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.

Background Higher cognitive reserve is reported to reduce risk of dementia. However, its role in reducing delirium risk is not well established. Objectives To examine the role of cognitive reserve on reducing delirium incidence and severity in older surgical patients. Design Prospective cohort study. Setting and Participants 142 older adults (mean age 71.2 y, 65% women) undergoing elective orthopedic surgery. Measurements Incidence (assessed by Confusion Assessment Method) and severity (Memorial Delirium Assessment Scale) of postoperative delirium were the primary outcomes. Predictors included early life (literacy) and late life (cognitive activities) proxies for cognitive reserve. Results 45 participants (32%) developed delirium. Higher cognitive activity participation was associated with lower incidence (odds ratio 0.92 corresponding to increase of 1 activity per week, 95% CI 0.86 to 0.98, p = 0.006) and lower severity of delirium (B = −0.06, 95% CI −0.11 to −0.01, p = 0.019) after adjustment for age, sex, medical illnesses and baseline cognition. Higher literacy was not associated with decreased delirium incidence and severity. Among the individual leisure activities, reading books, using electronic mail, singing and computer games were associated with lower dementia incidence and severity. Conclusion Higher late life cognitive reserve was associated with a reduced delirium incidence and severity in older surgical patients. Interventions to enhance cognitive reserve by initiating or increasing participation in cognitive activities may be explored as a delirium prophylaxis strategy.

Background Suicide rates among adolescents increased over the past few decades. Following psychiatric hospitalization, many adolescents return to school, a context that can influence recovery. Families can play an integral role in supporting adolescents through the hospitalization and school reentry process; however, little research has focused on family experiences during adolescent school reentry. Grounded in ecological systems theory, the aim of the present study was to explore the experiences of caregivers whose children were hospitalized for suicidal thoughts and behaviors (STBs) and provide recommendations for the school reentry process. Methods In‐depth interviews were conducted with caregivers (n = 19) whose adolescents returned to school following hospitalization for suicide‐related crises. Researchers analyzed the transcribed interviews using applied thematic analysis. Results Themes emerged regarding academic difficulties during hospitalization; breakdowns in communication between schools, families, and hospitals; logistical challenges during the school reentry planning process; and challenges navigating peer relationships and academics following school reentry. Implications and Conclusions Few reentry recommendations account for the specific challenges faced by families. Recommendations informed by caregiver experiences are needed to ensure that families can effectively support the recoveries of their children. This study presents caregiver‐informed recommendations to facilitate an improved reentry process for caregivers and adolescents.

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