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Vidyanti AN, Rahmawati F, Rahman RH, Prodjohardjono A, Gofir A. Lifestyle interventions for dementia risk reduction: A review on the role of physical activity and diet in Western and Asian Countries. J Prev Alzheimers Dis 2025; 12:100028. [PMID: 39863321 DOI: 10.1016/j.tjpad.2024.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 11/09/2024] [Accepted: 12/01/2024] [Indexed: 01/27/2025]
Abstract
Dementia, is a critical global public health challenge with no effective pharmacological treatments. Recent research highlights the significant role of lifestyle interventions, particularly physical activity and dietary habits, in mitigating cognitive decline among the elderly and preventing the progression to dementia in individuals with Mild Cognitive Impairment (MCI). This comprehensive review explores the impact of physical exercise and dietary approaches on cognitive health, comparing strategies adopted in Western and Asian countries. Physical activity, including aerobic, resistance, balance training, and dual-task exercises, has been shown to enhance neurogenesis, improve cerebral blood flow, and delay cognitive decline. In Western countries, structured regimens such as the Mediterranean (MedDiet) and MIND diets are prominent, while Asian countries often integrate traditional mind-body practices like Tai Chi and culturally relevant diets rich in antioxidants and polyphenols. Although both regions recognize the importance of lifestyle changes in reducing dementia risk, their approaches differ significantly, shaped by cultural norms and dietary preferences. This review underscores the need for culturally tailored public health strategies to promote cognitive health globally, highlighting the importance of individualized approaches in MCI and dementia prevention.
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Affiliation(s)
- Amelia Nur Vidyanti
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia/Dr Sardjto General Hospital Yogyakarta, Indonesia.
| | - Fitri Rahmawati
- Neurology Research Office, Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia
| | - Rifki Habibi Rahman
- Neurology Research Office, Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia
| | - Astuti Prodjohardjono
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia/Dr Sardjto General Hospital Yogyakarta, Indonesia
| | - Abdul Gofir
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia/Dr Sardjto General Hospital Yogyakarta, Indonesia
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Van Criekinge T, Sahu U, Bhatt T. Effect of Explicit Prioritization on Dual Tasks During Standing and Walking in People With Neurologic and Neurocognitive Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:2166-2183. [PMID: 38401769 DOI: 10.1016/j.apmr.2024.02.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To examine the effectiveness of explicit task (ie, equal, motor or cognitive) prioritization during dual tasking (DT) in adults with neurologic and neurocognitive disorders (stroke, Parkinson disease [PD], multiple sclerosis, dementia, Alzheimer disease, and mild cognitive impairment). DATA SOURCE A systematic search in 4 databases (PubMed, Web of Science, Embase, and Cochrane Central) yielded 1138 unique studies published up to 2023. STUDY SELECTION Forty-one experimental studies were selected that assessed the effect of explicit prioritization instructions on both motor and cognitive performance during dual-tasks related to standing and walking in selected populations. Primary outcome measures were walking speed and response accuracy. Availability of data allowed us to perform a meta-analysis on 27 of the 41 articles by using inverse variance with a random effects model. DATA EXTRACTION The data including design, subject characteristics, motor and cognitive tasks, prioritization, motor and cognitive outcomes, instructions, and key findings were extracted. Two assessors rated the selected studies for risk of bias and quality using the Quality Assessment Tools of the National Institutes of Health. DATA SYNTHESIS This study examined 1535 adults who were asked to perform motor-cognitive DT in standing or walking, including 381 adults with stroke, 526 with PD, 617 with multiple sclerosis, 10 with dementia, 9 with Alzheimer disease, and 8 with mild cognitive impairment. During all prioritization instructions, participants slowed down during DT (standardized mean difference (SMD)equal=0.43; SMDmotor=0.78; SMDcognitive=0.69, P<.03) while maintaining similar response accuracy (SMDequal=0.12; SMDmotor=0.23; SMDcognitive=-.01, P>.05). However, considerable between-group heterogeneity was observed resulting in different motor and cognitive responses between pathologies. CONCLUSION Motor prioritization was achieved in adults with PD and stroke, unlike adults with neurocognitive disorders who were negatively affected by any type DT prioritizing. The reported within-group heterogeneity revealed that effects of explicit task prioritization are dependent on motor and cognitive task complexity, and the type of instructions. Recommendations are provided to ensure accurate use of instructions during DT paradigms.
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Affiliation(s)
| | - Upasana Sahu
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL.
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Zhou JH, Wang RY, Liu YT, Cheng SJ, Liu HH, Yang YR. Improving Executive Function and Dual-Task Cost in Parkinson Disease: A Randomized Controlled Trial. J Neurol Phys Ther 2024; 48:188-197. [PMID: 39164804 DOI: 10.1097/npt.0000000000000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
BACKGROUND AND PURPOSE Dual-task walking is challenging for people with Parkinson disease (PD). Gait performance worsens while executing dual tasks, possibly due to a decline in executive function (EF). This study aimed to investigate the effects of dual-task training on EF and dual-task cost (DTC) in people with PD and to explore whether training-induced changes in EF were associated with changes in DTC. METHODS This study was a randomized controlled trial. A total of 28 people with PD participated. Participants were randomly assigned to the experimental group (dual-task training) and the control group (treadmill training). Both groups received a total of 16 training sessions during the 8 weeks. Assessments were conducted at baseline and postintervention. Primary outcomes included EF and dual-task cost. RESULTS Significant time-by-group interactions were found in executive function and DTC. The experimental group showed significant improvement in frontal assessment battery (FAB), trail-making test (TMT) part A, Stroop color and word test (SCWT), and DTC on speed in cognitive dual-task walking. There was a moderate to high correlation between the change values of the FAB, TMT part A, SCWT, and the change values of DTC in cognitive dual-task walking. DISCUSSION AND CONCLUSIONS Compared to treadmill training, dual-task training resulted in greater improvements in EF and DTC. Training-induced changes in EF were linked to changes in DTC when walking while performing a cognitive task but not when walking while performing a motor task. VIDEO ABSTRACT For more insights from the authors Supplemental Digital Content available at http://links.lww.com/JNPT/A485.
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Affiliation(s)
- Jun-Hong Zhou
- Department of Physical Therapy and Assistive Technology (J.-H.Z., R.-Y.W., S.-J.C., H.-H.L., Y.-R.Y) and Department of Neurology, School of Medicine (Y.-T.L.), National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurology (Y.-T.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology (S.-J.C.), Mackay Memorial Hospital, Taipei, Taiwan; and Department of Physical Therapy (H.-H.L.), Chung Shan Medical University, Taichung City, Taiwan
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Lee ES, Kim B. The impact of fear of falling on health-related quality of life in community-dwelling older adults: mediating effects of depression and moderated mediation effects of physical activity. BMC Public Health 2024; 24:2459. [PMID: 39256752 PMCID: PMC11385480 DOI: 10.1186/s12889-024-19802-1] [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: 06/03/2024] [Accepted: 08/14/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND The fear of falling is a common issue among older adults that negatively affects physical and psychological aspects of health-related quality of life, regardless of actual fall events. Interventions aimed at reducing fear of falling, independent of falls, may improve older adults' quality of life. This study examined the moderated mediation effect of physical activity in how fear of falling affects health-related quality of life through depression in community-dwelling older adults. METHODS This study used secondary data from the Korea Centers for Disease Control and Prevention's 2019 Community Health Survey. The study included 73,738 adults aged 65 years or older. The researchers used the fear of falling scale, International Physical Activity Questionnaire, Patient Health Questionnaire-9, and EuroQol 5 Dimension as research tools, and performed descriptive statistics, Pearson's correlation coefficient, and SPSS PROCESS macro analysis. The study used the bootstrapping method to assess the adjusted mediating effect by resampling 5,000 times, and determined statistical significance with a 95% confidence interval. RESULTS In the model in which fear of falling affects health-related quality of life by mediating depression, the moderated mediation effect of physical activity was statistically significant, as the bootstrapping result did not include 0 in the 95% confidence interval (Index of moderated mediation [95% CI] = 0.006 [0.004-0.007], 0.008 [0.006-0.009]). Depression and health-related quality of life impairment decreased as the level of physical activity increased through inactivity, minimal activity, and health promotion activities, as the negative mediating effects decreased. CONCLUSION Physical activity reduces depression and improves health-related quality of life by influencing older adults' fear of falling. Community-based programs are needed to encourage and support older adults in maintaining moderate physical activity to manage the depression caused by fear of falling, which is common among older adults, and to improve their health-related quality of life.
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Affiliation(s)
- Eun Sook Lee
- College of Nursing, Gyeongsang National University, Sustainable Health Research Institute, Jinju, Gyeongsang, 52725, South Korea
| | - Boyoung Kim
- College of Nursing, Chonnam National University, Gwangju, 61469, South Korea.
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Usta Ozdemir H, Kitis A, Ardıc FN. Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study. J Aging Phys Act 2024; 32:496-507. [PMID: 38521052 DOI: 10.1123/japa.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 12/28/2023] [Accepted: 01/20/2024] [Indexed: 03/25/2024]
Abstract
We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.
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Affiliation(s)
- Hande Usta Ozdemir
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ali Kitis
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Fazıl Necdet Ardıc
- Department of Otorhinolaryngology, Medicine Faculty, Pamukkale University, Denizli, Turkey
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Kartal Özcan E, Karabulut M, Karakoç K, Müjdeci B. Is There an Association Between Self-Reported Dual-Task Performance and Fear of Falling in Older Adults? J Aging Phys Act 2024; 32:370-375. [PMID: 38262398 DOI: 10.1123/japa.2023-0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/07/2023] [Accepted: 11/14/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Is there an association between self-reported dual-task performance and fear of falling in older adults? BACKGROUND/OBJECTIVES Fear of falling tends to increase with age and can negatively impact dual-task abilities, leading to potential declines in overall quality of life. Therefore, it becomes crucial to evaluate dual-task performance in older adults, particularly prior to the onset of fear of falling. This study aims to investigate the potential association between self-reported dual-task performance and fear of falling in older adults. METHODS A total of 51 individuals (19 females and 32 males) were recruited. The participants met the inclusion criteria were administered the Dual-Task Questionnaire (DTQ), Falls Efficiency Scale International, and Physical Activity Scale for the Elderly. Multiple linear regression was performed to predict DTQ scores based on age, body mass index, and Physical Activity Scale for the Elderly. RESULTS A moderate positive correlation was found between Falls Efficiency Scale International scores and self-reported DTQ scores (r: .448, p: .001). Age, body mass index, and Physical Activity Scale for the Elderly were not found to be significant predictors of DTQ scores. CONCLUSIONS Our study reveals a moderate positive association between fear of falling and self-reported dual-task performance in older adults. A direct relationship between physical activity performance, fear of falling, and self-reported dual-task performance was observed among older adults. Significance/Implications: Integrating self-reported measures like the DTQ in clinical evaluations can provide valuable insights into dual-task abilities of older adults.
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Affiliation(s)
- Ecem Kartal Özcan
- Department of Audiology, Gulhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Mustafa Karabulut
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kürşad Karakoç
- Audiology and Speech Pathology Doctoral Programme, Graduate School of Health Sciences, Ankara University, Ankara, Turkey
- Department of Audiology, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Banu Müjdeci
- Department of Audiology, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Miri S, Norasteh AA. Fear of falling, quality of life, and daily functional activity of elderly women with and without a history of falling: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:2619-2625. [PMID: 38694291 PMCID: PMC11060224 DOI: 10.1097/ms9.0000000000001977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/06/2024] [Indexed: 05/04/2024] Open
Abstract
Background This study aimed to evaluate the fear of falling, quality of life, and daily functional activity of older women aged 60 years or older with or without a history of falling. Materials and methods Two hundred older adult women were recruited for the cross-sectional study in Iran. This cross-sectional study collected data from July to August 2023 through convenience sampling. The researchers collected data using a five-part questionnaire, that collected information that included demographic characteristics, the Fall Efficacy Scale in the Elderly-International Version (FES-I), 12-item Quality of Life assessment (SF-12), Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). Results FES-I score in older women with a history of falls was significantly higher than those without a history of falls [median: 38.0, interquartile range (IQR): 31.5-44.0 versus median: 22.0, IQR: 20.0-30.0; P<0.001]. The median quality-of-life score using the SF-12 was significantly lower in women with a history of falls than in those without a history of falls (median: 25.0, IQR: 21.0-30.0 versus median: 35.0, IQR: 31.0-39.0; P<0.001). The ADL scores were significantly lower among women with a history of falls than those without (P<0.001). A similar result was obtained for IADL scores (P<0.001). Conclusion Overall, this study's findings highlight the adverse impact of a history of falls on three key factors: fear of falling, quality of life, and daily functional activity (including both basic and instrumental activities). The findings delineate that, ultimately, the history of falls can serve as a valuable indicator for better understanding trends in elderly care and addressing the associated challenges.
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Affiliation(s)
- Sahar Miri
- Department of Corrective Exercise and Sport Injury, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Ali Asghar Norasteh
- Department of Physiotherapy, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Xiong W, Wang D, Ren W, Liu X, Wen R, Luo Y. The global prevalence of and risk factors for fear of falling among older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:321. [PMID: 38580924 PMCID: PMC10998426 DOI: 10.1186/s12877-024-04882-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/08/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND As a common psychological problem among older adults, fear of falling was found to have a wide range prevalence in different studies. However, the global prevalence of it was unknown and a lack of the large sample confirmed its risk factors. OBJECTIVES To report the global prevalence of fear of falling and to explore its risk factors among older adults for further developing precise interventions to systematically manage FOF. DESIGN A systematic review and meta-analysis was conducted by PRISMA guidelines. METHODS Searches were conducted in PubMed, Web of Science, EMBASE, the Cochrane Library and the manual search in August 20, 2022, updated to September 2, 2023. Observational studies published in English were included and two researchers independently screened and extracted the data. Fixed or random effects mode was used to estimate the pooled prevalence of and risk factors for fear of falling. Heterogeneity resources were analyzed by subgroup and sensitivity analysis. Publication bias was assessed through funnel plots, Egger's test and Begg's test. RESULTS A total of the 153 studies with 200,033 participants from 38 countries worldwide were identified. The global prevalence of fear of falling was 49.60%, ranging from 6.96-90.34%. Subgroup analysis found the estimates pooled prevalence of it was higher in developing countries (53.40%) than in developed countries (46.7%), and higher in patients (52.20%) than in community residents (48.40%). In addition, twenty-eight risk factors were found a significant associations with fear of falling, mainly including demographic characteristics, physical function, chronic diseases and mental problems. CONCLUSION The global prevalence of FOF was high, especially in developing countries and in patients. Demographic characteristics, Physical function, chronic diseases and mental problems were a significant association with FOF. Policy-makers, health care providers and government officials should comprehensively evaluate these risk factors and formulate precise intervention measures to reduce FOF. TRIAL REGISTRATION The study was registered in the International Database of Prospectively Registered Systematic Reviews (PROSPERO): CRD42022358031.
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Affiliation(s)
- Wanhong Xiong
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
- Department of Oncology, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Dan Wang
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Wei Ren
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Xinyi Liu
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Renhui Wen
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Yu Luo
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China.
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Yeo J, Tay L, Pua YH, Mah SM, Tay EL, Wang MX, Ng YS. Single and Dual Task Gait Speed in Frailty Screening of Community-Dwelling Older Adults. J Prim Care Community Health 2024; 15:21501319241306700. [PMID: 39660674 PMCID: PMC11632872 DOI: 10.1177/21501319241306700] [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: 10/07/2024] [Revised: 11/17/2024] [Accepted: 11/21/2024] [Indexed: 12/12/2024] Open
Abstract
OBJECTIVE This study compares dual task (DT) gait speed between robust and frail older adults in the setting of a community-based frailty screening program. METHODS A cross-sectional study was conducted involving older adults aged 50 years or older. Participants were categorized as robust, pre-frail or frail using the FRAIL phenotype. Gait speed was measured under single task (ST) and 2 DT conditions: arithmetic (DT1) and verbal fluency (DT2) tasks. For the arithmetic task, participants counted upwards in multiples of 2, starting from 16. For the verbal fluency task, they named different animals as they walked. RESULTS A total of 976 participants were recruited, of which 779 were robust, 181 were pre-frail and 16 were frail. Robust participants exhibited significantly faster DT gait speeds (DT1: 1.12 (0.25)m/s; DT2: 0.97 (0.27)m/s than pre-frail/frail (PFF) participants (DT1: 0.88 (0.30)m/s); DT2: 0.78 (0.30)m/s). Robust participants also demonstrated a significantly faster ST gait speed (1.31 (0.22)m/s) vs 1.05 (0.31)m/s). CONCLUSION DT gait assessment combines both physical and cognitive domains and may serve as a more holistic tool for early frailty detection in the community. The significant differences observed in DT gait speeds highlight the need for integrating cognitive assessments into frailty screening protocols, supporting timely interventions to improve health outcomes.
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Affiliation(s)
- Joey Yeo
- Duke-NUS Medical School, Singapore, Singapore
| | - Laura Tay
- Sengkang General Hospital, Singapore, Singapore
| | - Yong Hao Pua
- Singapore General Hospital, Singapore, Singapore
| | - Shi Min Mah
- Sengkang General Hospital, Singapore, Singapore
| | - Ee Ling Tay
- Sengkang General Hospital, Singapore, Singapore
| | | | - Yee Sien Ng
- Duke-NUS Medical School, Singapore, Singapore
- Sengkang General Hospital, Singapore, Singapore
- Singapore General Hospital, Singapore, Singapore
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Goffredo M, Pagliari C, Turolla A, Tassorelli C, Di Tella S, Federico S, Pournajaf S, Jonsdottir J, De Icco R, Pellicciari L, Calabrò RS, Baglio F, Franceschini M. Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases. J Clin Med 2023; 12:jcm12093178. [PMID: 37176618 PMCID: PMC10179507 DOI: 10.3390/jcm12093178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND People with chronic neurological diseases, such as Parkinson's Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to expand the scope of our previously published research on the impact of telerehabilitation on quality of life in an MS sample, testing the impact of this type of intervention in a larger sample of neurological patients also including PD individuals on postural balance. METHODS We included 60 participants with MS and 72 with PD. All enrolled subjects were randomized into two groups: 65 in the intervention group and 67 in the control group. Both treatments lasted 30-40 sessions (5 days/week, 6-8 weeks). Motor, cognitive, and participation outcomes were registered before and after the treatments. RESULTS All participants improved the outcomes at the end of the treatments. The study's primary outcome (Mini-BESTest) registered a greater significant improvement in the telerehabilitation group than in the control group. CONCLUSIONS Our results demonstrated that non-immersive virtual reality telerehabilitation is well tolerated and positively affects static and dynamic balance and gait in people with PD and MS.
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Affiliation(s)
- Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
| | - Chiara Pagliari
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40138 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Sara Federico
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Sanaz Pournajaf
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
| | | | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | | | | | | | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00166 Rome, Italy
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Kouchaki L, Darvishpoor Kakhki A, Safavi Bayat Z, Khan HTA. Association between fear of falling and self-care behaviours of older people with hypertension. Nurs Open 2023; 10:3954-3961. [PMID: 36824048 PMCID: PMC10170935 DOI: 10.1002/nop2.1654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/01/2022] [Accepted: 02/04/2023] [Indexed: 02/25/2023] Open
Abstract
AIM This study investigated the association between fear of falling and self-care behaviours of older people with hypertension. DESIGN A cross-sectional study. METHODS This study was conducted in 2019 on 301 older people with hypertension above the age of 60 years in Tehran, Iran. Data were collected using a demographic questionnaire, the Persian Falls Efficacy Scale-International, and a hypertension-related self-care behaviour questionnaire. RESULTS Analyses revealed that gender, educational level and history of falling were significant factors associated with fear of falling; and marital status, educational level and income source were significant factors associated with self-care behaviours (p < 0.05). Partial correlations controlling for education revealed a significant positive correlation showing that high fear of falling is associated with worse health promotion self-care behaviours and significant inverse correlations with psycho-emotional, social and daily self-care behaviours (p < 0.05), meaning that high fear of falling is associated with better self-care for these dimensions. PATIENT OR PUBLIC CONTRIBUTION This study involved patients in order to evaluate the validity and reliability of the questionnaires. The study was conducted on older people with hypertension referred to hypertension clinics in hospitals.
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Affiliation(s)
- Leila Kouchaki
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Safavi Bayat
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hafiz T A Khan
- College of Nursing, Midwifery and Healthcare, University of West London, London, UK
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What is the relationship between falls, functional limitations, and depressive symptoms among Chinese older adults? The role of living alone. Maturitas 2023; 168:78-83. [PMID: 36521395 DOI: 10.1016/j.maturitas.2022.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 08/26/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Although the association between falls and depressive symptoms is well documented, the mechanisms underlying this association remain largely unexplored. We investigated the mediation role of functional limitations in the association between falls and depressive symptoms among Chinese older adults and determined whether the living arrangement (living alone or not) is a significant moderator of the above-mentioned mediation pathway. STUDY DESIGN Cross-sectional study. MAIN OUTCOME MEASURES Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale short form (CESD-10), on which higher scores indicate higher levels of depressive symptoms. RESULTS We used the harmonized China Health and Retirement Longitudinal Study national baseline data (2011-2012 year) involving 7410 participants aged 60 years and over. After adjusting for covariates (e.g., age and sex), the effects of falls on depressive symptoms were seen to be mediated by functional limitations among Chinese older adults (β = 0.82, p < .001). The moderated mediation analysis, which assesses whether an indirect effect is conditional on values of a moderating variable, found that the mediation effect was contingent upon the living arrangement (β = -0.60, p = .029). Specifically, the levels of functional limitations and depressive symptoms were higher for people with falls who were living with others relative to those living alone. CONCLUSIONS These results suggest that functional limitations are an important intervening variable that links falls to depressive symptoms among Chinese older adults. Interventions to promote older adults' physical function and prevent falls are recommended to decrease the risk of depressive symptoms. These interventions can particularly benefit those who live with others.
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SMARTfit Dual-Task Exercise Improves Cognition and Physical Function in Older Adults With Mild Cognitive Impairment: Results of a Community-Based Pilot Study. J Aging Phys Act 2023:1-12. [PMID: 36716745 DOI: 10.1123/japa.2022-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 02/01/2023]
Abstract
Mild cognitive impairment is an intermediate state between the cognitive decline often experienced in normal aging and dementia that affects 15% of Americans over 65 years of age. Our communities have an opportunity to support the development and adoption of evidence-based programs to help older adults preserve cognition and physical function. In partnership with a local urban YMCA in an underserved, predominantly minority neighborhood, we tested the appeal and therapeutic benefits of SMARTfit training among older adults with mild cognitive impairment. The participants reported a positive training experience. After 12 weeks of dual-task training, Trail-Making Test and Stroop Color-Word Interference Test scores improved, as did scores on the Short Physical Performance Battery. Results of our SMARTfit dual-task training intervention are encouraging. Larger randomized controlled trials must further investigate the development, implementation, and therapeutic impacts of SMARTfit dual-task training on cognitive and physical function in aging.
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Lowell RK, Conner NO, Derby H, Hill CM, Gillen ZM, Burch R, Knight AC, Reneker JC, Chander H. Quick on Your Feet: Modifying the Star Excursion Balance Test with a Cognitive Motor Response Time Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1204. [PMID: 36673958 PMCID: PMC9859199 DOI: 10.3390/ijerph20021204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 05/26/2023]
Abstract
The Star Excursion Balance Test (SEBT) is a common assessment used across clinical and research settings to test dynamic standing balance. The primary measure of this test is maximal reaching distance performed by the non-stance limb. Response time (RT) is a critical cognitive component of dynamic balance control and the faster the RT, the better the postural control and recovery from a postural perturbation. However, the measure of RT has not been done in conjunction with SEBT, especially with musculoskeletal fatigue. The purpose of this study is to examine RT during a SEBT, creating a modified SEBT (mSEBT), with a secondary goal to examine the effects of muscular fatigue on RT during SEBT. Sixteen healthy young male and female adults [age: 20 ± 1 years; height: 169.48 ± 8.2 cm; weight: 67.93 ± 12.7 kg] performed the mSEBT in five directions for three trials, after which the same was repeated with a response time task using Blazepod™ with a random stimulus. Participants then performed a low-intensity musculoskeletal fatigue task and completed the above measures again. A 2 × 2 × 3 repeated measures ANOVA was performed to test for differences in mean response time across trials, fatigue states, and leg reach as within-subjects factors. All statistical analyses were conducted in JASP at an alpha level of 0.05. RT was significantly faster over the course of testing regardless of reach leg or fatigue state (p = 0.023). Trial 3 demonstrated significantly lower RT compared to Trial 1 (p = 0.021). No significant differences were found between fatigue states or leg reach. These results indicate that response times during the mSEBT with RT is a learned skill that can improve over time. Future research should include an extended familiarization period to remove learning effects and a greater fatigue state to test for differences in RT during the mSEBT.
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Affiliation(s)
- Russell K. Lowell
- Resistance Exercise Performance Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
| | - Nathan O. Conner
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
| | - Hunter Derby
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
| | - Christopher M. Hill
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL 60115, USA
| | - Zachary M. Gillen
- Resistance Exercise Performance Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
| | - Reuben Burch
- Department of Industrial Systems and Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Human Factors and Athlete Engineering, Center for Advanced Vehicular Systems (CAVS), Mississippi State University, Starkville, MS 39759, USA
| | - Adam C. Knight
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
| | - Jennifer C. Reneker
- Department of Population Health Sciences, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Harish Chander
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS 39762, USA
- Human Factors and Athlete Engineering, Center for Advanced Vehicular Systems (CAVS), Mississippi State University, Starkville, MS 39759, USA
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dos Santos EPR, Ohara DG, Patrizzi LJ, de Walsh IAP, Silva CDFR, da Silva Neto JR, Oliveira NGN, Matos AP, Iosimuta NCR, Pinto ACPN, Pegorari MS. Investigating Factors Associated with Fear of Falling in Community-Dwelling Older Adults through Structural Equation Modeling Analysis: A Cross-Sectional Study. J Clin Med 2023; 12:545. [PMID: 36675475 PMCID: PMC9867366 DOI: 10.3390/jcm12020545] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 - 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International-Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship.
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Affiliation(s)
- Elane Priscila Rosa dos Santos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Daniela Gonçalves Ohara
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Lislei Jorge Patrizzi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Isabel Aparecida Porcatti de Walsh
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Caroline de Fátima Ribeiro Silva
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - José Ribeiro da Silva Neto
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Nayara Gomes Nunes Oliveira
- Department of Nursing in Education and Community Health, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Natalia Camargo Rodrigues Iosimuta
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Maycon Sousa Pegorari
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
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Zukowski LA, Shaikh FD, Haggard AV, Hamel RN. Acute effects of virtual reality treadmill training on gait and cognition in older adults: A randomized controlled trial. PLoS One 2022; 17:e0276989. [PMID: 36322594 PMCID: PMC9629584 DOI: 10.1371/journal.pone.0276989] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/17/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Everyday walking often involves walking with divided attention (i.e., dual-tasking). Exercise interventions for older adults should mimic these simultaneous physical and cognitive demands. This proof-of-concept study had a two-fold purpose: 1) identify acute cognitive and gait benefits of a single session of virtual reality treadmill training (VRTT), relative to conventional treadmill training (CTT), and 2) identify differences between those who reduced dual-task costs (i.e., responders) on gait or cognition and those who did not, after the session. METHODS Sixty older adults were randomized to complete a single 30-minute session of VRTT (n = 30, 71.2±6.5 years, 22 females) or CTT (n = 30, 72.0±7.7 years, 21 females). Pre- and post-exercise session, participants performed single-task walking, single-task cognitive, and dual-task walking trials while gait and cognition were recorded. Gait variables were gait speed and gait speed variability. Cognition variables were response reaction time, response accuracy, and cognitive throughput. Dual-task effects (DTE) on gait and cognition variables were also calculated. RESULTS Post-exercise, there were no group differences (all p>0.05). During single- and dual-task trials, both groups walked faster (single-task: F(1, 58) = 9.560, p = 0.003; dual-task: F(1, 58) = 19.228, p<0.001), responded more quickly (single-task: F(1, 58) = 5.054, p = 0.028; dual-task: F(1, 58) = 8.543, p = 0.005), and reduced cognitive throughput (single-task: F(1, 58) = 6.425, p = 0.014; dual-task: F(1, 58) = 28.152, p<0.001). Both groups also exhibited reduced DTE on gait speed (F(1, 58) = 8.066, p = 0.006), response accuracy (F(1, 58) = 4.123, p = 0.047), and cognitive throughput (F(1, 58) = 6.807, p = 0.012). Gait responders and non-responders did not differ (all p>0.05), but cognitive responders completed fewer years of education (t(58) = 2.114, p = 0.039) and better information processing speed (t(58) = -2.265, p = 0.027) than cognitive non-responders. CONCLUSIONS The results indicate that both VRTT and CTT may acutely improve gait and cognition. Therefore, older adults will likely benefit from participating in either type of exercise. The study also provides evidence that baseline cognition can impact training effects on DTE on cognition.
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Affiliation(s)
- Lisa A. Zukowski
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- * E-mail:
| | - Faisal D. Shaikh
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Alexa V. Haggard
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Renee N. Hamel
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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The mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in older adults admitted to hospital. Geriatr Nurs 2022; 48:132-138. [PMID: 36219931 DOI: 10.1016/j.gerinurse.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 12/14/2022]
Abstract
The aim of this research was to determine the mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in the older adults. This descriptive and cross-sectional study was conducted with 312 individuals in Istanbul between June-October 2021. The Edmonton Frail Scale (EFS) score was 7.06±3.69, Fear of Falling Avoidance Behavior Questionnaire (FFABQ) score was 17.84±15.3. Quality of Life Scale (SF-12) physical component score was 34.21±25.12 and mental component score was 41.81±17.87. EFS plays a mediating role in the effect of FFABQ on SF-12 and strengthens its negative effect on SF-12. The frailty severity of the participants was moderate, activity limitation and participation restriction due to fear of falling were low, and their quality of life in physical and mental components was low. Avoidance behavior has a direct effect on quality of life and an indirect effect with the role of frailty.
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Brustio PR, Mulasso A, D’Emanuele S, Zia G, Feletti L, Del Signore S, Rainoldi A. Indoor Mobility, Frailty, and Disability in Community-Dwelling Older Adults: A Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11386. [PMID: 36141659 PMCID: PMC9517026 DOI: 10.3390/ijerph191811386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
The general population, but especially older adults, were forced or encouraged to stay home during the recent COVID-19 pandemic. In this context, indoor mobility (IM, the number of steps performed daily at home) may be informative about the general health status of older adults. The present study aimed at evaluating the relationship between IM, frailty (loss of functional reserve including both physical and psychosocial domains), and disability (loss of autonomy measured as activities of daily life, ADLs) in a sample of community-dwelling Italian older adults. Specifically, the primary objective was to investigate IM and disability differences between robust and frail older adults. The secondary objective was to test if frailty is in the causal sequence between IM and disability, i.e., as a mediator in their relationship. Thirty-two participants (mean age = 70 ± 6 years; 56.2% women) were recruited. Frailty and disability were evaluated using the Tilburg Frailty Indicator and the Groningen Activity Restriction Scale, respectively. IM at home was measured via an Adamo wristwatch (a connected accelerometer). One-way analyses of covariance, controlling for age and gender, showed that robust participants, classified according to a score higher than five points in the Tilburg Frailty Indicator, performed significantly more IM (F1,28 = 4.639; p = 0.04) and presented lower disability grade than frail ones (F1,28 = 4.342; p =0.046). Only physical frailty was a mediator in the relationship between IM and disability (F2,29 = 8.538, p < 0.001), with a fully mediated model (z = -2.073, p < 0.04). Conversely, the total frailty score was not a mediator in the same relationship, but with IM accounted for the variance in disability (F2,29 = 8.538, p < 0.001; R2 = 33.7%). Our results suggested that frail older adults restricted their IM more and presented a higher level of disability compared to robust older adults. Moreover, data suggest that IM reduction may have a negative impact on physical frailty and indirectly increase disability.
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Affiliation(s)
- Paolo Riccardo Brustio
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Neuroscience, Biomedicine and Movement, University of Verona, 37124 Verona, Italy
- Department of Clinical and Biological Sciences, University of Torino, 10126 Torino, Italy
| | - Anna Mulasso
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy
| | - Samuel D’Emanuele
- Department of Neuroscience, Biomedicine and Movement, University of Verona, 37124 Verona, Italy
| | | | | | | | - Alberto Rainoldi
- NeuroMuscularFunction, Research Group, School of Exercise & Sport Sciences, University of Torino, 10126 Torino, Italy
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy
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19
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Wang J, Hong JT, Xiang Y, Zhang C. Do the dual-task "8-foot up and go" tests provide additional predictive value for early detection of cognitive decline in community-dwelling older women? Aging Clin Exp Res 2022; 34:2431-2439. [PMID: 35838984 DOI: 10.1007/s40520-022-02193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The 8-Foot Up and Go (8UG) test is a widely used mobility assessment. Some dual-task mobility assessments have been developed to help detect cognitive decline. AIMS This study developed a dual-task version of 8UG test to investigate the dual-task 8UG performance and to evaluate the ability of dual-task 8UG test in detecting cognitive decline. METHODS A total of 101 eligible community-dwelling women aged 60-74 years were grouped into the mild cognitive impairment group (MCI, n = 49) and the non-cognitive impairment group (NCI, n = 52). The 8UG tests under single-task (ST), manual dual-task (MT), and cognitive dual-task (CT) conditions were performed respectively. The dual-task cost (DTC) and the correct response rate (CRR) were calculated to quantify the dual-task interference. RESULTS Participants spent more time in performing the 8UG test under dual-task conditions. No differences were observed between NCI and MCI groups for 8UG parameters under ST and MT conditions (p > 0.05). When executing CT, significant differences were found in the number of correct answers and CRR (p < 0.05). CRR showed the strongest ability to predict MCI with a cut-off point of 0.50 (71.2% sensitivity and 61.2% specificity). DISCUSSION Both manual and cognitive dual-task were found to interfere with the 8UG performance. CRR with cutoff point of 0.50 could be a potential predictor of MCI in community-dwelling older women. CONCLUSIONS The CRR of the cognitive dual-task 8UG test could be recommended as a potential predictor for the early detection of MCI in community-dwelling older women.
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Affiliation(s)
- Jingjing Wang
- School of Exercise and Health, Shanghai University of Sport, Yangpu District, 650 Qing Yuan Huan Rd, Shanghai, 200438, China.,Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Jin-Tao Hong
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Yun Xiang
- School of Exercise and Health, Shanghai University of Sport, Yangpu District, 650 Qing Yuan Huan Rd, Shanghai, 200438, China.,School of Physical Education, Hubei Engineering University, Xiaogan, 432000, Hubei, China
| | - Chunhua Zhang
- School of Exercise and Health, Shanghai University of Sport, Yangpu District, 650 Qing Yuan Huan Rd, Shanghai, 200438, China.
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20
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Park S, Cho OH. Fear of falling and related factors during everyday activities in patients with chronic stroke. Appl Nurs Res 2021; 62:151492. [PMID: 34814996 DOI: 10.1016/j.apnr.2021.151492] [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] [Received: 04/30/2021] [Revised: 08/10/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study was to examine the impact of physical function, anxiety, and depression on the fear of falling associated with everyday activities in patients with stroke. This was a cross-sectional descriptive survey. Convenience sampling was used to select 127 patients with stroke who were undergoing rehabilitative therapy at a single rehabilitation hospital in South Korea. Fear of falling, anxiety, and depression were assessed using structured questionnaires. Physical parameters, including lower extremity function, functional mobility, balance ability, and lower extremity muscle strength, were measured using objective methods. A multiple regression analysis was used to identify the predictors of fear of falling. Female patients had a higher fear of falling associated with walking outdoors compared to male patients. Lower extremity strength was the only significant predictor of fear of falling when adjusting for age, sex, Mini Mental State Examination scores, and fall experience. Lower extremity strength was identified as the most important factor affecting the fear of falling associated with everyday activities in patients with stroke. Preventing muscle weakness in the lower extremities and providing education and support to improve patients' self-efficacy in outdoor activities are strategies that can be used to reduce the fear of falling in patients with stroke.
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Affiliation(s)
- Suna Park
- Department of Nursing, Davinchi Hospital, Daejeon, Republic of Korea
| | - Ok-Hee Cho
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju, Republic of Korea.
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21
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Agmon M, Bar-Shalita T, Kizony R. High Sensory Responsiveness in Older Adults is Associated with Walking Outside but Not Inside: Proof of Concept Study. Clin Interv Aging 2021; 16:1651-1657. [PMID: 34548788 PMCID: PMC8449548 DOI: 10.2147/cia.s322728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose Reduced mobility and a higher risk of falls among older adults are related to aging-associated sensory alteration. Sensory responsiveness (SR) has been found to be strongly correlated with postural control in studies on young adults in stimulating environments; however, SR has not been studied in the context of mobility among older adults, despite its potential to enhance fall risks. The aim of the current study is to characterize the associations between SR and gait under single and dual-task (ST, DT) conditions inside and outside the laboratory. Methods Twenty-six community-dwelling older adults (age 70.3 ± 4.6 years, 65.4% women) participated in this cross-sectional study. Gait variables were measured using the APDM system under single and dual task conditions, in a quiet corridor inside and in an ecological (outside) environment. SR was evaluated using the SR questionnaire and cognition was assessed with the Trail-Making Test and the Montreal Cognitive Assessment. Results SR was negatively associated with gait speed during ST (rs = −0.491, p < 0.05) and DT (rs = −0.528, p < 0.01) outside and with ST gait speed inside (rs = −0.528, p < 0.01). SR was positively associated with gait variability under DT (rs = 0.41, p < 0.05) and with DT cost (rs = 0.44, p < 0.05) only outside. Conclusion SR may play an important role in understanding mobility deterioration throughout the aging process, especially outside, illuminating the importance of SR evaluation among older adults during mobility assessment. Therefore, accounting for SR in gait research may contribute to a better understanding of mobility decline throughout the aging process.
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Affiliation(s)
- Maayan Agmon
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences University of Haifa, Haifa, Israel.,Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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22
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Lee D, Tak SH. Fear of Falling and Related Factors in Older Adults With Spinal Diseases. J Gerontol Nurs 2021; 47:29-35. [PMID: 34309452 DOI: 10.3928/00989134-20210624-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Fear of falling is common among older adults with spinal diseases. The purpose of the current study was to examine fear of falling and related factors in this population. A total of 138 participants were recruited and completed survey questionnaires along with the Timed Up & Go Test. Participants were 73.7 years old on average, 52% had fall experience, and 56% were taking more than four medications. Multivariate regression analyses revealed that the use of sleeping pills, residence type, pain, activities of daily living, gait ability, and gait efficacy were significant predictors of fear of falling. Findings suggest that a fall prevention intervention for older adults with spinal diseases should include pain management, functional improvement, and gait rehabilitation with a focus on gait performance and gait efficacy. In addition, it is important to improve living environment and sleep hygiene, which are conducive to falls. [Journal of Gerontological Nursing, 47(8), 29-35.].
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23
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Chen WC, Li YT, Tung TH, Chen C, Tsai CY. The relationship between falling and fear of falling among community-dwelling elderly. Medicine (Baltimore) 2021; 100:e26492. [PMID: 34190176 PMCID: PMC8257838 DOI: 10.1097/md.0000000000026492] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 06/09/2021] [Indexed: 01/04/2023] Open
Abstract
Researchers have repeatedly examined the relationship between a previous experience of a fall and subsequent fear of falling (FOF); however, few studies have investigated the effects of falling along various timelines among older adults. The objective of this study was to determine whether experiencing a fall in the previous month or the previous year led to FOF among the elderly.The National Health and Aging Trends Study (NHATS) in the U.S. collected information indicative of basic trends in the behavior of individuals aged 65 years and older. In the current study, we applied multiple logistic regression analysis of results from round 7 of the NHATS with the aim of identifying the risk factors associated with FOF among 5559 participants aged 65 years or older.FOF was reported by 48.8% of those who experienced a fall in the previous year and 46.8% experienced a fall in the previous month. The results of regression analysis revealed that after adjusting for sex, age, related chronic disease, activities of daily living, and instrumental activities of daily living, FOF was significantly associated with experiencing a fall during the previous month (OR = 2.29, 95% CI: 1.78-2.95) or during the previous year (OR = 2.60, 95% CI: 2.16-3.14).Our results indicate that experiences of falling during the previous month or the previous year were both significantly associated with a fear of falling, and caregivers should keep this in mind when dealing with community-living elderly individuals.
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Affiliation(s)
- Wei-Cheng Chen
- Taiwan Stipendiary Co., Ltd., Kaohsiung
- Institute of Health Policy and Management, National Taiwan University
| | - Yang-Tzu Li
- Department of Long Term Care, National Taipei University of Nursing and Health Science
| | - Tao-Hsin Tung
- Taiwan Association of Health Industry Management and Development, Taipei, Taiwan
| | - Chieh Chen
- Institute of Medical Sciences, Tzu Chi University, Hualien
| | - Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital
- Institute of Public Health, National Yang-Ming University
- MS Program in Transdisciplinary Long Term Care and Bachelor's Program in Business Management, Fu Jen Catholic University, New Taipei City, Taiwan
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Abit Kocaman A, Demirci C, Aydoğan Arslan S, Yildirim Şahan T, Vergili Ö, Oral MA, Bezgin S, Uğurlu K, Önal B, Keskin ED, Sertel M. The Cutoff Value of the Calf-Raise Senior Test for Older Faller. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1869138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ayşe Abit Kocaman
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Cevher Demirci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Balıkesir University, Balıkesir, Turkey
| | - Saniye Aydoğan Arslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Tezel Yildirim Şahan
- Gülhane Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, University of Health Science, Ankara, Turkey
| | - Özge Vergili
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - M. Ayhan Oral
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Sabiha Bezgin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Kübra Uğurlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Birol Önal
- Faculty of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - E. Dilek Keskin
- Faculty of Medical Sciences, Department of Physical Medicine and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Meral Sertel
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
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Brustio P, Rainoldi A, Petrigna L, Rabaglietti E, Pizzigalli L. Postural stability during dual- and triple-task conditions: The effect of different levels of physical fitness in older adults. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Do motor-cognitive and motor-motor dual task training effect differently balance performance in older adults? Eur Geriatr Med 2021; 12:371-378. [PMID: 33389715 DOI: 10.1007/s41999-020-00434-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Dual-task training (DTT) have been showed that have satisfying effects on older adults. The aim of this study was to compare the effect of motor-cognitive DTT (mCdtt) and motor-motor DTT (mMdtt) on balance, fear of falling, walking functionality and muscle strength in older adults. METHODS A total of 50 participants aged 60 and over (mean age: 67.72 ± 7.33 years), having a score ≥ 24 on the Mini-Mental State Exam (MMSE), being in the category of walking ability ≥ 4 according to the Functional Ambulation Category (FAC), having no problem in visual ability and hearing were included for this study. The participants who received mCdtt (Group 1) counted back from the two-digit number; and the participants who received mMdtt (Group 2) held half-filled glasses with both hands near the trunk with 90° flexion of elbow while performing exercises. The intervention program had lasted for 8 weeks. To assess balance, fear of falling, walking functionality and muscle strength of participants; Berg Balance Scale (BBS), Falls Efficacy Scale International (FES-I), Timed Up and Go (TUG) and the Hand-held dynamometer were used, respectively. RESULTS The results of our study showed that 8-week mCdtt and mMdtt program did not differ in balance fear of falling, walking functionality and muscle strength in older adults, although both trainings had improved balance ability. CONCLUSION It can be interpreted that both training programs can be suggested to enhance abovementioned parameters in older adults. Further studies are needed to elucidate the difference of clinical outcomes between the mCdtt and mMdtt program in older adults. TRIAL REGISTRATION NUMBER NCT04577092. DATE OF REGISTRATION 09/30/2020 "Retrospectively registered".
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Tsai CY, Tung TH, Li YT, Chen WC. The relationship between home ownership and fall-related outcomes: The National Health and Aging Trends Study. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000019. [PMID: 36962064 PMCID: PMC10021867 DOI: 10.1371/journal.pgph.0000019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/18/2021] [Indexed: 11/19/2022]
Abstract
Although many studies have tried to explore the association between fall incidents and fear of falling (FOF)/worry about fall-limited activities and various risk factors, few studies have recognized the relationship between house ownership and fall-related outcomes. The aim of this study was to assess whether house ownership will affect an older adult's experience of falling or lead to fear of falling. The National Health and Aging Trends Study (NHATS) collected data that would provide an understanding of basic trends in people aged 65 years and older living in the United States of America. This study conducted round one of the NHATS and did logistic regression to examine the relationship between house ownership and fall-related outcomes among 7,090 persons aged 65 or older. Twenty five percent of the sampled population who lacked house ownership. All fall-related outcomes (fall last month, fall last year, fear of falling, and worry about fall-limited activities) were statistically significant in the bivariate analysis. Multiple logistic regression analysis showed that house ownership (OR = 0.75, 95%CI: 0.65-0.86) was significantly associated with fear of falling after adjusting for other covariates. The findings underscore the association between the lack of house ownership and fall-related outcomes.
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Affiliation(s)
- Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- MS Program in Transdisciplinary Long Term Care and Bachelor's Program in Business Management, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tao-Hsin Tung
- Taiwan Association of Health Industry Management and Development, Taipei, Taiwan
| | - Yang-Tzu Li
- Department of long term care, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Wei-Cheng Chen
- Taiwan Stipendiary Co., Ltd., Kaohsiung, Taiwan
- Institute of Health Policy and Management, National Taiwan University, Taipei City, Taiwan
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Khanmohammadi R, Sheikh M, Bagherzadeh F, Hoomanian D, Khajavi D, Shaw I. Effect Of Cognitive And Exercise Rehabilitation On Gait In Male Schizophrenic Patients Suffering From Depression Disorder. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective ― The purpose of this study was to investigate the effect of cognitive and exercise rehabilitation training, and non-invasive brain stimulation on the gait of schizophrenic patients suffering from depression disorder. Methods ― Fifty-five male schizophrenic patients suffering from depression disorder aged 24 to 66 years were assigned to either a control group (n=10), cognitive rehabilitation group (n=10), exercise rehabilitation training group (n=13), transcranial direct current stimulation (tDCS) group (n=11) or multimodal intervention group (n=11). Gait was measured using a 10-meter gait speed test under normal, in dual-task cognitive-gait, and in dual task motor-gait conditions. Results ― Gait speed during the 10-meter walk test under normal conditions was significantly (P≤0.05) different from pre- to post-test in the exercise rehabilitation training, and cognitive rehabilitation multimodal intervention. Gait speed during the dual task motor-gait condition was significantly different from pre- to post-test in the exercise rehabilitation training, cognitive rehabilitation and, multimodal intervention groups (P≤0.05). Gait speed during the dual task cognitive-gait condition significantly changed from pre- to post-test following exercise rehabilitation training, cognitive rehabilitation, tDCS and the multimodal intervention group (P≤0.05). Conclusion ― This study’s findings demonstrate that exercise rehabilitation training, cognitive rehabilitation, and multimodal interventions could assist with preventing falls within Schizophrenic patients suffering from depression and thereby improve their functional independence.
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Chaparro GN, Sosnoff JJ, Hernandez ME. Effects of aerobic fitness on cognitive motor interference during self-paced treadmill walking in older adults. Aging Clin Exp Res 2020; 32:2539-2547. [PMID: 32008225 DOI: 10.1007/s40520-020-01479-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/11/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Older adults experience greater cognitive motor interference (CMI) due to declines in cognitive and physical function. Although aerobic fitness has beneficial effects on cognition, its association with CMI is not clear. AIMS This study aims to investigate the effects of aerobic fitness on CMI during self-paced treadmill walking in older adults. METHODS Thirty participants (67.6 ± 10.34 years, 21 females) were included in a 2-day cross-sectional design study. Aerobic fitness was assessed with the Rockport 1-mile test. The dual-task paradigm consisted of walking only, and dual-task standing and dual-task walking (i.e., standing/walking while performing the Modified Stroop color word test) on a treadmill. To assess CMI, gait speed and accuracy rate were measured to later calculate the dual-task cost for each parameter. RESULTS Individuals with low aerobic fitness exhibited significantly greater gait speed dual-task cost than individuals with high aerobic fitness (p < 0.05). There were no significant findings for accuracy rate dual-task cost. DISCUSSION These study findings are the first to demonstrate increases in CMI in relation to low aerobic fitness. Results can be attributed to the relationship between aerobic fitness and cognition as well as theories related to attentional capacity. CONCLUSION Older adults with low aerobic fitness possess greater CMI when compared to older adults with high aerobic fitness. This provides a foundation of knowledge on how aerobic fitness in older adults may affect CMI which can lead researchers to examine the causal relationships between an aerobic exercise intervention program and CMI in older adults.
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Lee S, Lee C, Rodiek S. Outdoor exposure and perceived outdoor environments correlated to fear of outdoor falling among assisted living residents. Aging Ment Health 2020; 24:1968-1976. [PMID: 31364392 DOI: 10.1080/13607863.2019.1647139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. PURPOSE This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. METHODS This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. RESULTS Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405-0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437-0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368-0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). CONCLUSION Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
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Affiliation(s)
- Sungmin Lee
- Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Chanam Lee
- Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA
| | - Susan Rodiek
- Department of Architecture, College of Architecture, Texas A&M University, College Station, TX, USA
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Lucero RJ, Romero S, Fieo R, Cortes Y, Cimiotti JP, Poghosyan L. Language equivalence of the modified falls efficacy scale (MFES) among English- and Spanish-speaking older adults: Rasch analysis. BMC Geriatr 2020; 20:286. [PMID: 32787777 PMCID: PMC7422612 DOI: 10.1186/s12877-020-01627-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/22/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To investigate item-level measurement properties of the Modified Falls Efficacy (MFES) Scale among English- and Spanish-speaking urban-dwelling older adults as a means to evaluate language equivalence of the tool. METHODS Secondary analysis of survey data from 170 English (n = 83) and Spanish (n = 87) speaking older adults who reported to the emergency department of a quaternary medical center in New York City between February 2010 and August 2011. The Rasch rating scale model was used to investigate item statistics and ordering of items, item and person reliability, and model performance of the Modified Falls Efficacy Scale. RESULTS The Modified Falls Efficacy Scale, for English- and Spanish-speakers, demonstrated acceptable fit to the Rasch model of a unidimensional measure. While the range of the construct is more limited for the Spanish group, the interval between tasks are much closer, reflecting little to no construct under-representation. CONCLUSION There is rationale for continued testing of a unidemsional English- and Spanish-MFES among urban community-dwelling older adults. Large-scale international studies linking the unidemsional MFES to patient outcomes will support the validity of this tool for research and practice.
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Affiliation(s)
- Robert J Lucero
- Department of Family, Community, and Health System Science, Center for Latin American Studies, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, Florida, 32610, USA.
| | - Sergio Romero
- North Florida/South Georgia Veterans Health System, Center of Innovation on Disability and Rehabilitation Research, 300 E. University Avenue, Gainesville, FL, 32601, USA
| | - Robert Fieo
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, Gainesville, Florida, NY, 32610, USA
| | - Yamnia Cortes
- The University of North Carolina at Chapel Hill, School of Nursing, S. Columbia Street, Chapel Hill, NC, 27599, USA
| | - Jeannie P Cimiotti
- Department of Family, Community, and Health Systems Science, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Lusine Poghosyan
- Columbia University, School of Nursing, Center for Health Policy, 560 W. 168th Street, New York, NY, 10032, USA
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Physical Frailty and Fall Risk in Community-Dwelling Older Adults: A Cross-Sectional Study. J Aging Res 2020; 2020:3964973. [PMID: 32714612 PMCID: PMC7355345 DOI: 10.1155/2020/3964973] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/25/2020] [Accepted: 04/13/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction Frailty is a condition in older adults with decreased physical and cognitive performance that can affect health outcomes associated with fracture, disability, and falls. The aim of this study was to compare fall risk with different physical frailty statuses and investigate factors associated with fall risk in community-dwelling older adults. Methods The population studied included 367 older adults (mean age = 73.2 years ± 7.0; 237 females (64.6%) and 130 males (35.4%)) who live in Chiang Mai, Thailand. This study was of cross-sectional design. Fried's phenotype was used to screen the physical frailty status. The physiological profile assessment (PPA) was used to screen for fall risk. One-way ANOVA analysis was used to compare the fall risk between the different levels of frailty status. Linear regression analysis was used to assess the association between frailty status and fall risk. Results The prevalence of the frailty group was 8.7% and that of the prefrailty group was 76.8%. The three statuses of frailty identified were found to have different levels of risk of falling. The frailty group had a higher fall risk than the nonfrailty group and the prefrailty group. In addition, the nonfrailty group had a lower fall risk than the prefrailty group. Conclusion The frailty group had the highest fall risk in this cohort of older adults living in a community-dwelling facility. Therefore, it is important to assess the frailty status among older adults as it can be a predictor for fall risk. This assessment will therefore lead to a reduction in the rate of disability and death in the community.
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van Schooten KS, Freiberger E, Sillevis Smitt M, Keppner V, Sieber C, Lord SR, Delbaere K. Concern About Falling Is Associated With Gait Speed, Independently From Physical and Cognitive Function. Phys Ther 2019; 99:989-997. [PMID: 30830212 DOI: 10.1093/ptj/pzz032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 11/12/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Higher levels of concern about falling in older people have been associated with slower walking speed and an increased risk of falls. However, it is unclear whether this relationship is independent or confounded by other fall risk factors, such as physical and cognitive function. OBJECTIVE The aim of this study was to examine the effects of concern about falling on gait speed, adjusted for physiological fall risk and cognitive function. DESIGN This was an observational, cross-sectional study. METHODS A total of 204 community-dwelling older people aged 70 years or older were recruited from 2 sites (Germany, n = 94; Australia, n = 110). Walking speed was measured over 6 m under 4 conditions: preferred speed, fast speed, speed while carrying a tray (functional dual task), and speed while answering a question (cognitive dual task). The Falls Efficacy Scale-International was used to assess concern about falling, the Physiological Profile Assessment was used to assess physiological fall risk, and the Digit Symbol Substitution Test and Trail Making Test were used to assess attention and executive function. RESULTS Higher levels of concern about falling were associated with slower gait speed. Following adjustment for age, history of falls, and female sex, and further adjustment for physical and cognitive function, the association between concern about falling and walking speed remained significant, with a considerable effect size (standardized β = 0.18 ± 0.08; P = .037). LIMITATIONS The use of walking speed as a sole measure of gait was a limitation of this study. CONCLUSIONS Gait speed, especially under dual-task conditions, was affected by concern about falling. Concern about falling was the strongest predictor of gait speed under all 4 conditions and should be included in routine geriatric assessments.
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Affiliation(s)
| | - Ellen Freiberger
- Institute for Biomedicine on Aging (IBA), Friedrich-Alexander-University of Erlangen-Nürnberg, Koberger Strasse 60, 90408 Nürnberg, Germany
| | | | - Veronika Keppner
- Institute for Biomedicine on Aging (IBA), Friedrich-Alexander-University of Erlangen-Nürnberg
| | - Cornel Sieber
- Institute for Biomedicine on Aging (IBA), Friedrich-Alexander-University of Erlangen-Nürnberg
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales
| | - Kim Delbaere
- Neuroscience Research Australia, Margarete Ainsworth Building, University of New South Wales, Barker Street, Randwick NSW 2031, Australia
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Rabaglietti E, De Lorenzo A, Brustio PR. The Role of Working Memory on Dual-Task Cost During Walking Performance in Childhood. Front Psychol 2019; 10:1754. [PMID: 31417472 PMCID: PMC6685415 DOI: 10.3389/fpsyg.2019.01754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/15/2019] [Indexed: 11/20/2022] Open
Abstract
This study examined the effect of a secondary motor task on walking ability, whether performance differed according to age and the possible relationship between cognitive abilities, specifically working memory, and dual-task costs in children with typical development. Fifty-three female children (mean age M = 10 ± 2 years), were divided into two different age groups: a young (7–9 years; n = 17) and an older group (10–13 years; n = 36). First, participants performed a Walking Test (WT) without additional tasks; afterward, they performed the same walking test while performing each of the following tasks: carrying (1) a glass of water, (2) a ball on a round tray and (3) the combination of both tasks (1) and (2). The Test of Memory and Learning were used to assess working memory. WTs under a dual-task condition generally produced worse results compared to a single-task condition [F(3,135) = 32.480, p < 0.001]. No age-related difference was observed [F(1,45) = 0.497, p = 0.485]. Age, digit forward and backward, facial memory, and paired recall accounted altogether for 28.6% of variance in dual-task ability during WT while carrying a glass of water and a ball on a round tray. Specifically, facial memory significantly accounted for the variance of DTC in WTWT (β = −0.381, p = 0.016). Moreover, a trend toward a statistical significance was observed for digit forward (β = −0.275, p = 0.085). Results underlined that regardless of the age, a dual-task performance might affect walking performance depending on the required secondary task. Moreover, our results showed the association between working memory skills and dual-task cost in walking ability.
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Affiliation(s)
| | | | - Paolo Riccardo Brustio
- NeuroMuscularFunction Research Group, Department of Medical Sciences, School of Exercise and Sport Sciences, University of Turin, Turin, Italy
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Kim H, Zhao YL, Kim N, Ahn YH. Home modifications for older people with cognitive impairments: Mediation analysis of caregivers' information needs and perceptions of fall risks. Int J Older People Nurs 2019; 14:e12240. [PMID: 31099499 DOI: 10.1111/opn.12240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/13/2019] [Accepted: 04/15/2019] [Indexed: 01/22/2023]
Abstract
AIMS AND OBJECTIVES The aims were to (a) identify how many older people with cognitive impairments are living in modified homes and (b) explore associated factors, and (c) examine the mediating effects that their caregivers' information needs and perceptions of fall risk and other factors. BACKGROUND Older people and their informal caregivers may consider implementing home modifications as an effective strategy for fall prevention. However, there is a lack of information on which older people's homes receive modifications and the various factors associated with such modifications among community-dwelling older people with cognitive impairments. DESIGN This cross-sectional and correlational study utilises a secondary data analysis. METHODS The data for this secondary analysis were taken from the 2015 National Online Survey of Caregivers, which includes information provided by 226 adult caregivers for older people with cognitive impairments. Descriptive analyses, hierarchical binary logistic regression and structural equation modelling were performed based on the Andersen and Newman framework of health services utilisation. RESULTS Overall, 46.5% of the older people lived in modified homes. Older people's impaired activities for daily living (ADLs), caregivers' information needs and perceptions of fall risk were all associated with home modifications (all p values<0.05). Caregivers' information needs mediated the relationship between impaired ADLs and home modifications (indirect effect = 0.026, p < 0.05), whereas the caregivers' perceptions of fall risk did not. CONCLUSIONS Older people with both cognitive and functional impairments are more likely to modify their home on behalf of care recipient's staying at home. Caregivers' information needs should thus be prioritized when considering home modifications to facilitate caring for older people with impaired ADLs. IMPLICATION FOR PRACTICE Nurses and other healthcare professionals should be prepared to offer appropriate information and comprehensive assessments of older people's conditions with regard to home modifications.
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Affiliation(s)
- Heejung Kim
- College of Nursing, Yonsei University, Seodaemun-gu, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seodaemun-gu, Seoul, Korea
| | | | - Namhee Kim
- College of Nursing, Yonsei University, Seodaemun-gu, Seoul, Korea
| | - Yong Han Ahn
- Department of Architecture and Architectural Engineering, Hanyang University-ERICA, Ansan, Sangnok-gu, Korea
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Mulasso A, Brustio PR, Rainoldi A, Zia G, Feletti L, N'dja A, Del Signore S, Poggiogalle E, Luisi F, Donini LM. A comparison between an ICT tool and a traditional physical measure for frailty evaluation in older adults. BMC Geriatr 2019; 19:88. [PMID: 30898096 PMCID: PMC6427849 DOI: 10.1186/s12877-019-1089-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/26/2019] [Indexed: 02/07/2023] Open
Abstract
Background Frailty is a clinical condition among older adults defined as the loss of resources in one or more domains (i.e., physical, psychological and social domains) of individual functioning. In frail subjects emergency situations and mobility levels need to be carefully monitored. This study aimed to: i) evaluate differences in the mobility index (MI) provided by ADAMO system, an innovative remote monitoring device for older adults; ii) compare the association of the MI and a traditional physical measure with frailty. Methods Twenty-five community-dwelling older adults (71 ± 6 years; 60% women) wore ADAMO continuously for a week. The time percentage spent in Low, Moderate and Vigorous Activities was assessed using ADAMO system. Walking ability and frailty were measured using the 400 m walk test and the Tilburg Frailty Indicator, respectively. Results Controlling for age and gender, the ANCOVA showed that frail and robust participants were different for Low (frail = 58.8%, robust = 42.0%, p < 0.001), Moderate (frail = 25.5%, robust = 33.8%, p = 0.008), and Vigorous Activity (frail = 15.7%, robust = 24.2%, p = 0.035). Using cluster analysis, participants were divided into two groups, one with higher and one with lower mobility. Controlling for age and gender, linear regression showed that the MI clusters were associated with total (β = 0.571, p = 0.002), physical (β = 0.381, p = 0.031) and social (β = 0.652, p < 0.001) frailty; and the 400 m walk test was just associated with total (β = 0.404, p = 0.043) and physical frailty (β = 0.668, p = 0.002). Conclusion ADAMO system seems to be a suitable time tracking that allows to measure mobility levels in a non-intrusive way providing wider information on individual health status and specifically on frailty. For the frail individuals with an important loss of resources in physical domain, this innovative device may represent a considerable help in preventing physical consequences and in monitoring functional status.
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Affiliation(s)
- Anna Mulasso
- NeuroMuscular Function Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Paolo Riccardo Brustio
- NeuroMuscular Function Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Alberto Rainoldi
- NeuroMuscular Function Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Torino, Torino, Italy.
| | | | | | | | | | - Eleonora Poggiogalle
- Food Science and Human Nutrition Research Unit, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Federica Luisi
- Food Science and Human Nutrition Research Unit, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Lorenzo Maria Donini
- Food Science and Human Nutrition Research Unit, Department of Experimental Medicine, Sapienza University, Rome, Italy
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Dancing in the golden age: a study on physical function, quality of life, and social engagement. Geriatr Nurs 2018; 39:635-639. [DOI: 10.1016/j.gerinurse.2018.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/23/2018] [Indexed: 01/09/2023]
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Paraschiv-Ionescu A, Büla CJ, Major K, Lenoble-Hoskovec C, Krief H, El-Moufawad C, Aminian K. Concern about Falling and Complexity of Free-Living Physical Activity Patterns in Well-Functioning Older Adults. Gerontology 2018; 64:603-611. [PMID: 29972821 DOI: 10.1159/000490310] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fall-related psychological concerns are common among older adults, potentially contributing to functional decline as well as to restriction of activities and social participation. To effectively prevent such negative consequences, it is important to understand how even very low concern about falling could affect physical activity behavior in everyday life. We hypothesized that concern about falling is associated with a reduction in diversity, dynamics, and performance of daily activities, and that these features can be comprehensively quantified in terms of complexity of physical activity patterns. METHODS A sample of 40 community-dwelling older adults were assessed for concern about falling using the Falls Efficacy Scale-International (FES-I). Free-living physical activity was assessed using a set of metrics derived from data recorded with a chest-worn tri-axial accelerometer. The devised metrics characterized physical activity behavior in terms of endurance (total locomotion time, longest locomotion period, usual walking cadence), performance (cadence of longest locomotion period, locomotion periods with at least 30 steps and 100 steps/min), and complexity of physical activity patterns. Complexity was quantified according to variations in type, intensity, and duration of activities, and was considered as an adaptive response to environmental exigencies over the course of the day. RESULTS Based on FES-I score, participants were classified into two groups: not concerned at all/fully confident (n = 25) and concerned/less confident (n = 15). Demographic and health-related variables did not differ significantly between groups. Comparison of physical activity behavior indicated no significant differences for endurance-related metrics. In contrast, performance and complexity metrics were significantly lower in the less confident group compared to the fully confident group. Among all metrics, complexity of physical activity patterns appeared as the most discriminative feature between fully confident and less confident participants (p = 0.001, non-parametric Cliff's delta effect size = 0.63). CONCLUSIONS These results extend our understanding of the interplay between low concern about falling and physical activity behavior of community-dwelling older persons in their everyday life context. This information could serve to better design and evaluate personalized intervention programs in future prospective studies.
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Affiliation(s)
| | - Christophe J Büla
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | - Kristof Major
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | | | - Hélène Krief
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | - Christopher El-Moufawad
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Kamiar Aminian
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Brustio PR, Rabaglietti E, Formica S, Liubicich ME. Dual-task training in older adults: The effect of additional motor tasks on mobility performance. Arch Gerontol Geriatr 2017; 75:119-124. [PMID: 29245071 DOI: 10.1016/j.archger.2017.12.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/01/2017] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Dual-task (DT) performance is common to most activities of daily living and difficulties in DT activities may reduce quality of life in older adults. This study investigated the effect of DT training in a sample of older adults. METHODS Sixty older adults (mean=74.4±3.1years) participated in the study. Twenty-two older adults were included in the control (CG), 19 in the single-task (ST) training and 19 in DT training group. ST group received balance and walking training twice a week for16 weeks, while DT training group performed the same training with additional motor tasks. Data were gathered on 6m timed walk (6MTW), timed up and go test (TUG) and four square step test (FSST). DT conditions required participants to complete 6MTW, TUG and FSST, either (i) while carrying a glass of water or (ii) while carrying a ball on a round tray. RESULTS A significant Group x Time interaction was found in TUG (F [2,57]=29.5; p<0.01; partial η2=0.51) and in FSST (F [2,57]=23.2; p<0.01; partial η2=0.44). After intervention DT showed better scores in overall TUG (mean difference=1.21s [95% CI, 0.82-1.60]; p<0.05) and FSST (mean difference=2.51s [95% CI, 1.67-3.35]; p<0.01), whereas CG and ST did not exhibit significant changes. CONCLUSION Our results suggested that 16 weeks of motor DT training, using motor additional tasks as manipulation of common objects of everyday life, could improve mobility in older age.
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Affiliation(s)
- Paolo Riccardo Brustio
- NeuroMuscularFunction Research Group, School of Exercise and Sport Sciences, Department of Medical Sciences, University of Torino, Torino, Italy; Department of Psychology, University of Torino, Torino, Italy.
| | - Emanuela Rabaglietti
- Department of Psychology, University of Torino, Torino, Italy; SUISM, Centro Servizi, University of Torino, Torino, Italy
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Kong W, Wanning L, Sessa S, Zecca M, Magistro D, Takeuchi H, Kawashima R, Takanishi A. Step Sequence and Direction Detection of Four Square Step Test. IEEE Robot Autom Lett 2017. [DOI: 10.1109/lra.2017.2723929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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