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Almutairi GR, Almegbas NR, Alosaimi RM, Alqahtani MA, Batook SG, Alfageh IA, Alshehri MM, Alanazi SF, Alhowimel AS, Alqahtani BA, Alhwoaimel NA, Alenazi AM. Comorbidities, medications, depression, and physical performance measures associated with severe cognitive impairments in community-dwelling adults. PLoS One 2024; 19:e0309765. [PMID: 39298495 DOI: 10.1371/journal.pone.0309765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/17/2024] [Indexed: 09/21/2024] Open
Abstract
Cognitive impairment negatively impacts health, psychological, social, and economic domains. Cognitive impairment commonly affects physical functions in older adults, whereas these are deteriorated. However, the prevalence and associated factors of cognitive impairment among community-dwelling adults in Saudi Arabia have not been investigated yet. This study aimed to examine the prevalence of severe cognitive impairment and its associated factors in community-dwelling older adults in Saudi Arabia. This cross-sectional study involved adults aged ≥50 years. Demographic data and clinical data, including number of medications and body mass index (BMI), were collected. Cognitive impairment and depressive symptoms were measured using Arabic versions of the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9), respectively. The participants were divided into severe cognitive impairment and mild cognitive impairment or normal cognitive function groups based on a score of <20 or ≥20, respectively, using the MoCA. Physical measures included dynamic gait index (DGI) scores, timed up-and-go (TUG), 5 times sit-to-stand (5XSST), functional reach test, and 6-minute walk test. A total of 206 participants (female: n = 96) were included. The prevalence of severe cognitive impairment in the community-dwelling older adults was 12.6%. The number of chronic conditions (odds ratio [OR]: 2.31, p<0.001), number of medications (OR: 1.36, p = 0.003), and depressive symptoms using PHQ-9 (OR: 1.11, p = 0.009) were significantly associated with severe cognitive impairment after adjustment for other covariates, including age, sex, and BMI. Based on the physical function measures, only the scores for DGI (OR: 0.86, p = 0.003), TUG (OR: 1.16, p = 0.035) and 5XSST (OR: 1.25, p <0.001) were significantly associated with severe cognitive impairment. This study revealed a high prevalence of severe cognitive impairment among community-dwelling adults in Saudi Arabia. Its major risk factors include depressive symptoms, number of chronic conditions and medications, and physical measures, including DGI, TUG, and 5XSST.
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Affiliation(s)
- Gamar R Almutairi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Noura R Almegbas
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Rawan M Alosaimi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Maha A Alqahtani
- Department of Research and Innovation, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Saleh G Batook
- East Jeddah General Hospital, Western Region, Jeddah, Saudi Arabia
| | | | - Mohammed M Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | | | - Ahmed S Alhowimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Bader A Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Norah A Alhwoaimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Oki Y, Osaki T, Kumagai R, Murata S, Encho H, Ono R, Yasuda H, Kowa H. An 18-month multimodal intervention trial for preventing dementia: J-MINT PRIME Tamba. Alzheimers Dement 2024. [PMID: 39229900 DOI: 10.1002/alz.14170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/20/2024] [Accepted: 07/12/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND The number of people with dementia is increasing in Japan, and establishing evidence for preventing dementia is necessary. METHODS This study was a randomized controlled trial in cognitively normal community-dwelling older adults aged 65 to 85 with diabetes and/or hypertension. Participants were randomly assigned in a 1:1 ratio. The intervention group underwent 90 min of group-based weekly physical exercise, cognitive training, nutritional counseling, and vascular risk management for 18 months. The primary endpoint was the change in a cognitive composite score calculated by averaging the z-scores of seven neuropsychological tests from baseline to 18 months. RESULTS We randomly assigned 203 participants to two groups, and 178 (87.7%) completed the 18-month follow-up. There was a significant group difference in the cognitive composite score change at 18 months (mean difference 0.16, 95% confidence interval: 0.04 to 0.27; p = 0.009). DISCUSSION An 18-month multimodal intervention for older adults at risk of dementia could improve their cognitive function. The trial was registered in the Clinical Trial Registration System (UMIN000041938). HIGHLIGHTS Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT) PRIME Tamba was a randomized controlled trial to prevent dementia. We provided a multifactorial intervention based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial methodology. The primary outcome, the cognitive composite score, improved with our intervention. Executive function/processing speed and memory improved in the intervention group. Intervention adherence was high, and no serious adverse events occurred.
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Affiliation(s)
- Yutaro Oki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Tohmi Osaki
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Hyogo, Japan
| | - Ryoko Kumagai
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Shunsuke Murata
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Centre Research Institute, Suita, Osaka, Japan
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Haruhi Encho
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Hyogo, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Ibaraki, Osaka, Japan
| | - Hisafumi Yasuda
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Hisatomo Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
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Martins VF, Peyré-Tartaruga LA, Haas AN, Kanitz AC, Martinez FG, Gonçalves AK. Observational evidence of the association between physical and psychological determinants of aging with cognition in older adults. Sci Rep 2024; 14:12574. [PMID: 38821915 PMCID: PMC11143211 DOI: 10.1038/s41598-024-58497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/29/2024] [Indexed: 06/02/2024] Open
Abstract
Aging involves physical and cognitive deterioration in older adults. Detecting predictors of dementia early is crucial to identify its onset. This study aimed to associate physical and psychological determinants with cognitive performance in older adults. Observational study with 221 older adults, classified according to cognitive impairment. We evaluated cognitive function by Mini-Mental State Examination. Physical determinants encompassed muscle strength, functional mobility, and cardiorespiratory fitness, while psychological consisted of quality of life and activities of daily living. Multiple linear regression was performed to investigate this relationship. Physical and psychological determinants were significantly linked to cognitive impairment, including lower muscle strength, reduced functional mobility and of cardiorespiratory fitness. The influence of environment, autonomy, and engagement in daily activities on cognitive impairment was also observed. The analysis of physical and psychological determinants could help to aid in distinguishing individuals with cognitive impairment.
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Affiliation(s)
- Valéria Feijó Martins
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Human Locomotion Laboratory (LocoLab), Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy.
| | - Aline Nogueira Haas
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Global Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Ana Carolina Kanitz
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávia Gomes Martinez
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andréa Kruger Gonçalves
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Ghahfarrokhi MM, Shirvani H, Rahimi M, Bazgir B, Shamsadini A, Sobhani V. Feasibility and preliminary efficacy of different intensities of functional training in elderly type 2 diabetes patients with cognitive impairment: a pilot randomised controlled trial. BMC Geriatr 2024; 24:71. [PMID: 38238647 PMCID: PMC10797744 DOI: 10.1186/s12877-024-04698-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Aging and type-2 diabetes (T2D) are the most important risk factors for cognitive impairment and Alzheimer's disease. Exercise training is an effective, safe, and practical intervention in improving glucose metabolism, physical function, and cognitive disorders. This pilot study investigated the feasibility and preliminary efficacy of high-intensity low-volume (HIFT) vs. low-intensity high-volume (LIFT) functional training in elderly T2D patients with cognitive impairment. METHODS Forty-eight elderly T2D patients (31 female, 17 male, age 67.5 ± 5.8 years, MMSE score 18.8 ± 2.6, FBG 209.5 ± 37.9) were randomly assigned to HIFT, LIFT and control groups. Cognitive impairment was diagnosed with MMSE ≤ 23 based Iranian society. The SDMT, CVLT-II, BVMT-R, and Stroop tests were used to evaluated processing speed, learning, memory and attention respectively. Physical fitness tests include: tandem stance and walk test; TUG; 6MWT, 10MWT; SSST; 5TSTS; and hand grip was used to evaluated static and dynamic balance, agility, walking endurance, gait speed, lower limb function and lower and upper body strength respectively. As well as, Biochemical (FBG, insulin, HOMA-IR, HbA1c) and physiological outcomes (SBP, and DBP) were assessed. The HIFT group performed six weeks of functional training (three sessions per week) with 120-125% of the lactate threshold. The LIFT group performed six weeks of functional training (five sessions per week) with a 70-75% lactate threshold. Feasibility, safety, and acceptability of exercise programs were assessed at the end of the study. RESULT HIFT showed a higher adherence rate (91% vs. 87.5%), safety, and acceptability compared to LIFT. MMSE and Stroop scores, 6MWT, FBG, insulin, HOMA-IR, HbA1c, SBP, and DBP significantly improved in HIFT (all, P ≤ 0.004) and LIFT (all, P ≤ 0.023). Changes in 6MWT, FBG, insulin, HOMA-IR, and HbA1c in HIFT (all, P ≤ 0.001) and LIFT (all, P ≤ 0.008) were significant compared to the control group. Changes in Stroop scores were significant only in the HIFT group compared to the control group (P = 0.013). SDMT, CVLT-II, BVMT-R, balance test, 10MWT, SSST, TUG and hang grip significantly improved only in HIFT (all, P ≤ 0.038). CONCLUSION HIFT vs. LIFT is a safe, feasible, and effective approach for improving some aspects of physical, biochemical, and cognitive function in elderly T2D patients with cognitive impairment. This pilot study provides initial proof-of-concept data for the design and implementation of an appropriately powered randomised controlled trial (RCT) of HIFT vs. LIFT in a larger sample of elderly T2D patients with cognitive impairment. TRIAL REGISTRATION Randomized controlled trial (RCT) (Iranian Registry of Clinical Trials, trial registration number: IRCT20230502058055N1. Date of registration: 11/06/2023.
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Affiliation(s)
| | - Hossein Shirvani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mostafa Rahimi
- Department of Sport Science, Shahrekord University, Shahrekord, Iran
| | - Behzad Bazgir
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Shamsadini
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Sobhani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Albalwi AA, Alharbi AA. Optimal procedure and characteristics in using five times sit to stand test among older adults: A systematic review. Medicine (Baltimore) 2023; 102:e34160. [PMID: 37390277 PMCID: PMC10313281 DOI: 10.1097/md.0000000000034160] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Falls are a major concern for people of all ages, especially older adults with declining physical functions and deteriorating muscle strength. The Five Times Sit to Stand Test is used for the assessment of lower limb strength along with balance and postural control. Therefore, the systematic review at hand aimed to determine the optimal procedure and characteristics among older adults. METHODS The following databases served as the primary sources through which the target studies were searched for and obtained for review. They included Google Scholar, Pedro, BIOMED Central, Cochrane Library, MEDLINE, PUBMED and Science DIRECT. With the aim of fulfilling the eligibility criteria, 16 full-text studies were included and the quality assessment was performed. using the Thomas Tool. RESULTS The total number of the subjects who participated in the included studies was 15,130 and the ages of the aforementioned participants ranged from 60 to 80 years. In 15 of the studies, a stopwatch was used as the scoring method where the mean chair height of 42 cm was reported. Two studies reported that no significant influence of the arm position (P = .096) on the time allocated for test completion was identified. However, posterior foot placement (P < .001) led to shorter times of completion. Individuals who are unable to complete the test are more susceptible to activities of daily living related disabilities (P < .01) when compared to fall risk (P = .09). CONCLUSION The Five Times Sit-to-Stand Test is a safe test, providing added value to apply risk for falls in people at moderate risk and in healthy populations using standardized chair heights and stopwatches.
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Affiliation(s)
- Abdulaziz Aoudh Albalwi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Ahmad Abdullah Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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O'Dowd A, Hirst RJ, Setti A, Kenny RA, Newell FN. Older adults with slow sit to stand times show reduced temporal precision of audio-visual integration. Exp Brain Res 2023; 241:1633-1642. [PMID: 37170028 PMCID: PMC10224838 DOI: 10.1007/s00221-023-06628-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
Sustained integration of sensory inputs over increased temporal delays is associated with reduced cognitive and physical functioning in older adults and adverse outcomes such as falls. Here, we explored the relationship between multisensory integration and a clinically relevant measure of balance/postural control; Sit-to-Stand Time, the efficiency with which an older adult can transition between a seated and a standing posture. We investigated whether temporal multisensory integration was associated with performance on the Five-Times Sit-to-Stand Test (FTSST) in a large sample of 2556 older adults (mean age = 63.62 years, SD = 7.50; 55% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). K-means clustering was applied to FTSST data, yielding three clusters characterised by fast (mean = 10.88 s; n = 1122), medium (mean = 14.34 s; n = 1133) and slow (mean = 18.97 s; n = 301) sit-to-stand times. At wave 3 of TILDA, older adults participated in the Sound Induced Flash Illusion (SIFI), a measure of the precision of temporal audio-visual integration, which included three audio-visual stimulus onset asynchronies (SOAs): 70, 150 and 230 ms. Older adults with the slowest sit-to-stand times were more susceptible to the SIFI at the longest SOA (230 ms) compared to the shortest SOA (70 ms) relative to those with the fastest times (p = 0.02). Older adults who take longer to repeatedly transition from a seated to a standing posture exhibit an expanded temporal binding window for audio-visual events, supporting a link between multisensory perception and balance/postural control in ageing.
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Affiliation(s)
- A O'Dowd
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.
| | - R J Hirst
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - A Setti
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Mercer Institute for Successful Ageing, St James Hospital, Dublin, Ireland
| | - F N Newell
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Makizako H, Kiyama R, Nakai Y, Kawada M, Tomioka K, Taniguchi Y, Takenaka T, Kubozono T, Ohishi M. Reference values of chair stand test and associations of chair stand performance with cognitive function in older adults. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Noublanche F, Simon R, Ben-Sadoun G, Annweiler C. Physical Activity and Fall Prevention in Geriatric Inpatients in an Acute Care Unit (AGIR Study): Protocol for a Usability Study. JMIR Res Protoc 2022; 11:e32288. [PMID: 35816381 PMCID: PMC9315880 DOI: 10.2196/32288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background Falls are one of the world’s top 10 risks associated with disability in people older than 60 years. They also represent more than two-thirds of adverse events in hospitals, mainly affecting patients older than 65 years. Physical activity is a central intervention in fall prevention for older people. Whatever the details of the prevention strategy that is adopted (ie, how a mono- or multifactorial intervention is evaluated, the category of person the intervention targets, and where it is used), it is important to ensure that the proposed intervention is feasible and usable for the patient and the health care team. Objective The primary objective is to study the usability of carrying out a physical activity intervention, including 3 types of exercises, in older patients hospitalized in a geriatric acute care unit and categorized according to 3 fall risk levels: low, moderate, and high. The secondary objectives are to determine the difficulty of the physical exercise for patients with different fall risk levels, to study the health care team’s perceptions of the intervention’s feasibility, and to study the benefits for patients. Methods This is an open-label, unicenter, nonrandomized, usability prospective clinical trial. The intervention tested is a daily physical activity program. It consists of 3 types of physical exercise: staying out of bed for at least 3 hours, performing balance exercises while standing for 2 minutes, and the Five Times Sit to Stand transfer exercise. These exercises are carried out under the supervision of the health care team. Fall risk in the patients is classified with the Brief Geriatric Assessment tool. The exercise program starts on the second day of hospitalization after inclusion in the study. Patient assessment continues until the last day of hospitalization or the 20th day of hospitalization, whichever is earlier. For each fall-risk group and each type of exercise, the intervention will be defined as usable if at least 80% of the participants complete 75% or more of the exercises (ie, the ratio between the number of days when the patient completes a type of exercise and the total number of hospitalization days). The perceived feasibility by the health care team is measured with 2 scales, measuring perceived difficulty and time spent with the patient. The intervention benefit is evaluated using the performance of the Five Times Sit to Stand test before and after the intervention. Results The first patient was recruited on March 16, 2015. The study enrolled 266 patients, including 75 with low fall risk, 105 with moderate risk, and 85 with high risk. Conclusions We have not yet analyzed the results, but our observations suggest that the usability of each type of exercise for a given patient will depend on their fall risk level. Trial Registration ClinicalTrials.gov NCT02393014; https://clinicaltrials.gov/ct2/show/NCT02393014 International Registered Report Identifier (IRRID) DERR1-10.2196/32288
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Affiliation(s)
- Frédéric Noublanche
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital of Angers, Angers, France.,Laboratoire de Psychologie des Pays de la Loire, Université Angers, Université de Nantes, EA 4638 LPPL, SFR Confluences, F-49000, Angers, France
| | - Romain Simon
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital of Angers, Angers, France
| | - Grégory Ben-Sadoun
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital of Angers, Angers, France.,Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital of Angers, Angers, France.,Laboratoire de Psychologie des Pays de la Loire, Université Angers, Université de Nantes, EA 4638 LPPL, SFR Confluences, F-49000, Angers, France.,Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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Greene BR, Doheny EP, McManus K, Caulfield B. Estimating balance, cognitive function, and falls risk using wearable sensors and the sit-to-stand test. WEARABLE TECHNOLOGIES 2022; 3:e9. [PMID: 38486905 PMCID: PMC10936403 DOI: 10.1017/wtc.2022.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/16/2022] [Accepted: 05/11/2022] [Indexed: 03/17/2024]
Abstract
The five times sit-to-stand test (FTSS) is an established functional test, used clinically as a measure of lower-limb strength, endurance and falls risk. We report a novel method to estimate and classify cognitive function, balance impairment and falls risk using the FTSS and body-worn inertial sensors. 168 community dwelling older adults received a Comprehensive Geriatric Assessment which included the Mini-Mental State Examination (MMSE) and the Berg Balance Scale (BBS). Each participant performed an FTSS, with inertial sensors on the thigh and torso, either at home or in the clinical environment. Adaptive peak detection was used to identify phases of each FTSS from torso or thigh-mounted inertial sensors. Features were then extracted from each sensor to quantify the timing, postural sway and variability of each FTSS. The relationship between each feature and MMSE and BBS was examined using Spearman's correlation. Intraclass correlation coefficients were used to examine the intra-session reliability of each feature. A Poisson regression model with an elastic net model selection procedure was used to estimate MMSE and BBS scores, while logistic regression and sequential forward feature selection was used to classify participants according to falls risk, cognitive decline and balance impairment. BBS and MMSE were estimated using cross-validation with low root mean squared errors of 2.91 and 1.50, respectively, while the cross-validated classification accuracies for balance impairment, cognitive decline, and falls risk were 81.96, 72.71, and 68.74%, respectively. The novel methods reported provide surrogate measures which may have utility in remote assessment of physical and cognitive function.
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Affiliation(s)
| | - Emer P. Doheny
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
- School of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland
| | - Killian McManus
- Kinesis Health Technologies Ltd, Dublin, Ireland
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Torstveit AH, Miaskowski C, Løyland B, Grov EK, Ritchie CS, Paul SM, Engh AME, Utne I. Characteristics associated with decrements in objective measures of physical function in older patients with cancer during chemotherapy. Support Care Cancer 2022; 30:10031-10041. [PMID: 36326906 PMCID: PMC9715479 DOI: 10.1007/s00520-022-07416-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Study purposes were to evaluate for inter-individual variability in the trajectories of three objective measures of physical function (PF) in older patients receiving chemotherapy (n = 112) and determine which characteristics were associated with worse PF. METHODS Balance, gait speed, and chair-stand test were evaluated at initiation and 1, 3, 6, 9, and 12 months following chemotherapy. Hierarchical linear modeling was used to assess inter-individual variability in the trajectories of the three tests. Demographic, clinical, and symptom characteristics, and levels of cognitive function associated with initial levels and changes over time in each of the tests were determined. RESULTS Gait speed and chair-stand tests improved over time. Balance declined until month 6, then increased. Characteristics associated with decreases in balance scores at initiation of chemotherapy were lower level of education and lower Karnofsky Performance Status (KPS) score. For initial levels of poorer gait speed, older age, poorer Trail Making Test B (TMTB), and worse Attentional Function Index scores were the associated characteristics. Lower KPS scores, higher body mass index, and poorer TMTB scores were associated with poorer chair-stand times at initiation of chemotherapy. Worse trajectories of chair-stand times were associated with poorer chair-stand time at enrollment. Characteristic associated with lower initial levels and improved trajectories of balance was older age at enrollment. CONCLUSIONS Determination of characteristics associated with decrements in balance, gait speed, and chair-stand can assist clinicians to identify older oncology patients at risk for decrements in PF. Interventions to maintain and improve PF need to be implemented with higher risk patients.
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Affiliation(s)
- Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | | | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
| | - Christine Seel Ritchie
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Mongan Institute Center for Aging and Serious Illness, Boston, MA USA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA USA
| | - Anna Marie Ellström Engh
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway ,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Pilestredet 32, Oslo, Norway
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11
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Noh B, Yoon H, Youm C, Kim S, Lee M, Park H, Kim B, Choi H, Noh Y. Prediction of Decline in Global Cognitive Function Using Machine Learning with Feature Ranking of Gait and Physical Fitness Outcomes in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111347. [PMID: 34769864 PMCID: PMC8582857 DOI: 10.3390/ijerph182111347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Gait and physical fitness are related to cognitive function. A decrease in motor function and physical fitness can serve as an indicator of declining global cognitive function in older adults. This study aims to use machine learning (ML) to identify important features of gait and physical fitness to predict a decline in global cognitive function in older adults. A total of three hundred and six participants aged seventy-five years or older were included in the study, and their gait performance at various speeds and physical fitness were evaluated. Eight ML models were applied to data ranked by the p-value (LP) of linear regression and the importance gain (XI) of XGboost. Five optimal features were selected using elastic net on the LP data for men, and twenty optimal features were selected using support vector machine on the XI data for women. Thus, the important features for predicting a potential decline in global cognitive function in older adults were successfully identified herein. The proposed ML approach could inspire future studies on the early detection and prevention of cognitive function decline in older adults.
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Affiliation(s)
- Byungjoo Noh
- Department of Kinesiology, Jeju National University, Jeju 63243, Korea;
| | - Hyemin Yoon
- Department of Management Information Systems, Dong-A University, Busan 49315, Korea; (H.Y.); (Y.N.)
| | - Changhong Youm
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea; (H.P.); (B.K.); (H.C.)
- Correspondence: (C.Y.); (S.K.); Tel.: +82-51-200-7830 (C.Y.); +82-05-200-7484 (S.K.); Fax: +82-51-200-7505 (C.Y.)
| | - Sangjin Kim
- Department of Management Information Systems, Dong-A University, Busan 49315, Korea; (H.Y.); (Y.N.)
- Correspondence: (C.Y.); (S.K.); Tel.: +82-51-200-7830 (C.Y.); +82-05-200-7484 (S.K.); Fax: +82-51-200-7505 (C.Y.)
| | - Myeounggon Lee
- Department of Health and Human Performance, University of Houston, Houston, TX 77004, USA;
| | - Hwayoung Park
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea; (H.P.); (B.K.); (H.C.)
| | - Bohyun Kim
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea; (H.P.); (B.K.); (H.C.)
| | - Hyejin Choi
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea; (H.P.); (B.K.); (H.C.)
| | - Yoonjae Noh
- Department of Management Information Systems, Dong-A University, Busan 49315, Korea; (H.Y.); (Y.N.)
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12
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Khalil H, Rehan R, Al-Sharman A, El-Salem K. The clinical correlates of the chair sit to stand performance in people with multiple sclerosis. Physiother Theory Pract 2021; 38:2884-2895. [PMID: 34156901 DOI: 10.1080/09593985.2021.1931590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: This study aimed to evaluate the motor and non-motor factors associated with sit-to-stand performance in people with Multiple Sclerosis (PwMS). Design: Observational cross-sectional study. Subjects: A total of 88 individuals with MS participated in this study. Main Measures: Standing performance was measured using the five-times-sit-to-stand test (FTSTS). The Berg Balance Scale to assess balance, the 10-Meter Walking Test (10-MWT) was used to assess walking speed; the Patient Determined Disease Steps (PDDS) was used to assess disability level. Furthermore, Brief International Cognitive Assessment for MS (BICAMS) was used to assess cognitive status, Hospital Anxiety and Depression scale (HADS) to assess depression and anxiety, and the Modified Fatigue Impact scale (MFIS) to evaluate fatigue. Spearman correlation coefficient was used to determine the relationship between all these variables and the FTSTS. Furthermore, multiple linear regression was conducted to determine predictive factors of the FTSTS. Results: FTSTS score was correlated significantly with BBS, PDDS, BICAMS, 10-MWT and MFIS (r ranged from 0.3 to 0.52; P < .05). However, there was no significant correlation observed between the FTSTS and HADS-depression or HADS-anxiety. Considering the multiple regression analysis, the following factors were significantly predictive of the FTSTS: 10-MWT, MFIS and the BICAMS-z score (R2: 0.433, P < .0001). Conclusion: The study concludes that sit to stand is multifactorial and is potentially associated with walking speed, cognitive function and fatigue. These factors should be considered by healthcare professionals in interpreting the sit-to-stand performance of PwMS and in designing rehabilitation interventions.
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Affiliation(s)
- Hanan Khalil
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Reem Rehan
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Faculty of Medicine, Department of Neurosciences, Jordan University of Science and Technology, Irbid, Jordan
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13
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Sverdrup K, Selbæk G, Bergh S, Strand BH, Thingstad P, Skjellegrind HK, Skjerve KN, Tangen GG. Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: The HUNT study. Arch Gerontol Geriatr 2021; 95:104400. [PMID: 33798998 DOI: 10.1016/j.archger.2021.104400] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/20/2021] [Accepted: 03/20/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes. METHODS 11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates. RESULTS Gait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD. CONCLUSIONS Physical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency.
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Affiliation(s)
- Karen Sverdrup
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway; Department of Geriatric Medicine, Oslo University Hospital, Norway; Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway; Department of Geriatric Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway; Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway; Department of Geriatric Medicine, Oslo University Hospital, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Trondheim Municipality, Trondheim, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kjerstin Næss Skjerve
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Trondheim Municipality, Trondheim, Norway
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway; Department of Geriatric Medicine, Oslo University Hospital, Norway
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Alves JFN, Cavalcante BR, Valença ADA, Campos IR, Tomaz MLL, Araújo RCD, Souza MFD. Association between physical functioning with cognition among community-dwelling older adults: a cross-sectional study. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Declines in physical and cognitive functioning often co-exist through aging. Gait-related parameters have been related to cognitive function, although it is unclear whether other measures of physical functioning are similarly related to cognition. Here, we analyzed the relationship between physical functioning with cognition in older adults. Methods: In total, 116 participants were included (M age = 69 years, SD = 6; 71% women). We quantified cognitive functioning using the Montreal Cognitive Assessment (MoCA) and executive functioning tasks (Digit Span Forward minus Backward and verbal fluency tests). Physical function measures included gait speed, Short-physical Performance Battery (SPPB), five-times Sit-to-Stand Test, the Timed Up and Go (TUG) test, the Six-minute Walk Test (6MWT), and lower extremity muscle strength. We used multiple linear regression analyses to explore the association between cognitive measures and each measure of physical functioning, adjusting for age, sex, education, and RCT. Results: We observed a positive association between muscle strength and the MoCA (b = 0.84, SE = 0.40, 95%CI 0.05–1.64) after controlling for covariates. Significant associations were also found between the five-times-sit-to-stand test (b = -0.63, SE = 0.26, 95%CI -1.15–-0.12), TUG (b = -1.13, SE = 0.57, 95%CI -2.26–-0.01), 6MWT (b = 0.04, SE = 0.02, 95%CI 0.01–0.07), and lower extremity muscle strength (b = 1.92, SE = 0.93, 95%CI 0.09–3.77) with the FAS verbal fluency test, and between the TUG (b = -0.62, SE = 0.24, 95%CI -1.11–-0.14) with animal naming. Conclusion: In community-dwelling older adults, higher levels of muscle strength, dynamic balance and cardiorespiratory fitness were positively related with global cognition and executive control measures.
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15
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Kakavas S, Papanikolaou A, Kompogiorgas S, Stavrinoudakis E, Balis E, Bulbasakos G. Sit-to-stand tests in patients hospitalised for chronic obstructive pulmonary disease exacerbation: association with pulmonary function tests and risk of future exacerbations. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background/Aims The sit-to-stand test is a quick and cost-effective measure of exercise tolerance and lower body strength. The literature focuses on its use in stable patients with chronic obstructive pulmonary disease. This study in patients hospitalised for chronic obstructive pulmonary disease exacerbation aimed to investigate possible associations of the sit-to-stand test with pulmonary function and risk of future acute exacerbations. Methods This study was conducted on a sample of 22 patients with chronic obstructive pulmonary disease. Participants' clinical details were recorded before they undertook spirometry, 30-second and five-repetition sit-to-stand tests. Participants were assessed via a structured telephone interview for the occurrence of acute exacerbation events in the 12 months following discharge. Results Patients were classified based on the presence or absence of acute exacerbations of chronic obstructive pulmonary disease over 12 months. A negative correlation was observed between five-repetition sit-to-stand test performance time and number of repetitions during the 30-second sit-to-stand test; longer sit-to-stand times and fewer repetitions were observed in patients who experienced exacerbations during follow up. The 30-second sit-to-stand test repetitions correlated positively with forced expiratory volume in 1 second (FEV1). Five-repetition sit-to-stand test performance correlated negatively with FEV1, FEV1% predicted, forced vital capacity and FEV1/forced vital capacity ratio. From the various exercise parameters, five-repetition sit-to-stand test performance time demonstrated a moderate ability to predict exacerbations. Conclusions This study is the first to focus on the use of the sit-to-stand tests in inpatients with acute exacerbation of chronic obstructive pulmonary disease. There was a significant correlation between the 30-second sit-to-stand test and five-repetition sit-to-stand test results. Both tests were associated with pulmonary function indices and risk of future chronic obstructive pulmonary disease exacerbations.
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Affiliation(s)
- Sotirios Kakavas
- First Pulmonary Department, Evangelismos General Hospital of Athens, Athens, Greece
| | | | - Steven Kompogiorgas
- First Pulmonary Department, Evangelismos General Hospital of Athens, Athens, Greece
| | | | - Evangelos Balis
- First Pulmonary Department, Evangelismos General Hospital of Athens, Athens, Greece
| | - Georgios Bulbasakos
- First Pulmonary Department, Evangelismos General Hospital of Athens, Athens, Greece
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16
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Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134786. [PMID: 32635202 PMCID: PMC7369886 DOI: 10.3390/ijerph17134786] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/31/2022]
Abstract
This study aimed to identify classifier variables by considering both gait and physical fitness for identifying adults aged over 75 years and global cognitive function declines in older adults. The participants included 735 adults aged 65–89 years who were asked to walk at three different speeds (slower, preferred, and faster) while wearing inertial measurement units embedded in shoe-type data loggers and to perform nine physical fitness tests. The variability in the stance phase as well as the strength, balance, and functional endurance showed a strong dependence on the age being over 75 years. The cognitive function was evaluated by the Mini-Mental State Examination; a longer stance phase at a slower walking speed and decreased grip strength and five times sit-to-stand were associated with cognitive function. These findings may be useful for determining the decline in physical performance of older adults. A longer stance phase and decreased grip strength and five times sit-to-stand may be factors that help distinguish declines in cognitive function from normal age-related declines.
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17
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Effects of Computerized Cognitive Training on Physical Mobility in Community-Dwelling Older Adults With Cardiovascular Disease: A Pilot Study. Cardiopulm Phys Ther J 2020. [DOI: 10.1097/cpt.0000000000000122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Sherwood JJ, Inouye C, Webb SL, O J. Reliability and Validity of the Sit-to-Stand as a Muscular Power Measure in Older Adults. J Aging Phys Act 2020; 28:455-466. [PMID: 31810060 DOI: 10.1123/japa.2019-0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022]
Abstract
The study aims were to analyze the reliability and validity of the GymAware™ linear position transducer's velocity and power measures during the sit-to-stand, compared with the Dartfish 2D videography analysis, and to assess the relationship of age and handgrip strength with velocity and power in 48 older men and women (77.6 ± 11.1 years). The results showed excellent agreement between GymAware- and Dartfish-derived sit-to-stand velocity (intraclass correlation coefficient2-1 = .94 and power intraclass correlation coefficient2-1 = .98) measures. A moderate and negative relationship was found between age and velocity (r = -.62; p < .001) and age and power (r = -.63; p < .001). A moderate and positive relationship was found between handgrip strength and velocity (r = .43; p = .002) and handgrip strength and power (r = .54; p < .001). The results show the GymAware velocity and power measures during the sit-to-stand in older adults to be reliable and valid.
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19
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Montero-Odasso M, Almeida QJ, Bherer L, Burhan AM, Camicioli R, Doyon J, Fraser S, Muir-Hunter S, Li KZH, Liu-Ambrose T, McIlroy W, Middleton L, Morais JA, Sakurai R, Speechley M, Vasudev A, Beauchet O, Hausdorff JM, Rosano C, Studenski S, Verghese J. Consensus on Shared Measures of Mobility and Cognition: From the Canadian Consortium on Neurodegeneration in Aging (CCNA). J Gerontol A Biol Sci Med Sci 2020; 74:897-909. [PMID: 30101279 PMCID: PMC6521916 DOI: 10.1093/gerona/gly148] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Indexed: 02/02/2023] Open
Abstract
Background A new paradigm is emerging in which mobility and cognitive impairments, previously studied, diagnosed, and managed separately in older adults, are in fact regulated by shared brain resources. Deterioration in these shared brain mechanisms by normal aging and neurodegeneration increases the risk of developing dementia, falls, and fractures. This new paradigm requires an integrated approach to measuring both domains. We aim to identify a complementary battery of existing tests of mobility and cognition in community-dwelling older adults that enable assessment of motor-cognitive interactions. Methods Experts on mobility and cognition in aging participated in a semistructured consensus based on the Delphi process. After performing a scoping review to select candidate tests, multiple rounds of consultations provided structured feedback on tests that captured shared characteristics of mobility and cognition. These tests needed to be sensitive to changes in both mobility and cognition, applicable across research studies and clinics, sensitive to interventions, feasible to perform in older adults, been previously validated, and have minimal ceiling/floor effects. Results From 17 tests appraised, 10 tests fulfilled prespecified criteria and were selected as part of the “Core-battery” of tests. The expert panel also recommended a “Minimum-battery” of tests that included gait speed, dual-task gait speed, the Montreal Cognitive Assessment and Trail Making Test A&B. Conclusions A standardized assessment battery that captures shared characteristics of mobility and cognition seen in aging and neurodegeneration may increase comparability across research studies, detection of subtle or common reversible factors, and accelerate research progress in dementia, falls, and aging-related disabilities.
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Affiliation(s)
- Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Address correspondence to: Manuel Montero-Odasso MD, PhD, AGSF, FRCPC, FGSA, Gait and Brain Lab, Parkwood Institute, University of Western Ontario and Lawson Health Research Institute, 550 Wellington Road, London, Ontario N6C 0A7, Canada. E-mail:
| | - Quincy J Almeida
- Department of Kinesiology and Physical Education, Sun Life Financial Movement Disorders Research Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Louis Bherer
- Department of Psychology and PERFORM Centre, Concordia University, Montréal, Quebec, Canada
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Quebec, Canada
- Department of Medicine, University of Montreal, Quebec, Canada
- Montreal Heart Institute, Research Centre, Quebec, Canada
| | - Amer M Burhan
- Department of Psychiatry, Geriatric Psychiatry, Schulich School of Medicine, University of Western Ontario, London, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Richard Camicioli
- Department of Medicine, Geriatric and Cognitive Neurology, University of Alberta, Edmonton, Canada
| | - Julien Doyon
- Functional Neuroimaging Unit, University of Montreal, Quebec, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Susan Muir-Hunter
- Department of Medicine, Division of Geriatric Medicine, University of Western Ontario, London, Canada
- Faculty of Health Sciences, School of Physical Therapy, University of Western Ontario, London, Canada
| | - Karen Z H Li
- Department of Psychology and PERFORM Centre, Concordia University, Montréal, Quebec, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Centre for Hip Health and Mobility, University of British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Research Institute, University of British Columbia, Canada
| | - William McIlroy
- Division of Neurology and Department of Medicine, University of Toronto, Ontario, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Ontario, Canada
- Department of Kinesiology, University of Waterloo, Ontario, Canada
| | - Laura Middleton
- Department of Kinesiology, University of Waterloo, Ontario, Canada
| | - José A Morais
- Department of Medicine, Division of Geriatrics and Centre of Excellence in Aging and Chronic Disease, McGill University, Montréal, Quebec, Canada
| | - Ryota Sakurai
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Akshya Vasudev
- Department of Psychiatry, Geriatric Psychiatry, Schulich School of Medicine, University of Western Ontario, London, Canada
- Department of Medicine, Division of Clinical Pharmacology, University of Western Ontario, London, Canada
| | - Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, McGill University, Montréal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quebec, Canada
- RUIS McGill Centre of Excellence on Aging and Chronic Disease – CEViMaC, Montréal, Quebec, Canada
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Israel
- Rush Alzheimer’s Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Stephanie Studenski
- Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
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Padberg I, Schneider A, Rohmann JL, Kelley SW, Grittner U, Siegerink B. Impact of COPD and anemia on motor and cognitive performance in the general older population: results from the English longitudinal study of ageing. Respir Res 2020; 21:40. [PMID: 32013976 PMCID: PMC6998076 DOI: 10.1186/s12931-020-1305-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/27/2020] [Indexed: 12/11/2022] Open
Abstract
Background Cognitive and motor-performance decline with age and the process is accelerated by decline in general health. In this study, we aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction. Methods The English Longitudinal Study of Aging is a population-based cohort study including measurements of lung-function and HB levels together with cognitive and motor performance testing. Data were collected from 5709 participants including three measurement time over eight years. COPD was defined using lung-function-parameters and clinical symptoms. HB was assessed continuously and low HB was defined using clinical anemia cutoffs. Linear mixed-effects regression models were used to quantify the associations of COPD and HB with outcome measures, both individually and in combination. Results Participants with both low HB and COPD demonstrated worse motor performance compared to individuals with only one exposure, resulting in up to 1 s (95%CI, 0.04–1.8) longer time needed to complete the five times sit to stand task than what would be expected based on purely additive effects. Additionally in individuals with COPD, the time to complete the motor-performance task per unit decrease in continuous HB levels was longer than in participants without COPD after full adjustment for confounding (up to 1.38 s/unit HB level, 95% CI: 0.65–2.11). Conclusion In persons with COPD low HB levels may contribute to low motor-performance in a supra additive fashion. Further studies should re-evaluate whether earlier treatment of lower HB in these individuals might be beneficial.
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Affiliation(s)
- Inken Padberg
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Alice Schneider
- Insititute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Jessica Lee Rohmann
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sean Walter Kelley
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychology, Trinity College Dublin, Dublin, Germany
| | - Ulrike Grittner
- Insititute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Bob Siegerink
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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21
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Beauchet O, Sekhon H, Launay CP, Rolland Y, Schott AM, Allali G. Motoric cognitive risk syndrome and incident dementia: results from a population-based prospective and observational cohort study. Eur J Neurol 2019; 27:468-474. [PMID: 31571342 DOI: 10.1111/ene.14093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Motoric cognitive risk syndrome (MCR), which is the juncture of subjective cognitive complaint and slow gait speed, is a pre-dementia stage. The aims of the study are (i) to compare characteristics between individuals who have MCR defined using slow walking speed and/or increased five-times-sit-to-stand (FTSS) time as its motor component(s); and (ii) to characterize the association of MCR and its various motor components with incident dementia including Alzheimer disease and non-Alzheimer dementia in the participants of the Epidémiologie de l'Ostéoporose (EPIDOS) study. METHODS This prospective and observational cohort study selected 651 participants recruited from the EPIDOS study in Toulouse (France). MCR was defined as the association of subjective cognitive complaint and slow gait speed and/or increased FTSS time in participants without either dementia and mobility disabilities at baseline. Individuals with dementia were prospectively diagnosed during the physical and neuropsychological assessments included in the 7-year follow-up. RESULTS The prevalence of MCR was around 7% when using an exclusive motor criterion, either slow gait speed or increased FTSS time, and was 20.9% when MCR subgroups were pooled. MCR was positively associated with incident dementia regardless of its type, and with Alzheimer disease in the slow gait speed MCR subgroup [odds ratio (OR) > 2.18 with P ≤ 0.037] but not with non-Alzheimer dementia. No significant association between incident dementia and MCR defined using increased FTSS time was shown. CONCLUSIONS Our findings confirm that MCR is associated with incident dementia and that slow gait speed is the appropriate motor criterion for detecting dementia risk.
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Affiliation(s)
- O Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Dr Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Centre of Excellence on Longevity, McGill Integrated University Health Network, Montreal, QC, Canada.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore
| | - H Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Centre of Excellence on Longevity, McGill Integrated University Health Network, Montreal, QC, Canada.,Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - C P Launay
- Geriatric Medicine and Geriatric Rehabilitation Service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Y Rolland
- Department of Geriatric, Toulouse University Hospital, Toulouse, France
| | - A-M Schott
- Pôle de Santé Publique, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - G Allali
- Department of Neurology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
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Suwannarat P, Kaewsanmung S, Thaweewannakij T, Amatachaya S. The use of functional performance tests by primary health-care providers to determine walking ability with and without awalking device in community-dwelling elderly. Physiother Theory Pract 2019; 37:64-72. [PMID: 31025583 DOI: 10.1080/09593985.2019.1606372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Primary health-care (PHC) providers are important for community involvement in health promotion and prevention efforts, particularly today that the number of elderly is increasing dramatically. The use of a standard practical measure would help in promoting the effectiveness of referral and monitoring processes. Objectives: To investigate the use of functional performance tests in terms of the appropriate cutoff point to determine walking ability with and without a walking device in community-dwelling elderly, and reliability of the tests when used by PHC providers. Methods: Community-dwelling people aged 65 years or older who walked with or without a walking device (n = 309) were interviewed and assessed for information related to the use of a walking device in daily living. Then, they were randomly assessed for their functional ability using the Timed Up and Go Test (TUG), Five Times Sit-to-Stand Test (FTSST), and the 10-Meter Walk Test (10MWT). PHC providers, including a physical therapist, village health volunteer, and a caregiver, assessed 30 participants' functional performances, to address rater reliability of the tests. Results: The findings suggested that outcomes of the tests (TUG < 12 s, FTSST < 15 s, and 10MWT > 0.8 m/s) can indicate the ability of walking without a walking device of the participants. These tests could be used by PHC providers, except for the FTSST by a caregiver. Conclusions: The findings offer a clear cutoff point for promoting the involvement of PHC providers and the standardization of a screening, monitoring, and referral process among many clinical and community settings.
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Affiliation(s)
- Patcharawan Suwannarat
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) research group, Khon Kaen University , Khon Kaen, Thailand
| | - Supapon Kaewsanmung
- Improvement of Physical Performance and Quality of Life (IPQ) research group, Khon Kaen University , Khon Kaen, Thailand.,Department of Physical Therapy, School of Health Sciences, Mae Fah Luang University , Thailand
| | - Thiwabhorn Thaweewannakij
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) research group, Khon Kaen University , Khon Kaen, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University , Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) research group, Khon Kaen University , Khon Kaen, Thailand
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23
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Cognitive Function Is Associated With Mobility in Community Dwelling Older Adults With a History of Cardiovascular Disease. Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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24
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Santos SCAD, Figueiredo DMPD. [Predictors of the fear of falling among community-dwelling elderly Portuguese people: an exploratory study]. CIENCIA & SAUDE COLETIVA 2019; 24:77-86. [PMID: 30698242 DOI: 10.1590/1413-81232018241.29932016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/18/2017] [Indexed: 11/22/2022] Open
Abstract
The fear of falling constitutes a real risk factor for falls. It has also been associated with functional decline, decreased quality of life and increased social isolation among the elderly population. This study analyzed predictors of the fear of falling in elderly Portuguese people that live in the community. A cross-sectional study with a convenience sample of 98 participants (57.1% women; mean age 74.07 ± 8.74 years) was conducted. Data were collected with a protocol which includes a questionnaire for sociodemographic and health information, the Activity Specific Balance Confidence Scale, the Hospital Anxiety and Depression Scale, the Lubben Social Network Scale-6, the Timed Up and Go, and Five Times Sit to Stand Test. Data were analyzed using descriptive and inferential statistics. The results showed that female gender (p = 0.01), the perception of good (p = 0.01) and moderate (p = 0.02) physical health and the symptoms of depression (p ≈ 0.00) are predictors of fear of falling. Controlling these predictors is a fundamental aspect for promoting the independence of elderly people minimizing the consequences that are associated with the fear of falling.
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Affiliation(s)
- Sónia Cristina Antunes Dos Santos
- Departamento de Educação e Psicologia, Escola Superior de Saúde, Universidade de Aveiro (ESSUA). Campus Universitário de Santiago Edifício 30, Agras do Crasto. 3810-193 Aveiro Portugal.
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Sekhon H, Launay CP, Chabot J, Allali G, Beauchet O. Motoric Cognitive Risk Syndrome: Could It Be Defined Through Increased Five-Times-Sit-to-Stand Test Time, Rather Than Slow Walking Speed? Front Aging Neurosci 2019; 10:434. [PMID: 30766485 PMCID: PMC6366305 DOI: 10.3389/fnagi.2018.00434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Slow walking speed, time to perform the five-times-sit-to-stand (FTSS) test and motoric cognitive risk syndrome (MCR; defined as slow gait speed combined with subjective cognitive complaint) have been separately used to screen older individuals at risk of cognitive decline. This study seeks to (1) compare the characteristics of older individuals with MCR, as defined through slow walking speed and/or increased FTSS time; and (2) examine the relationship between MCR and its motor components as well as amnestic (a-MCI) and non-amnestic (na-MCI) Mild Cognitive Impairment. Methods: A total of 633, individuals free of dementia, were selected from the cross-sectional “Gait and Alzheimer Interactions Tracking” study. Slow gait speed and increased FTSS time were used as criteria for the definition of MCR. Participants were separated into five groups, according to MCR status: MCR as defined by (1) slow gait speed exclusively (MCRs); (2) increased FTSS time exclusively (MCRf); (3) slow gait speed and increased FTSS time (MCRsaf); (4) MCR; irrespective of the mobility test used (MCRsof); and (5) the absence of MCR. Cognitive status (i.e., a-MCI, na-MCI, cognitively healthy) was also determined. Results: The prevalence of MCRs was higher, when compared to the prevalence of MCRf (12.0% versus 6.2% with P ≤ 0.001). There existed infrequent overlap (2.4%) between individuals exhibiting MCRs and MCRf, and frequent overlap between individuals exhibiting MCRs and na-MCI (up to 50%). a-MCI and na-MCI were negatively [odd ratios (OR) ≤ 0.17 with P ≤ 0.019] and positively (OR ≥ 2.41 with P ≤ 0.019) related to MCRs, respectively. Conclusion: Individuals with MCRf are distinct from those with MCRs. MCRf status does not relate to MCI status in the same way that MCRs does. MCRs is related negatively to a-MCI and positively to na-MCI. These results suggest that FTTS cannot be used to define MCR when the goal is to predict the risk of cognitive decline, such as future dementia.
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Affiliation(s)
- Harmehr Sekhon
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Cyrille P Launay
- Geriatric Medicine and Geriatric Rehabilitation Service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Julia Chabot
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Division of Geriatric Medicine, Department of Medicine, St. Mary's Hospital Center, McGill University, Montreal, QC, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Olivier Beauchet
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Yang M, Guo Y, Gong J, Deng M, Yang N, Yan Y. Relationships between functional fitness and cognitive impairment in Chinese community-dwelling older adults: a cross-sectional study. BMJ Open 2018; 8:e020695. [PMID: 29780027 PMCID: PMC5961618 DOI: 10.1136/bmjopen-2017-020695] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the associations between each functional fitness (FF) domain and cognitive impairment (CI) in Chinese community-dwelling older adults. DESIGN A community-based, cross-sectional study was conducted. SETTING Participants were selected by multistage stratified random sampling in Wuhan City, Hubei Province, Central China, during December 2015-May 2016. PARTICIPANTS A total of 2096 (1031 male and 1065 female) adults older than 65 years were included in our study. Exclusion criteria were age <65 years, losing self-living ability, previously diagnosed with dementia by a neurological physician, severe physical pain, congestive heart failure, dizziness and uncontrolled hypertension (exceeding 160/100 mm Hg). PRIMARY AND SECONDARY OUTCOME MEASURES The Senior Fitness Test and the Mini-Mental State Examination were used to measure FF (including 30 s chair stand, 30 s arm curl, 2 min step, 8 foot up-and-go, chair sit-and-reach and back scratch) and screen CI, respectively. Activities of daily living and instrumental activities of daily living questionnaires were administered to evaluate functional status (FS). RESULTS 32.16% were classified as the CI group. The results showed that the CI group had significantly lower frequency of 30 s chair stand, 30 s arm curl and 2 min step, and longer time to complete the 8 foot up-and-go, shorter chair sit-and-reach and back scratch distance than the non-CI adults (p<0.05). Except for back scratch, older adults with moderate and high levels of FF were less likely to have CI than those with low levels, adjusted by sociodemographics, chronic disease, health condition, health behaviour and FS (p<0.05). CONCLUSIONS The relationship between FF and CI was independent of FS decline in Chinese community-dwelling older people.
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Affiliation(s)
- Mei Yang
- Department of Maternal and Child Health, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Guo
- Chronic disease prevention and control, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jie Gong
- Chronic disease prevention and control, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Mengyao Deng
- Department of Maternal and Child Health, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Niannian Yang
- Chronic disease prevention and control, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Yaqiong Yan
- Chronic disease prevention and control, Wuhan Centers for Disease Prevention and Control, Wuhan, China
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Guo Y, Yang M, Yan Y, Wang L, Gong J. Sex differentials in relationships between functional fitness and cognitive performance in older adults: a canonical correlation analysis. Sci Rep 2018. [PMID: 29515144 PMCID: PMC5841399 DOI: 10.1038/s41598-018-22475-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to explore the sex differentials in correlations between functional fitness (FF) and cognitive impairment (CI) in older adults without dementia. A community-based cross-sectional study was conducted using 2096 adults more than 65 years of age. The Senior Fitness test and Mini-mental State Examination (MMSE) were used to measure FF and cognitive performance. Canonical correlation analysis (CCA) was performed to evaluate the relationships between FF and MMSE. Our results confirmed the relationships between FF and CI, furthermore FF and MMSE were significantly different between men and women (P < 0.05). CCA results showed overall FF was positively correlated with overall MMSE in both men (canonical coefficient = 0.37, P < 0.0001) and women (first canonical coefficient = 0.42, P < 0.0001; second canonical coefficient = 0.17, P = 0.004). Among men, 30s-arm curl and language were most highly correlated with FF and MMSE, respectively. Whereas among women, 30s-arm curl and eight-foot up-and-go were most highly correlated with FF, and orientation and recall were most highly correlated with MMSE. In conclusion, there was a sex difference in the relationships between FF and MMSE, which facilitated generating insight into cognitive performance improvement from the perspective of FF enhancement by sex. Prospective studies are needed to explore the causality between FF and cognitive performance.
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Affiliation(s)
- Yan Guo
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Mei Yang
- Department of Maternal and Child Health, School of Public Health, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Liang Wang
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China.
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Vaidya T, Chambellan A, de Bisschop C. Sit-to-stand tests for COPD: A literature review. Respir Med 2017; 128:70-77. [DOI: 10.1016/j.rmed.2017.05.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/23/2017] [Accepted: 05/13/2017] [Indexed: 11/26/2022]
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Blackwood J, Shubert T, Forgarty K, Chase C. Relationships Between Performance on Assessments of Executive Function and Fall Risk Screening Measures in Community-Dwelling Older Adults. J Geriatr Phys Ther 2017; 39:89-96. [PMID: 26050194 DOI: 10.1519/jpt.0000000000000056] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Fall-related injuries are a leading cause of institutionalization and morbidity in older adults. Limitations in cognition, including deficits in higher cognitive processes, like executive function (EF), contribute to a higher risk of falling in older adults. Specifically, declines in EF have been associated with changes in gait, limited mobility, and an increased frequency of falling. It is unknown whether associations between performance on commonly used clinical assessments of EF and performance on commonly used physical performance measures of fall risk are present. The purpose of this study was to examine the relationship between a clinical measure of EF, the Trail Making Test Part B (TMT-B), and 3 physical performance measures of fall risk: the Timed Up and Go (TUG) test, gait speed, and the Five Times Sit to Stand (FTSTS) test, in a group of community-dwelling older adults. METHODS Forty-seven community-dwelling older adults met the inclusion/exclusion criteria. Demographic information was obtained and measures of fall risk and cognition were performed. Correlations and linear regression analyses to assess relationships between measures were completed. To account for the high prevalence of mild cognitive impairment (MCI) in this population, the sample was screened and stratified for MCI in post hoc analyses. RESULTS The EF performance was not significantly correlated with performance on the FTSTS test (ρ = 0.26, P > .05) but was significantly correlated with the TUG test (ρ = 0.31, P < .05) and gait speed (r = -0.36, P < .05). These relationships remained after adjusting for age and education in multivariate models. Results from post hoc analyses demonstrated that only those with MCI had significant relationships between EF and physical performance measures. TMT-B scores in the MCI group were significantly correlated with gait speed (ρ = -0.51, P < .05) and TUG test (ρ = 0.58, P < .05). DISCUSSION A significant relationship exists between performance on clinical assessments of EF and fall risk assessments that integrate a mobility task for those individuals who screen positive for MCI. For those who screened negative, no significant relationship exists. Given the large prevalence of undiagnosed MCI in community-dwelling older adults, this finding could be used as an indication to screen older adults for MCI. CONCLUSIONS Screening tools that require cognitive resources such as gait speed appear to have significant relationships with performance of EF for those who screen positive for MCI. This information could be used clinically to identify older adults with cognitive limitations, which could put them at higher risk for falling.
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Affiliation(s)
- Jennifer Blackwood
- 1Physical Therapy Department, University of Michigan-Flint 2UNC Division of Physical Therapy, UNC Chapel Hill, Chapel Hill, North Carolina 3College of Health and Human Services, Western Michigan University, Kalamazoo, Michigan
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Duval GT, Paré PY, Gautier J, Walrand S, Dinomais M, Annweiler C. Vitamin D and the Mechanisms, Circumstances and Consequences of Falls in Older Adults: A Case-Control Study. J Nutr Health Aging 2017; 21:1307-1313. [PMID: 29188894 DOI: 10.1007/s12603-016-0857-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine i) whether cases of elderly fallers had lower serum 25-hydroxyvitamin D (25OHD) concentration than controls without history of falls; and ii) whether serum 25OHD concentration was associated with specific mechanisms, circumstances and consequences of falls. DESIGN Case-control study with a 1:2 ratio. SETTING Geriatric ward of the University Hospital of Angers, France, between February 2012 and March 2014. PARTICIPANTS 216 inpatients (72 cases and 144 age- and gender-matched controls). MEASUREMENT Falls were defined as involuntary events causing the person to the ground or other lower level. The main mechanisms, circumstances and consequences of falls were identified using standardized questionnaires. Vitamin D deficiency was defined as serum 25OHD concentration ≤25nmol/L. Age, gender, body mass index, polypharmacy, use antihypertensive drugs, use psychoactive drugs, disability, cognitive performance, serum concentrations of parathyroid hormone, creatinine and albumin, and season of evaluation were used as potential confounders. RESULTS 216 participants (72 cases and 144 controls) were included in the study. There was no between-group difference in the prevalence of vitamin D deficiency (P=0.176). After adjusting for confounding factors, vitamin D deficiency was positively associated with falls (OR=4.03, P=0.014). Finally, the fallers with vitamin D deficiency exhibited more often orthostatic hypotension (68.8% against 33.3%, P=0.039) and a history of recurrent falls (85% against 50%, P=0.002) than those without vitamin D deficiency. CONCLUSION This case-control study reported that vitamin D deficiency was associated with falls in older inpatients. There was a greater prevalence of orthostatic hypotension and of the reccurrence of falls among fallers with vitamin D deficiency, suggesting that vitamin D may influence the conditions predisposing to falls rather than the fall by itself.
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Affiliation(s)
- G T Duval
- Cédric Annweiler, MD, PhD, Division of Geriatric Medicine, Angers University Hospital, F-49933 Angers Cedex 9, France; E-mail: ; Phone: ++33 2 41 35 54 86; Fax: ++33 2 41 35 48 94
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Sobol NA, Hoffmann K, Vogel A, Lolk A, Gottrup H, Høgh P, Hasselbalch SG, Beyer N. Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease. Aging Ment Health 2016; 20:1139-1146. [PMID: 26161932 DOI: 10.1080/13607863.2015.1063108] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) causes a gradual decline in cognition, limitations of dual-tasking and physical function leading to total dependence. Hence, information about the interaction between physical function, dual-task performance and cognition may lead to new treatment strategies with the purpose of preserving function and quality of life. The objective of this study was to investigate the associations between physical function, dual-task performance and cognition in community-dwelling patients with mild AD. METHODS Baseline results from 185 participants (50-90 years old) in the single blinded multicenter RCT 'ADEX' (Alzheimer's disease: the effect of physical exercise) were used. Assessments included tests of physical function: 400-m walk test, 10-m walk test, Timed Up and Go test and 30-s chair stand test; dual-task performance, i.e., 10-m walk while counting backwards from 50 or naming the months backwards; and cognition, i.e., Mini Mental State Examination, Symbol Digit Modalities Test, the Stroop Color and Word Test, and Lexical verbal fluency test. RESULTS Results in the 30-s chair stand test correlated significantly with all tests of cognition (r = .208-.242) while the other physical function tests only randomly correlated with tests of cognition. Results in the dual-task counting backwards correlated significantly with results in all tests of cognition (r = .259-.388), which accounted for 7%-15% of the variation indicating that a faster time to complete dual-task performance was associated with better cognitive performance. CONCLUSION The evidence of the associations between physical function, dual-task performance and cognition is important when creating new rehabilitation interventions to patients with mild AD.
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Affiliation(s)
- Nanna Aue Sobol
- a Musculoskeletal Rehabilitation Research Unit, Department of Physical and Occupational Therapy, and Institute of Sports Medicine, Bispebjerg Hospital , University of Copenhagen , Copenhagen , Denmark
| | - Kristine Hoffmann
- b Danish Dementia Research Centre, Department of Neurology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark
| | - Asmus Vogel
- b Danish Dementia Research Centre, Department of Neurology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark
| | - Annette Lolk
- c Dementia Clinic , Odense University Hospital , Odense , Denmark
| | - Hanne Gottrup
- d Dementia Clinic, Department of Neurology , Aarhus University Hospital , Aarhus , Denmark
| | - Peter Høgh
- e Regional Dementia Research Center, Region Zealand, Roskilde Hospital , University of Copenhagen , Roskilde , Denmark
| | - Steen G Hasselbalch
- b Danish Dementia Research Centre, Department of Neurology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark
| | - Nina Beyer
- a Musculoskeletal Rehabilitation Research Unit, Department of Physical and Occupational Therapy, and Institute of Sports Medicine, Bispebjerg Hospital , University of Copenhagen , Copenhagen , Denmark
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Lee SH, Han JH, Jin YY, Lee IH, Hong HR, Kang HS. Poor physical fitness is independently associated with mild cognitive impairment in elderly Koreans. Biol Sport 2016; 33:57-62. [PMID: 26985135 PMCID: PMC4786587 DOI: 10.5604/20831862.1185889] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 01/30/2015] [Accepted: 04/01/2015] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to investigate the association between physical fitness and mild cognitive impairment (MCI) in elderly Koreans. This was a cross-sectional study that involved 134 men and 299 women aged 65 to 88 years. Six senior fitness tests were used as independent variables: 30 s chair stand for lower body strength, arm curl for upper body strength, chair-sit-and-reach for lower body flexibility, back scratch for upper body flexibility, 8-ft up-and-go for agility/dynamic balance, and 2-min walk for aerobic endurance. Global cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). Potential covariates such as age, education levels, blood lipids, and insulin resistance (IR) markers were also assessed. Compared to individuals without MMSE-based MCI, individuals with MMSE-based MCI had poor physical fitness based on the senior fitness test (SFT). There were significant positive trends observed for education level (p=0.001) and MMSE score (p<0.001) across incremental levels of physical fitness in this study population. Individuals with moderate (OR=0.341, p=0.006) and high (OR=0.271, p=0.007) physical fitness based on a composite score of the SFT measures were less likely to have MMSE-based MCI than individuals with low physical fitness (referent, OR=1). The strength of the association between moderate (OR=0.377, p=0.038) or high (OR=0.282, p=0.050) physical fitness and MMSE-based MCI was somewhat attenuated but remained statistically significant even after adjustment for the measured compounding factors. We found that poor physical fitness was independently associated with MMSE-based MCI in elderly Koreans.
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Affiliation(s)
- S H Lee
- The Division of Humanities and Social Sciences, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - J H Han
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - Y Y Jin
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - I H Lee
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - H R Hong
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - H S Kang
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
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Blackwood J, Shubert T, Fogarty K, Chase C. The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study. J Nutr Health Aging 2016; 20:138-45. [PMID: 26812509 DOI: 10.1007/s12603-015-0598-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. DESIGN This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. PARTICIPANTS Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). INTERVENTION Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. MEASUREMENTS Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. RESULTS Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. CONCLUSION A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.
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Affiliation(s)
- J Blackwood
- J. Blackwood, University of Michigan-Flint, Physical Therapy, 303 East Kearsley Street, Flint, MI 48502, USA, 8107623373, FAX: 8107666668,
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Ng SSM, Kwong PWH, Chau MSP, Luk ICY, Wan SS, Fong SSM. Effect of arm position and foot placement on the five times sit-to-stand test completion times of female adults older than 50 years of age. J Phys Ther Sci 2015; 27:1755-9. [PMID: 26180314 PMCID: PMC4499977 DOI: 10.1589/jpts.27.1755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 02/14/2015] [Indexed: 01/06/2023] Open
Abstract
The five times-sit-to stand test (FTSTS) is a clinical test which is commonly used to assessed the functional muscle strength of the lower limbs of older adults. The aim of this study was to examine the effect of different arm positions and foot placements on the FTSTS completion times of older female adults. [Subjects and Methods] Twenty-nine healthy female subjects, aged 63.1±5.3 years participated in this cross-sectional study. The times required to complete the FTSTS with 3 different arm positions (hands on thighs, arms crossed over chest, and an augmented arm position with the arms extended forward) and 2 foot placements (neutral and posterior) were recorded. The interaction effect and main effect of arm positions and foot placements were examined using a 3 (arm position) × 2 (foot placement) two-way repeated measures analysis of variance (ANOVA). [Results] There was no interaction effect among the 3 arm positions in the 2 foot placements. A significant main effect was identified for foot placement, but not arm position. Posterior foot placement led to a shorter FTSTS time compared to that of normal foot placement. [Conclusion] With the same arm position, FTSTS completion times with posterior foot placement tended to be shorter. Therefore, the standard foot placement should be used for FTSTS administration.
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Affiliation(s)
- Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Patrick W H Kwong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Michael S P Chau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Isaac C Y Luk
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Sam S Wan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shirley S M Fong
- Institute of Human Performance, The University of Hong Kong, Hong Kong
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Foot placement and arm position affect the five times sit-to-stand test time of individuals with chronic stroke. BIOMED RESEARCH INTERNATIONAL 2014; 2014:636530. [PMID: 25032220 PMCID: PMC4083881 DOI: 10.1155/2014/636530] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/04/2014] [Accepted: 05/19/2014] [Indexed: 11/17/2022]
Abstract
Objectives. To investigate the effect of two foot placements (normal or posterior placement) and three arm positions (hands on the thighs, arms crossed over chest, and augmented arm position with elbow extended) on the five times sit-to-stand (FTSTS) test times of individuals with chronic stroke. Design. Cross-sectional study. Setting. University-based rehabilitation clinic.
Participants. A convenience sample of community-dwelling individuals with chronic stroke (N = 45). Methods. The times in completing the FTSTS with two foot placements and the three arm positions were recorded by stopwatch. Results. Posterior foot placement led to significantly shorter FTSTS times when compared with normal foot placement in all the 3 arm positions (P ≤ 0.001). In addition, hands on thigh position led to significantly longer FTSTS times than the augmented arm position (P = 0.014). Conclusion. Our results showed that foot placement and arm position could influence the FTSTS times of individuals with chronic stroke. Standardizing the foot placement and arm position in the test procedure is essential, if FTSTS test is intended to be used repeatedly on the same subject.
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Physical performance is associated with working memory in older people with mild to severe cognitive impairment. BIOMED RESEARCH INTERNATIONAL 2014; 2014:762986. [PMID: 24757674 PMCID: PMC3971508 DOI: 10.1155/2014/762986] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/02/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. METHODS This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years). Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. RESULTS The full models explain 49-57% of the variance in working memory and 40-43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3-7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. CONCLUSIONS Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.
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Identifying axial and cognitive correlates in patients with Parkinson's disease motor subtype using the instrumented Timed Up and Go. Exp Brain Res 2013; 232:713-21. [PMID: 24292517 DOI: 10.1007/s00221-013-3778-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/12/2013] [Indexed: 10/26/2022]
Abstract
Parkinson's disease (PD) is clinically highly heterogeneous, often divided into tremor dominant (TD) and postural instability gait difficulty (PIGD). To better understand these subtypes and to help stratify patients, we applied an objective marker, i.e., an instrumented version of the traditional "Timed Up and Go" test (iTUG). It is not known whether the iTUG is sensitive to PD motor phenotypes or what are its behavioral and cognitive correlates. Subjects performed the iTUG wearing a body-fixed sensor. Subcomponents were studied including walking, transitions and turning. Gait, balance and cognitive function and the associations between iTUG, behavioral and cognitive domains were assessed. We also compared two representative subtypes, with minimal symptom overlap, referred to here as predominant PIGD (p-PIGD) and predominant TD (p-TD). One hundred and six patients with PD performed the iTUG. Significant correlations were found between iTUG measures and the PIGD score, but not with TD score. Thirty p-PIGD and 31 p-TD patients were identified. Both groups were similar with respect to age and disease duration (p > 0.75). The p-PIGD patients took significantly longer to complete the iTUG (p = 0.026), used more steps (p = 0.031), albeit with similar step duration (p = 0.936). In the sit-to-stand transition, the p-PIGD patients exhibited lower anterior-posterior jerk (p = 0.04) and lower pitch range (p = 0.012). During the turn, the p-PIGD patients had a lower yaw amplitude (p < 0.038). Cognitive domains were correlated with iTUG measures in the p-PIGD patients, but not in the p-TD. These findings demonstrate that a single sensor can identify axial and cognitive correlates using subcomponents of the iTUG and reveals subtle alterations between the PD motor subtypes.
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Doheny EP, Walsh C, Foran T, Greene BR, Fan CW, Cunningham C, Kenny RA. Falls classification using tri-axial accelerometers during the five-times-sit-to-stand test. Gait Posture 2013; 38:1021-5. [PMID: 23791781 DOI: 10.1016/j.gaitpost.2013.05.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 04/28/2013] [Accepted: 05/20/2013] [Indexed: 02/02/2023]
Abstract
The five-times-sit-to-stand test (FTSS) is an established assessment of lower limb strength, balance dysfunction and falls risk. Clinically, the time taken to complete the task is recorded with longer times indicating increased falls risk. Quantifying the movement using tri-axial accelerometers may provide a more objective and potentially more accurate falls risk estimate. 39 older adults, 19 with a history of falls, performed four repetitions of the FTSS in their homes. A tri-axial accelerometer was attached to the lateral thigh and used to identify each sit-stand-sit phase and sit-stand and stand-sit transitions. A second tri-axial accelerometer, attached to the sternum, captured torso acceleration. The mean and variation of the root-mean-squared amplitude, jerk and spectral edge frequency of the acceleration during each section of the assessment were examined. The test-retest reliability of each feature was examined using intra-class correlation analysis, ICC(2,k). A model was developed to classify participants according to falls status. Only features with ICC>0.7 were considered during feature selection. Sequential forward feature selection within leave-one-out cross-validation resulted in a model including four reliable accelerometer-derived features, providing 74.4% classification accuracy, 80.0% specificity and 68.7% sensitivity. An alternative model using FTSS time alone resulted in significantly reduced classification performance. Results suggest that the described methodology could provide a robust and accurate falls risk assessment.
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Affiliation(s)
- Emer P Doheny
- The TRIL (Technology Research for Independent Living) Centre, Ireland; Health Research and Innovation, Intel Labs, Intel Corporation, Leixlip, Co. Kildare, Ireland.
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Puhan MA, Siebeling L, Zoller M, Muggensturm P, ter Riet G. Simple functional performance tests and mortality in COPD. Eur Respir J 2013; 42:956-63. [PMID: 23520321 PMCID: PMC3787814 DOI: 10.1183/09031936.00131612] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Exercise tests are important to characterise chronic obstructive pulmonary disease patients and predict their prognosis, but are often not available outside of rehabilitation or research settings. Our aim was to assess the predictive performance of the sit-to-stand and handgrip strength tests. The prospective cohort study in Dutch and Swiss primary care settings included a broad spectrum of patients (n=409) with Global Initiative for Chronic Obstructive Lung Disease stages II to IV. To assess the association of the tests with outcomes, we used Cox proportional hazards (mortality), negative binomial (centrally adjudicated exacerbations) and mixed linear regression models (longitudinal health-related quality of life) while adjusting for age, sex and severity of disease. The sit-to-stand test was strongly (adjusted hazard ratio per five more repetitions of 0.58, 95% CI 0.40–0.85; p=0.004) and the handgrip strength test moderately strongly (0.84, 95% CI 0.72–1.00; p=0.04) associated with mortality. Both tests were also significantly associated with health-related quality of life but not with exacerbations. The sit-to-stand test alone was a stronger predictor of 2-year mortality (area under curve 0.78) than body mass index (0.52), forced expiratory volume in 1 s (0.61), dyspnoea (0.63) and handgrip strength (0.62). The sit-to-stand test may close an important gap in the evaluation of exercise capacity and prognosis of chronic obstructive pulmonary disease patients across practice settings. The 1-min sit-to-stand test predicts mortality in COPD patients and can easily be implemented across practice settingshttp://ow.ly/mxrPx
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Jordre B, Schweinle W, Beacom K, Graphenteen V, Ladwig A. The five times sit to stand test in senior athletes. J Geriatr Phys Ther 2012; 36:47-50. [PMID: 22864460 DOI: 10.1519/jpt.0b013e31826317b5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The Five Times Sit to Stand Test (FTSST) has been established as a valid and reliable functional measure for older adults. Norms have been clearly defined for community-dwelling older adults and can be useful in the identification of mobility decline and prediction of future disability. However, because of the high rates of inactivity in the population of community-dwelling older adults, it seems inappropriate to compare high-functioning older adults, for example, senior athletes, to these norms. With trends showing increased senior athlete participation, new norms may be necessary to appropriately evaluate this population of older adults. The purpose of this study was to (1) compare results of the FTSST in senior athletes older than 60 years to norms for community-dwelling adults of the same age (2) determine the effects of age, gender, and sport intensity on FTSST performance in senior athletes, and (3) establish norms appropriate for this population of interest. METHODS The FTSST was performed on 276 (104 men, 172 women) senior athletes age 50 to 91 years (mean age = 64.9, SD = 15) reporting an average of 4 hours of cardiovascular training and 1 hour of strength training each week. All were actively engaged in national or state senior game competitions. RESULTS All participants were able to complete the test. One hundred ninety-four participants between 60 and 89 years of age showed significantly faster times than currently reported norms. Performance was negatively associated with age, but did not differ significantly between genders. Participants in more physically demanding sports did show the best FTSST times, although athletes engaged in more leisure sports still outperformed norms for community-dwelling seniors. CONCLUSION Senior athletes show significantly greater FTSST speed than norms derived from community-dwelling older adults. New normative guidelines are presented to assist the screening of these athletes on this functional performance measure.
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Affiliation(s)
- Becca Jordre
- Department of Physical Therapy, School of Health Sciences, University of South Dakota, Vermillion, SD 57069, USA.
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Wallmann HW, Evans NS, Day C, Neelly KR. Interrater Reliability of the Five-Times-Sit-to-Stand Test. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2012. [DOI: 10.1177/1084822312453047] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The sit-to-stand (STS) task, an important activity required to maintain functional independence, can be used to assess physical performance. The purpose of this study was to determine the interrater reliability of the five-times-sit-to-stand test (FTSTS). Ninety-two subjects, mean age of 65 years, performed the FTSTS without the use of the upper extremities. A video recording of each subject’s performance was independently assessed to determine the test completion time by three clinicians with similar education and years of clinical experience. An intraclass correlation coefficient (ICC2,1) was used to determine the interrater reliability of the FTSTS. Statistical analysis revealed excellent interrater reliability among all three researchers: ICC = 1.000. When clinicians with equal education and clinical experience administer the FTSTS, it has excellent interrater reliability.
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Hofmeister M. Cognitive conscious stimuli with movement. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:283-284. [PMID: 22567067 PMCID: PMC3345349 DOI: 10.3238/arztebl.2012.0283b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Martin Hofmeister
- *Verbraucherzentrale Bayern e.V., Referat Lebensmittel und Ernährung, München,
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Greene BR, Kenny RA. Assessment of Cognitive Decline Through Quantitative Analysis of the Timed Up and Go Test. IEEE Trans Biomed Eng 2012; 59:988-95. [DOI: 10.1109/tbme.2011.2181844] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND/OBJECTIVE Vitamin D deficiency is highly prevalent in Saudi Arabia. The study objective was to compare vitamin D deficiency in Saudi married couples. SUBJECTS/METHODS This cross-sectional study was carried out in the Royal Guard primary health care center in Riyadh, Saudi Arabia on a consecutive sample of 50 Saudi married couples attending the center without complaints related to vitamin D deficiency. Data were collected through an interview questionnaire addressing the risk factors and dietary habits. Quantitative determination of total 25-hydroxy vitamin D in blood was done by Electro-Chemical Luminescence assay. Fieldwork was carried out from December 2010 to January 2011. RESULTS Men had higher sun exposure (P = 0.001), more use of light clothes at home (P = 0.002) and more intake of milk (P = 0.023) and soft drinks (P = 0.001). Vitamin D was higher in men with mean difference about 9 nmol/l (P < 0.001). The prevalence of vitamin D deficiency (<25 nmol/l) was 70% in women, compared with 40% in men (P = 0.001). Multivariate analysis identified male gender, physical activity and the intake of milk as statistically significant positive independent predictors of vitamin D level, adjusted for factors as age, sun exposure, clothing, skin color, BMI, soft drinks and animal protein intake. CONCLUSION Vitamin D deficiency is very high among Saudi married couples, especially wives. Female gender is an independent predictor of lower vitamin D level, in addition to sedentary lifestyle and low milk consumption. There is a need to revise the levels set for the diagnosis of vitamin D deficiency or insufficiency in the study region.
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Annweiler C, Fantino B, Parot-Schinkel E, Thiery S, Gautier J, Beauchet O. Alzheimer's disease--input of vitamin D with mEmantine assay (AD-IDEA trial): study protocol for a randomized controlled trial. Trials 2011; 12:230. [PMID: 22014101 PMCID: PMC3212921 DOI: 10.1186/1745-6215-12-230] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 10/20/2011] [Indexed: 12/15/2022] Open
Abstract
Background Current treatments for Alzheimer's disease and related disorders (ADRD) are symptomatic and can only temporarily slow down ADRD. Future possibilities of care rely on multi-target drugs therapies that address simultaneously several pathophysiological processes leading to neurodegeneration. We hypothesized that the combination of memantine with vitamin D could be neuroprotective in ADRD, thereby limiting neuronal loss and cognitive decline. The aim of this trial is to compare the effect after 24 weeks of the oral intake of vitamin D3 (cholecalciferol) with the effect of a placebo on the change of cognitive performance in patients suffering from moderate ADRD and receiving memantine. Methods The AD-IDEA Trial is a unicentre, double-blind, randomized, placebo-controlled, intent-to-treat, superiority trial. Patients aged 60 years and older presenting with moderate ADRD (i.e., Mini-Mental State Examination [MMSE] score between 10-20), hypovitaminosis D (i.e., serum 25-hydroxyvitamin D [25OHD] < 30 ng/mL), normocalcemia (i.e., serum calcium < 2.65 mmol/L) and receiving no antidementia treatment at time of inclusion are being recruited. All participants receive memantine 20 mg once daily -titrated in 5 mg increments over 4 weeks- and each one is randomized to one of the two treatment options: either cholecalciferol (one 100,000 IU drinking vial every 4 weeks) or placebo (administered at the same pace). One hundred and twenty participants are being recruited and treatment continues for 24 weeks. Primary outcome measure is change in cognitive performance using Alzheimer's Disease Assessment Scale-cognition score. Secondary outcomes are changes in other cognitive scores (MMSE, Frontal Assessment Battery, Trail Making Test parts A and B), change in functional performance (Activities of Daily Living scale, and 4-item Instrumental Activities of Daily Living scale), posture and gait (Timed Up & Go, Five Time Sit-to-Stand, spatio-temporal analysis of walking), as well as the between-groups comparison of compliance to treatment and tolerance. These outcomes are assessed at baseline, 12 and 24 weeks, together with the serum concentrations of 25OHD, calcium and parathyroid hormone. Discussion The combination of memantine plus vitamin D may represent a new multi-target therapeutic class for the treatment of ADRD. The AD-IDEA Trial seeks to provide evidence on its efficacy in limiting cognitive and functional declines in ADRD. Trial Registration ClinicalTrials.gov number, NCT01409694
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