Abstract
Ladder falls are a common cause of injury in the domestic setting, particularly among older adults. There is a need, therefore, to understand contributing factors of safe and effective ladder use in this group. This study investigated associations between individual human factors (vision, lower and upper limb sensation, upper limb control, strength, balance, cognitive function and psychological status) with task performance on a ladder (time to climb a household stepladder and change a light bulb) under single and secondary cognitive task conditions in 104 older adults. Measures of upper limb control, strength, balance, cognitive processing speed and psychological domains were significantly associated with ladder task completion time in the single task condition; with the addition of executive function and global cognition significantly associated with ladder task completion time in the dual task condition. Knee extension strength, upper limb bimanual coordination, cognitive processing speed and fear of falling were found to be robust predictors of ladder task completion times. These findings help identify individuals with greater ladder use ability and presumably lower fall risk. This work can guide ladder fall interventions, such as strength and balance training, ladder design and targeted safety instructions.
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