dual-task related gait changes depended on visual observation that does not give sufficient measures of gait and has poor inter-rater reliability related to its subjectivity. A better understanding of the nature of dual-task interferences, the use of user-friendly portable gait analysis systems that provide simple and objective gait measurements most likely allow the development of efficient dual-task-based fall risk assessment tests. Additionally, the analysis of changes in the performance of attention-demanding tasks seems to constitute a relevant new orientation of research in the detection of risk of falling.