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Hu K, Guan Z, He Z, Luo S, Fang H, Zhang Y, Ding L, Xu Y, Jiang L, Fu C, Zhao X, Jia J, Wu C. Mechanical Property, Efficacy, and User Experience of an Innovative Wearable Device in Preventing Fall-Induced Injuries. Innov Aging 2024; 8:igae066. [PMID: 39131202 PMCID: PMC11310589 DOI: 10.1093/geroni/igae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Indexed: 08/13/2024] Open
Abstract
Background and Objectives With the global population aging at an unprecedented pace, the imminent surge in falls and fall-induced injuries necessitates urgent attention. Innovative assistive technologies are crucial in addressing this daunting challenge. This study aimed to evaluate the mechanical properties, efficacy, safety, and user experience of the Intelligent Bone Protection Vest (IBPV), a novel, reusable, non-airbag wearable device. Research Design and Methods The IBPV integrates a machine learning-based algorithm for real-time monitoring of wearer motion and a unique honeycomb-structured foldable cushion for fall impact attenuation. We evaluated the impact attenuation capabilities of the IBPV and conducted 2 human subject studies to assess its efficacy and safety. Additionally, semistructured interviews were conducted to qualitatively explore its usability, safety, and opportunities for enhancement. Results The compression tests confirmed the energy absorption capacity of the honeycomb-structured foldable cushion. In over 800 fall tests involving 14 young and middle-aged subjects using a touchdown fall test, as well as 7 older subjects using a novel fall simulation test, the IBPV demonstrated an overall protection rate exceeding 84%. Discussion and Implications These results underscored the potential of the IBPV in reducing fall-induced injuries by mitigating the impact force on the hip during falls. Future studies with more rigorous design are needed to confirm whether this active wearable device may serve as a dependable fall protection product.
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Affiliation(s)
- Kaixin Hu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyang Guan
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
- School of Population Health, Faculty of Health Science, Curtin University, Bentley, Western Australia, Australia
| | - Zhijie He
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Siran Luo
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Hongbin Fang
- Institute of AI and Robotics, Fudan University, Shanghai, China
| | - Yan Zhang
- Suzhou Youxing Health Technology Co., Ltd, Suzhou, Jiangsu, China
| | - Li Ding
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Xu
- Shanghai Jinshan Zhongren Aged Care Hospital, Shanghai, China
| | - Liuya Jiang
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai, China
| | - Conghui Fu
- Shanghai Jinshan Zhongren Aged Care Hospital, Shanghai, China
| | - Xiaoqing Zhao
- Suzhou Youxing Health Technology Co., Ltd, Suzhou, Jiangsu, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
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Fujisawa C, Umegaki H, Sugimoto T, Nakashima H, Komiya H, Watanabe K, Nagae M, Yamada Y, Tajima T, Sakai T, Sakurai T. Objective physical function declines in the absence of subjective physical complaints among patients with amnestic mild cognitive impairments and mild alzheimer's disease. Eur Geriatr Med 2024:10.1007/s41999-024-01005-x. [PMID: 38877373 DOI: 10.1007/s41999-024-01005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/05/2024] [Indexed: 06/16/2024]
Abstract
PURPOSE To examine the extent to which patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) perceive their own physical decline. METHODS This study included 4450 outpatients (1008 normal cognition [NC], 1605 aMCI, and 1837 mild AD) who attended an initial visit to a memory clinic between July 2010 and June 2021. Their physical function was assessed by the Timed Up and Go test, one-leg standing test, and grip strength. For physical complaints, data were obtained on reports of fear of falling and dizziness or staggering. Logistic regression analysis was performed to compare the patients' physical function and complaints for each stage of NC, aMCI, and mild AD. RESULTS Objective physical function declined from aMCI and the mild AD stage, but subjective physical complaints decreased by 20-50% in aMCI and 40-60% in mild AD compared with the NC group. CONCLUSION As objective physical functional declined from the aMCI stage onward, subjective physical complaints decreased. This suggests a need for objective assessment of physical function in aMCI and mild AD patients even when they have no physical complaints in the clinical setting.
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Affiliation(s)
- Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan.
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan.
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Taiki Sugimoto
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Tomihiko Tajima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Tomomichi Sakai
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Mahmoudzadeh Khalili S, Simpkins C, Yang F. A Meta-Analysis of Fall Risk in Older Adults With Alzheimer's Disease. J Am Med Dir Assoc 2024; 25:781-788.e3. [PMID: 38378160 PMCID: PMC11065606 DOI: 10.1016/j.jamda.2024.01.005] [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: 08/31/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES Falls are the leading cause of injuries in older adults. Although it is well recognized that Alzheimer's disease (AD) increases the fall risk of older adults, the reported fall risk in people with AD varies drastically. The principal purpose of this study was to summarize and synthesize previous studies reporting fall risk-related metrics in people with AD. DESIGN This was a meta-analysis. SETTING AND PARTICIPANTS Thirty-one studies reporting relevant fall data among 4654 older adults with AD were included. METHODS The fall prevalence, average number of falls, rate of recurrent fallers, and rate of injured fallers of included studies were meta-analyzed using random-effects models with inverse variance weights. RESULTS The pooled annual fall prevalence in older people with AD is 44.27% with an average annual number of falls of 1.30/person and a yearly rate of recurrent fallers of 42.08%. The reported rate of injured fallers was 45.0%. CONCLUSIONS AND IMPLICATIONS Our results reinforce that people with AD experience a higher fall risk than their cognitively healthy counterparts. The pooled fall metrics in this meta-analysis extend our understanding of the fall risk in people with AD. In addition, standardized approaches are needed to report fall-related data for people with AD.
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Affiliation(s)
| | - Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA, USA.
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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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Abou L, Peters J, Freire B, Sosnoff JJ. Fear of falling and common symptoms of multiple sclerosis: Physical function, cognition, fatigue, depression, and sleep - A systematic review. Mult Scler Relat Disord 2024; 84:105506. [PMID: 38422635 DOI: 10.1016/j.msard.2024.105506] [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: 01/12/2024] [Revised: 02/03/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Fear of falling (FOF) is a common concern among persons with multiple sclerosis (MS) and affects the performance of their daily living activities. Falls may result in FOF, leading to worsening of symptoms of MS, physical deconditioning, and exposure to future falls. This may trigger a vicious cycle between FOF and falls. A better understanding of the relationship between FOF and symptoms of MS may be helpful to develop a conceptual model to guide fall prevention interventions. OBJECTIVE To synthesize the correlational and predictive relationships between FOF and common symptoms of MS. METHODS Databases including PubMed, Embase, Web of Science, Scopus, CINHAL, PsycINFO, and SPORTDiscuss were searched from inception to October 2023. Studies examining correlations and/or predictions between FOF and common MS symptoms that include measures of gait, postural control, fatigue, cognition, pain, sleep, depression, and anxiety were identified by two independent reviewers. Both reviewers also conducted the methodological quality assessment of the included studies. RESULTS Twenty-three studies with a total of 2819 participants were included in the review. Correlational findings indicated that increased FOF was significantly associated with greater walking deficits (lower gait speed, smaller steps), reduced mobility, and poorer balance. Increased FOF was also significantly correlated with higher cognitive impairments, more fatigue, sleep disturbances, and depression. Decreased gait parameters, reduced balance, lower physical functions, cognitive impairments, and sleep deficits were found as significant predictors of increased FOF. CONCLUSION Evidence indicates significant correlational and bidirectional predictive relationships exist between FOF and common MS symptoms. A comprehensive conceptual framework accounting for the interaction between FOF and MS symptoms is needed to develop effective falls prevention strategies.
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Affiliation(s)
- Libak Abou
- Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | - Joseph Peters
- Kansas City University College of Osteopathic Medicine, Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Bruno Freire
- Health and Sports Sciences Center, Santa Catarina State University, Florianópolis, SC, Brazil
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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Yao S, Chen XW. The association between depressive symptoms with fear of falling and cognitive decline in older adults in the Korean community: An analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006-2020. Arch Gerontol Geriatr 2024; 117:105177. [PMID: 37690256 DOI: 10.1016/j.archger.2023.105177] [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: 07/03/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES This study aimed to investigate the effects of fear of falling (FOF) on cognitive decline in older adults in the Korean community, depending on the presence of accompanying depressive symptoms. METHODS A total of 6263 individuals were included in the final analysis. Based on their baseline evaluation results for depressive symptoms and FOF, the subjects were divided into four groups: "normal control" (NC, n = 3783), "depression only" (Dep-only, n = 291), "fear of falling only" (FOF-only, n = 1755), and "depression with fear of falling" (Dep-FOF, n = 434). Cognitive decline was defined as a loss of more than three points in the K-MMSE score in participants with at least two years of follow-up. We examined the association between FOF accompanied by depressive symptoms and cognitive decline using a multivariate Cox proportional hazard model. RESULTS Cognitive decline occurred in 76.3%, 68.5%, 63.9%, and 56.4% of the Dep-FOF, FOF-only, Dep-only, and NC groups, respectively. Our findings suggest that individuals with FOF do not always have cognitive decline (HR = 1.03, 95% CI = 0.95-1.12, P = 0.43) compared to individuals without FOF. Furthermore, depressive symptoms with FOF are associated with a higher risk of cognitive decline (HR = 1.23, 95% CI = 1.08-1.41, P = 0.002) in community-dwelling older adults in Korea. CONCLUSION Healthcare providers should be attentive to community-dwelling older adults who experience both depressive symptoms and FOF because our findings suggest that this unique combination increases the risk of cognitive decline.
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Affiliation(s)
- Shaoli Yao
- Department of Neurology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China.
| | - Xi-Wen Chen
- Department of Neurology, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, Sichuan, China
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Alissa N, Rehan R, Al-Sharman A, Latrous M, Aburub AS, El-Salem K, Morris L, Khalil H. Cognitive status and sleep quality can explain the fear of falling and fall history in people with Parkinson's disease. Int J Rehabil Res 2023; 46:338-343. [PMID: 37581294 DOI: 10.1097/mrr.0000000000000596] [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: 08/16/2023]
Abstract
Fear of falling (FOF) is highly prevalent in people with Parkinson's disease (PwPD) and contributes to high fall risk. Studies reporting on the relationship between falls, FOF, and non-motor factors such as cognitive function and sleep quality in Parkinson's disease are limited. This study aimed to investigate (1) the relationship of cognitive function and sleep quality with FOF, and history of falls in PwPD; (2) differences in cognitive function and sleep quality between Parkinson's disease fallers and non-fallers; and (3) a cut-off score for cognitive function and sleep quality to discriminate Parkinson's disease fallers from non-fallers. Fifty PwPD were assessed for FOF [Falls Efficacy Scale-International (FES-I)], cognition [Montréal Cognitive Assessment (MOCA)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and falls history. The MOCA is significantly associated with FES-I scores ( R2 = 0.429, P < 0.0001). Both MOCA ( P = 0.012) and PSQI ( P = 0.027) were associated with falls history even after adjusting for confounding factors (age, sex, L-dopa use, Parkinson's disease severity). Both MOCA and PSQI scores were able to distinguish fallers from non-fallers with cut-off scores of 15.5 and 7.5, respectively. Although our findings revealed that both cognitive function and sleep quality are important factors influencing falls and FOF in PwPD, it remains to be determined if addressing cognitive impairments and poor sleep quality may favorably impact balance before integrating such screenings into fall prevention programs.
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Affiliation(s)
- Nesreen Alissa
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, Baltimore, Maryland, USA
| | - Reem Rehan
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Department of Physical Therapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mariem Latrous
- Department of Physical Therapy and Rehabilitation Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Ala' S Aburub
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Department of Physiotherapy, Israa University, Amman
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Linzette Morris
- Department of Physical Therapy and Rehabilitation Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hanan Khalil
- Department of Physical Therapy and Rehabilitation Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Conceição ASGG, Sant Ana LFG, Mattar GP, de Fátima R Silva M, Ramos AR, Oliveira AM, Carvalho CL, Gonçalves OR, Varotto BLR, Martinez LD, Leduc V, Fonseca LM, Forlenza OV. Balance and Gait: Associations With Cognitive Impairment and Dementia in Individuals With Down Syndrome. Alzheimer Dis Assoc Disord 2023; 37:349-356. [PMID: 37788381 DOI: 10.1097/wad.0000000000000580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/14/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS. METHODS We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities. RESULTS The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia ( P <0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score ( P <0.05). CONCLUSION A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.
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Affiliation(s)
| | - Lívea F G Sant Ana
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Guilherme P Mattar
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Maria de Fátima R Silva
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
- Old Age Research Group, Department and Institute of Psychiatry
| | - Andressa R Ramos
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | | | - Claudia L Carvalho
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | | | - Bruna L R Varotto
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Luana D Martinez
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Vinícius Leduc
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Luciana M Fonseca
- Dental Team, Instituto de Psiquiatria do, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, Brazil
- Department of Community and Behavioral Health, Washington State University, Pullman, WA
| | - Orestes V Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
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Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer's disease. Ir J Med Sci 2023; 192:2401-2408. [PMID: 36656422 DOI: 10.1007/s11845-023-03279-9] [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: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Optimal trunk control relies on adequate musculoskeletal, motor, and somatosensory systems that are often affected in people with Alzheimer's disease (AD). Therefore, the aim of this study was to compare trunk control between people with AD and healthy older adults, and investigate the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with AD. METHODS The study was completed with 35 people with AD and 33 healthy older adults with matching age and gender. Trunk control was evaluated with Trunk Impairment Scale (TIS); balance with Berg Balance Scale (BBS), Functional Reach Test (FRT), One-Leg Standing Test (OLST) and Five-Repeat Sit-and-Stand Test (5STS); gait with Dynamic Gait Index (DGI); functional mobility with Timed Up and Go (TUG) Test; fear of falling with Falls Efficacy Scale-International (FES-I). RESULTS BBS, FRT, OLST, and DGI scores were lower and 5STS and TUG Test scores were higher in people with AD compared to healthy older adults (p < 0.05). There was no difference in FES-I score between people with AD and healthy older adults (p > 0.05). TIS was associated with BBS, FRT, OLST, 5STS, DGI, TUG Test, and FES-I (r between - 0.341 and 0.738; p < 0.05 for all). CONCLUSION Trunk control is affected and related with balance, gait, functional mobility, and fear of falling in people with AD. For this reason, we think that trunk control should be evaluated in the early period, and applications for trunk control should be included in rehabilitation approaches in order to improve balance, gait, functional mobility, and reduce fear of falling.
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Affiliation(s)
- Taskin Ozkan
- Giresun University, Vocational School of Health Services, Therapy and Rehabilitation, Giresun, 28200, Turkey.
| | | | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
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Minta K, Colombo G, Taylor WR, Schinazi VR. Differences in fall-related characteristics across cognitive disorders. Front Aging Neurosci 2023; 15:1171306. [PMID: 37358956 PMCID: PMC10289027 DOI: 10.3389/fnagi.2023.1171306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Approximately 40-60% of falls in the elderly lead to injuries, resulting in disability and loss of independence. Despite the higher prevalence of falls and morbidity rates in cognitively impaired individuals, most fall risk assessments fail to account for mental status. In addition, successful fall prevention programmes in cognitively normal adults have generally failed in patients with cognitive impairment. Identifying the role of pathological aging on fall characteristics can improve the sensitivity and specificity of fall prevention approaches. This literature review provides a thorough investigation into fall prevalence and fall risk factors, the accuracy of fall risk assessments, and the efficacy of fall prevention strategies in individuals with diverse cognitive profiles. We show that fall-related characteristics differ between cognitive disorders and fall risk assessment tools as well as fall prevention strategies should critically consider each patient's cognitive status to facilitate the identification of fallers at an earlier stage and support clinical decision-making.
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Affiliation(s)
- Karolina Minta
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Giorgio Colombo
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - William R. Taylor
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Department of Health Sciences and Technology, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Victor R. Schinazi
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Department of Psychology, Bond University, Gold Coast, QLD, Australia
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Grimme SA, Kollakidou A, Sønderskov Zarp C, Hornecker E, Krüger N, Graf P, Marchetti E. Floor Cleaners as Helper Pets: Projecting Assistive Robots' Agency on Zoomorphic Affordances. SN COMPUTER SCIENCE 2023; 4:372. [PMID: 37152861 PMCID: PMC10148613 DOI: 10.1007/s42979-023-01769-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/03/2023] [Indexed: 05/09/2023]
Abstract
Care of ageing adults has become a dominant field of application for assistive robot technologies, promising support for ageing adults residing in care homes and staff, in dealing with practical routine tasks and providing social and emotional relieve. A time consuming and human intensive necessity is the maintenance of high hygiene quality in care homes. Robotic vacuum cleaners have been proven effective for doing the job elsewhere, but-in the context of care homes-are counterproductive for residents' well-being and do not get accepted. This is because people with dementia manifest their agency in more implicit and emotional ways, while making sense of the world around them. Starting from these premises, we explored how a zoomorphic designed vacuum cleaner could better accommodate the sensemaking of people with dementia. Our design reconceptualises robotic vacuum cleaners as a cat-like robot, referring to a playful behaviour and appearance to communicate a non-threatening and familiar role model. Data from an observational study shows that residents responded positively to our prototype, as most of them engaged playfully with it as if it was a pet or a cat-like toy, for example luring it with gestures. Some residents simply ignored the robot, indicating that it was not perceived as frightening or annoying. The level of activity influenced reactions; residents ignored our prototype if busy with other occupations, which proves that it did not cause significant disturbance. We further report results from focus group sessions with formal and informal caregivers who discussed a video prototype of our robot. Caregivers encouraged us to enhance the animal like characteristics (in behaviour and materiality) even further to result in richer interactions and provoke haptic pleasure but also pointed out that residents should not mistake the robot for a real cat.
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Affiliation(s)
- Sophie Alice Grimme
- OFFIS e.V., Institut für Informatik, Escherweg 2, 26121 Oldenburg, Germany
- Bauhaus-Universität Weimar, Bauhausstraße 11, 99423 Weimar, Germany
| | - Avgi Kollakidou
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | | | - Eva Hornecker
- Bauhaus-Universität Weimar, Bauhausstraße 11, 99423 Weimar, Germany
| | - Norbert Krüger
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Philipp Graf
- Bauhaus-Universität Weimar, Bauhausstraße 11, 99423 Weimar, Germany
- Chemnitz Technical University, Straße der Nationen 62, 09111 Chemnitz, Germany
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12
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Hopkins J, Hill K, Jacques A, Burton E. Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis. Clin Rehabil 2022; 37:215-243. [PMID: 36189497 DOI: 10.1177/02692155221129832] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To identify falls prevalence, falls risk factors and evaluate the effectiveness of falls prevention interventions for community-dwelling people with Mild Cognitive Impairment. DATA SOURCES Peer-reviewed articles (inception to 4 August 2022) from PubMed, CINAHL, PsycInfo, EMBASE, Scopus, SportDiscus and the Cochrane library. REVIEW METHODS All types of methodological approaches were considered. Inclusion criteria were community-dwelling; diagnosis of Mild Cognitive Impairment; aged 50+ years. Interventions needed to include falls prevention programs aiming to reduce falls and/or risk of falls. Outcomes of interest included number and/or rate of falls, falls prevalence and falls risk factors. For controlled trials, any control group was included. Quality assessment was completed using Cochrane's Risk of Bias Tool for randomized controlled trials and the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields for all other studies. Where statistical data pooling was not possible, narrative synthesis was used to present data in tables and figures. RESULTS Forty-seven studies were included. Prevalence of falls was 43% when data were gathered prospectively for 12 months. Confirmed falls risk factors included slow gait, dual-tasking, postural control and non-amnesic Mild Cognitive Impairment. Few studies evaluated interventions to reduce falls. Six meta-analyses were conducted, no significant reduction in falls was found. CONCLUSIONS Until further high-quality, adequately powered studies are available to guide practice, best practice guidelines recommend balance training as a core component of falls prevention programs for older people generally, as well as people with Mild Cognitive Impairment.
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Affiliation(s)
- Jane Hopkins
- Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia
| | - Keith Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Angela Jacques
- Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia.,Institute for Health Research, 3431University of Notre Dame Australia, Fremantle, WA, Australia
| | - Elissa Burton
- Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia.,enAble Institute, 1649Curtin University, Perth, WA, Australia
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13
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Shiratsuchi D, Makizako H, Nakai Y, Bae S, Lee S, Kim H, Matsuzaki-Kihara Y, Miyano I, Ota H, Shimada H. Associations of fall history and fear of falling with multidimensional cognitive function in independent community-dwelling older adults: findings from ORANGE study. Aging Clin Exp Res 2022; 34:2985-2992. [PMID: 36050582 DOI: 10.1007/s40520-022-02235-4] [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: 05/23/2022] [Accepted: 08/18/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community. AIM To analyse the associations between fall history and FoF and multidimensional cognitive function in independent community-dwelling older adults. METHODS The data from 9759 (73.3 ± 5.4 years, 59.9% women) older individuals enrolled in the cross-sectional ORANGE study were analysed. Simple questions were used to assess fall history in the past year and current FoF. Assessments of multidimensional cognitive function were performed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) to evaluate memory, attention, executive function, and processing speed. The independent associations of fall history and FoF with multidimensional cognitive function were assessed using multivariate linear regressions adjusted for potential confounding variables. RESULTS A total of 18.3% and 35.4% of participants presented with fall history and FoF, respectively. Fall history (p = 0.008) and FoF (p = 0.002) were significantly associated with memory. FoF, but not fall history was associated with attention (p = 0.004), executive function (p < 0.01), and processing speed (p < 0.01). CONCLUSION In independent community-dwelling older adults, fall history was associated only with the memory domain; in contrast, fear of falling was associated with multidimensional cognitive function. This study provides weak evidence suggesting the need to assess falls and FoF in all situations involving independent community-dwelling older adults.
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Affiliation(s)
- Daijo Shiratsuchi
- Graduate School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.,Department of Rehabilitation, Japan Community Health Care Organization Kumamoto General Hospital, 10-10 Toricho, Yatsushiro, Kumamoto, 866-8660, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kagoshima, 899-4395, Japan
| | - Seongryu Bae
- Department of Health Care and Science, Dong-A University, 37 Nakdong-Daero 550beon-gil Saha-Gu, Busan, 604-714, Korea
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi , Tokyo, 173-0015, Japan
| | - Yuriko Matsuzaki-Kihara
- Department of Rehabilitation, Japan Health Care College, 11-1-50 Tsukisamuhigashi3jo, Toyohira, Sapporo, Hokkaido, 062-0053, Japan
| | - Ichiro Miyano
- Department of Public Health, Kochi Medical School, Kochi University, Oko, Nankoku, Kochi, 783-8505, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
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14
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Rondão CADM, Mota MP, Oliveira MM, Peixoto F, Esteves D. Multicomponent exercise program effects on fitness and cognitive function of elderlies with mild cognitive impairment: Involvement of oxidative stress and BDNF. Front Aging Neurosci 2022; 14:950937. [PMID: 36092805 PMCID: PMC9453672 DOI: 10.3389/fnagi.2022.950937] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Regular exercise has been shown to be one of the most important lifestyle influences on improving functional performance, and decreasing morbidity and all-cause mortality among older people. However, although there is some evidence on the effects of aerobic training on oxidative stress, there is little information regarding the effects of multicomponent exercise (dual-task training) and combination of exercise with cognitive stimulation on oxidative stress. In this context, the aim of this study was to verify the effects of a multicomponent exercise program on physical fitness and cognitive function in the elderly with mild cognitive impairment and determine the role of oxidative stress and brain-derived neurotrophic factor (BDNF). At baseline, 37 elderly nursing home residents with mild cognitive impairment were divided into two groups: the control group (CG, n = 12, 81.8 years) and the experimental group (EG, n = 25, 83.2 years). These elderlies followed multicomponent exercise training for 24 weeks, with two sessions per week and 45–50 min per session. The exercises included both aerobic and strength exercises, considering functional movements and light to moderate intensity. Cognitive stimulation comprehended exercises based on word games, puzzles, mathematical calculations, forward and backward counting, computer exercises, exergames, and games on a balanced platform. Physical assessments (weight, height, and body mass index), health and functional parameters (fitness tests: chair stand, arm curls, chair sit-and-reach, eight feet up-and-go, back scratch, 6-min walking, feet together, semi-tandem, and full tandem), lipid profile (total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides), measures of lipid peroxidation damage, thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), and BDNF were measured in plasma, based on which analyses were performed before and after the 24 weeks of the multicomponent exercise intervention. The results showed an overall improvement in physical and functional performance. Regarding biochemical measures, multicomponent exercises lead to a significant decrease in oxidative damage. The results indicate that multicomponent exercise training induces benefits in functional capacity and reduces damage due to oxidative stress.
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Affiliation(s)
- Catarina Alexandra de Melo Rondão
- Department of Sports, University of Beira Interior, Covilhã, Portugal
- Camara Municipal do Fundão, Fundão, Portugal
- *Correspondence: Catarina Alexandra de Melo Rondão
| | - Maria Paula Mota
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Maria Manuel Oliveira
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Centro de Química, Vila Real, Portugal
| | - Francisco Peixoto
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Centro de Química, Vila Real, Portugal
| | - Dulce Esteves
- Department of Sports, University of Beira Interior, Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
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15
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Özden F, Yıldız Kızkın Z, Özkeskin M. Psychometric Properties of the Turkish Version of the Fear of Falling Questionnaire-Revised (FFQ-R) in Nursing Home Residents with Mild Cognitive Decline. Exp Aging Res 2022; 49:360-371. [PMID: 35916299 DOI: 10.1080/0361073x.2022.2106716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of the study was to investigate the validity and reliability of the Turkish version of the Fear of Falling Questionnaire-Revised (FFQ-R) in older adults with mild cognitive impairment (MCI) living in a nursing home. METHODS The study was conducted with 107 (69 women) older adults. The participants were evaluated with the FFQ-R, the Falls Efficacy Scale (FES), the Mini-Mental State Examination (MMSE), the Barthel Index and Montgomery-Åsberg Depression Rating Scale (MADRS)". FFQ-R was refilled one month later for retesting. RESULTS Cronbach's alpha value of the FFQ-R was 0.971. The global internal consistency was excellent (>0.80). Intraclass correlation coefficient of the FFQ-R was 0.962 (95% CI: 0.92-0.98), indicating excellent test-retest reliability. The Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) values of the FFQ-R was 0.80 and 2.21, respectively. The correlation between the total score of FFQ-R and the FES was excellent (r = 0.963, p < .001). The relationship between FFQ-R and MMSE was excellent (r = -0.821, p < .001). Besides, there was a moderate correlation between the FFQ-R with Barthel Index (r = -0.648, p < .001) and FFR-Q with MADRS (r = 0.568, p < .001). CONCLUSION Turkish version of the FFQ-R is a valid and reliable tool to assess the fear of falling in nursing home residents.
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Affiliation(s)
- Fatih Özden
- Department of Elderly Care, Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Muğla, Turkey
| | - Zeynep Yıldız Kızkın
- Department of Occupational Therapy, Artvin Çoruh University, Vocational School of Health Services, Artvin, Turkey
| | - Mehmet Özkeskin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ege University, İzmir, Turkey
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16
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Chen PH, Yang YY, Liao YY, Cheng SJ, Wang PN, Cheng FY. Factors Associated with Fear of Falling in Individuals with Different Types of Mild Cognitive Impairment. Brain Sci 2022; 12:brainsci12080990. [PMID: 35892431 PMCID: PMC9332262 DOI: 10.3390/brainsci12080990] [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: 07/05/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
Mild cognitive impairment (MCI) is considered an intermediate state between normal aging and early dementia. Fear of falling (FOF) could be considered a risk indicator for falls and quality of life in individuals with MCI. Our objective was to explore factors associated with FOF in those with MCI due to Alzheimer’s disease (AD-MCI) and mild cognitive impairment in Parkinson’s disease (PD-MCI). Seventy-one participants were separated into two groups, AD-MCI (n = 37) and PD-MCI (n = 34), based on the disease diagnosis. FOF was assessed using the Activities-specific Balance Confidence scale. The neuropsychological assessment and gait assessment were also measured. FOF was significantly correlated with global cognitive function, attention and working memory, executive function, Tinetti assessment scale scores, gait speed, and stride length in the AD-MCI group. Moreover, attention and working memory were the most important factors contributing to FOF. In the PD-MCI group, FOF was significantly correlated with gait speed, and time up and go subtask performance. Furthermore, turn-to-walk was the most important factor contributing to FOF. We noted that FOF in different types of MCI was determined by different factors. Therapies that aim to lower FOF in AD-MCI and PD-MCI populations may address attention and working memory and turn-to-walk, respectively.
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Affiliation(s)
- Pei-Hao Chen
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei 106, Taiwan
| | - Ya-Yuan Yang
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Kaifeng Minquan Day Care Center, Taipei 104, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Shih-Jung Cheng
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Department of Neurology, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Correspondence: ; Tel.: +886-226-360-303
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17
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Chronic pain as a moderator between fear of falling and poor physical performance among community-dwelling older adults. Geriatr Nurs 2022; 45:140-146. [DOI: 10.1016/j.gerinurse.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022]
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18
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Kraut R, Holtzer R. Recurrent but not single report of fear of falling predicts cognitive decline in community-residing older adults. Aging Ment Health 2022; 26:100-106. [PMID: 33938782 DOI: 10.1080/13607863.2021.1916878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Literature regarding the association of fear of falling (FOF), a common concern in aging, and cognition is scarce. Moreover, whether frequency of FOF endorsement influences age-related cognitive decline has not been reported. Here we determined whether FOF status (no FOF, single-report FOF, recurrent FOF), predicted decline in global cognitive function (GCF), memory, and attention/executive functions. METHODS Participants were community-residing older adults (n = 421; mean age = 76.29 ± 6.48; %female = 56.06). FOF was assessed bimonthly through yes/no responses to "do you have a fear of falling?" during the first year of the study. Recurrent status required two or more FOF endorsements. GCF was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS); composite scores were used to assess memory as well as attention/executive functions. Cognitive measures were administered annually for up to six years. RESULTS Stratification of the cohort by FOF status showed that 81 participants reported recurrent FOF, 60 participants endorsed FOF once and 280 participants reported no FOF. Linear mixed effects models revealed that compared to no FOF, recurrent FOF was associated with worse declines in GCF (estimate=-0.03, p=.006), memory (estimate=-0.04, p=.012) and attention/executive functions (estimate=-0.04, p=.006). Comparisons between single-report FOF and no FOF, however, were not significant. CONCLUSIONS These findings demonstrate that recurrent but not single-report FOF is a risk factor for cognitive decline in community-residing older adults.
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Affiliation(s)
- Rebecca Kraut
- Ferkauf Graduate School of Psychology, Clinical Psychology Doctorate Program, Yeshiva University, New York, New York, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Clinical Psychology Doctorate Program, Yeshiva University, New York, New York, USA.,Neurology, Albert Einstein College of Medicine, New York, New York, USA
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19
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Cognitive performances better identify fallers than mobility assessment among older adults with fear of falling. Aging Clin Exp Res 2021; 33:2709-2714. [PMID: 31576516 DOI: 10.1007/s40520-019-01338-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 08/23/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Half of the people with fear of falling (FoF) are non-fallers, and the reason why some people considered non-fallers are afraid of falling is unknown, but reduced mobility or cognition, or both concurrently must be considered as potential risk factors. AIM The study aimed to determine if mobility and/or cognitive abilities could identify people with a history of falls in older adults with FoF. METHODS Twenty-six older adults with FoF participated in this study. Full cognitive and mobility assessments were performed assessing global cognitive impairments (MoCA score < 26), executive functions, memory, processing speed, visuospatial skills, mobility impairment (TUG time > 13.5 s), gait, balance and physical capacity. Information about falls occurring during the year prior to the inclusion was collected. Logistic regression analyses were performed to explore the association between falls and cognitive and mobility abilities. RESULTS No significant differences in age, sex, level of education or body mass index were detected between fallers and non-fallers. Cognitive impairments (MoCA score < 26) distinguished between fallers and non-fallers (p = 0.038; R2 = 0.247). Among specific cognitive functions, visuospatial skills distinguished between fallers and non-fallers (p = 0.027; R2 = 0.258). Mobility impairments (TUG time > 13.5 s), gait, balance and physical capacity were not related to past falls. DISCUSSION/CONCLUSION In older adults with FoF, global cognitive deficits detected by the MoCA are important factors related to falls and more particularly visuospatial skills seem to be among the most implicated functions. These functions could be targeted in multifactorial interventions.
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20
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Lenouvel E, Novak L, Biedermann A, Kressig RW, Klöppel S. Preventive treatment options for fear of falling within the Swiss healthcare system : A position paper. Z Gerontol Geriatr 2021; 55:597-602. [PMID: 34590162 PMCID: PMC9587118 DOI: 10.1007/s00391-021-01957-w] [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: 01/07/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022]
Abstract
Fear of falling (FoF) results in social, functional, physical, and psychological symptoms, including secondary disorders, such as depression and general anxiety disorder (GAD). A vicious cycle develops, where symptoms maintain and reinforce FoF and its consequences, including increasing the risk of falling. In this position paper, we suggest screening for FoF using the falls efficacy scale international (FES-I) questionnaire. The presence of a high score (> 23) warrants an investigation into frailty and exclusion of depression and GAD, during the clinical interview. Stratifying frailty, based on the Fried frailty criteria will guide treatment options based on the most significant health concerns. Frail older adults should first receive physiotherapy and exercise interventions, as physical disabilities are their most significant characteristic, while pre-frail and non-frail older adults should receive multicomponent interventions, consisting of cognitive behavioral therapy (CBT) with physical exercise. The non-frail with predominantly GAD and depression should receive specialized CBT interventions. Currently, only exercise interventions are available for FoF treatment in Switzerland. Although some exercise interventions use CBT elements, such as goal setting and reflections on behavior and feelings, they are not systematically used, are not part of a quality-assured procedure, and do not address the psychological-cognitive aspects of FoF. As the pre-frail and non-frail are the largest groups to use these services, adapting current exercise programs by incorporating a CBT component would be the most practical means to provide optimized care.
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Affiliation(s)
- Eric Lenouvel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Murtenstraße 21, 3008, Bern, Switzerland. .,Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Lan Novak
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Murtenstraße 21, 3008, Bern, Switzerland
| | | | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER & University of Basel, Basel, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Murtenstraße 21, 3008, Bern, Switzerland
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21
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Yang R, Xu D, Wang H, Xu J. Longitudinal trajectories of physical functioning among Chinese older adults: the role of depressive symptoms, cognitive functioning and subjective memory. Age Ageing 2021; 50:1682-1691. [PMID: 34228776 DOI: 10.1093/ageing/afab135] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Maintaining physical functioning (i.e. mobility, activities of daily living [ADLs], instrumental activities of daily living [IADLs]) in older adults is essential for independent living. However, little is known about how longitudinal trajectories of physical functioning differ by varying levels of depressive symptoms, subjective memory impairment and cognitive functioning. We aimed to examine whether, and to what degree, the rate of change in physical functioning over time was associated with depressive symptoms, subjective memory and cognitive functioning. DESIGN A correlational longitudinal design. METHODS The sample included 5,519 older adults (mean age = 68.13 years) from the China Health and Retirement Longitudinal Study (three waves: 2011-15) who self-reported their depressive symptoms, subjective memory impairment and physical functioning. Cognitive functioning was assessed through interview-based tests. RESULTS There were significant increases in mobility impairment (β = 0.27, P < 0.001), ADLs impairment (β = 0.05, P < 0.001) and IADLs impairment (β = 0.03, P = 0.006) over time. Compared with the mean score at baseline in 2011, the mobility, ADLs and IADLs impairment increased by 13.32, 10.57 and 4.34% for every 2 years, respectively. Those with high depressive symptoms had accelerated rates of mobility (β = 0.212, P < 0.001), ADLs (β = 0.104, P < 0.001) and IADLs impairment (β = 0.076, P = 0.002). Those with poorer cognitive functioning had more rapid rates of mobility impairment. In contrast, those with differing levels of subjective memory impairment did not experience different physical functioning trajectories. CONCLUSIONS High depressive symptoms and poor cognitive functioning may be precursors to rapid declines in physical functioning. Proactive screening for these precursors may attenuate physical decline among Chinese older adults.
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Affiliation(s)
- Rumei Yang
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Dongjuan Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
| | - Haocen Wang
- Department of Health and Kinesiology, Texas A&M University, College station, TX 77845, USA
| | - Jiayun Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
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22
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Salisbury D, Mathiason MA, Yu F. Exercise Dose and Aerobic Fitness Response in Alzheimer's Dementia in the FIT-AD Trial. Int J Sports Med 2021; 43:850-858. [PMID: 34492709 DOI: 10.1055/a-1639-2307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to examine the effects of a 6-month cycling aerobic exercise intervention on cardiorespiratory fitness and the dose-response relationship in community-dwelling older adults with mild-to-moderate Alzheimer's dementia. The FIT-AD trial was a single blind, 2-parallel group, pilot randomized controlled trial. The aerobic exercise group participated in a 6-month, thrice weekly, moderate-vigorous intensity cycling intervention while control group performed stretching. Cardiorespiratory fitness was evaluated by peak oxygen consumption from cardiopulmonary exercise test and peak walking distance from the shuttle walk test and 6-minute walk test. Aerobic exercise dose was calculated using the novel heart rate physical activity score. The aerobic exercise group significantly increased peak oxygen consumption (1.28 ml/kg/min; p=.03) in subgroup who achieved maximal criteria on cardiopulmonary exercise test. Changes in peak oxygen consumption and peak walking distance on the shuttle walk and 6-minute walk tests did not significantly differ between aerobic exercise and stretching groups. Notably, the aerobic exercise dose was strongly and significantly correlated to change in peak oxygen consumption (r=.60; n=16; p=.01), in subset who met maximal test criteria. Emphasis on exercise dose is needed in aerobic exercise programs to maximize cardiorespiratory fitness gains in persons with mild-moderate Alzheimer's dementia.
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Affiliation(s)
- Dereck Salisbury
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| | - Michelle A Mathiason
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| | - Fang Yu
- Edison College of Nursing and Health Innovation, Arizona State University, Phoenix, United States
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Gaßner H, List J, Martindale CF, Regensburger M, Klucken J, Winkler J, Kohl Z. Functional gait measures correlate to fear of falling, and quality of life in patients with Hereditary Spastic Paraplegia: A cross-sectional study. Clin Neurol Neurosurg 2021; 209:106888. [PMID: 34455170 DOI: 10.1016/j.clineuro.2021.106888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/12/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Gait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients' self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard. METHODS HSP patients ("pure" phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test). RESULTS Functional gait measures correlated to fear of falling (gait speed: r = -0.726; step length: r = -0.689; TUG: r = 0.721; 2-min: r = -0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = -0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = -0.787; step length: r = -0.821; TUG: r = 0.756; 2-min: r = -0.791). CONCLUSION Functional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician's evaluation and support the clinical workup by more objective parameters.
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Affiliation(s)
- Heiko Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Julia List
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | | | - Martin Regensburger
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Jochen Klucken
- Medical Valley - Digital Health Application Center GmbH, Bamberg, Germany; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Zacharias Kohl
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany; Department of Neurology, University of Regensburg, Regensburg, Germany.
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Adam CE, Fitzpatrick AL, Leary CS, Hajat A, Phelan EA, Park C, Semmens EO. The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073712. [PMID: 33918186 PMCID: PMC8038190 DOI: 10.3390/ijerph18073712] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Falls are common in older adults and result in injuries, loss of independence, and death. Slow gait is associated with falls in older adults, but few studies have assessed the association between gait speed and falls among those with mild cognitive impairment (MCI). (2) Methods: The association between gait speed and falls was assessed in 2705 older adults with and without MCI participating in the Ginkgo Evaluation of Memory Study. Gait speed was measured via a 15-foot walk test and fall history through self-report. We used data collected at the 12-month (2001–2003) and 18-month visits (2002–2004). (3) Results: Participant average age was 78.5 years (sd = 3.2); 45% were female, and 14% had MCI at baseline. The average gait speed was 0.93 m/s (sd = 0.20). Sixteen percent (n = 433) and 18% (n = 498) reported at least one fall at the 12-month and 18-month visits, respectively. Faster gait speed was associated with decreased risk of falling (RR: 0.95, 95% CI: 0.91, 0.99) for every 10 cm/s increase in gait speed adjusted for age, gender, study arm, site, and MCI status. (4) Conclusions: The relationship between gait speed and risk of falling did not vary by MCI status (interaction p-value = 0.78).
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Affiliation(s)
- Claire E. Adam
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
- Correspondence:
| | - Annette L. Fitzpatrick
- Department of Family Medicine, University of Washington, Box #356390, Seattle, WA 98195-6390, USA;
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
- Department of Global Health, University of Washington, UW Box #351620, Seattle, WA 98195-7965, USA
| | - Cindy S. Leary
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
| | - Elizabeth A. Phelan
- Division of Gerontology and Geriatric Medicine, Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499, USA;
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
| | - Erin O. Semmens
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
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Soysal P, Tan SG, Smith L. A comparison of the prevalence of Fear of Falling between older patients with Lewy body dementia, Alzheimer's disease, and without dementia. Exp Gerontol 2021; 146:111248. [PMID: 33486068 DOI: 10.1016/j.exger.2021.111248] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/09/2021] [Accepted: 01/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The development of cognitive impairment and Fear of Falling (FoF) are strongly linked, but prevalence of FoF is not known in patients with different types of dementia. This study aims to evaluate and compare the prevalence and severity of FoF in patients' with dementia with Lewy bodies (DLB), Alzheimer disease (AD), and non-dementia. METHODS 46 participants with DLB, 86 participants with AD and participants without dementia (controls), underwent Comprehensive Geriatric Assessment (CGA). The Falls Efficacy Scale-International (FES-I) was used to determine and classify FoF. An overall score on the FES-I of 16-19, 20-27 and ≥28, was accepted as low, moderate, and high concern about FoF, respectively. RESULTS Prevalence of high FoF was 86.9% in DLB, 36.0% in AD and 37.4% in controls. All CGA parameters were worse in the DLB and AD group than non-dementia group (p < 0.001). The prevalence of high FoF/FES-scores was significantly higher in the DLB group than in the AD and non-dementia group (p < 0.001), but was similar in AD and non-dementia groups (p > 0.05). The significant relationship between DLB and FoF was maintained when adjusted for age, CGA parameters, and orthostatic hypotension (OR: 2.55, CI: 1.03-6.25, p = 0.041 comparison to AD; OR: 4.79, CI: 2.10-10.92, p < 0.001 comparison to non-dementia). CONCLUSION Eight out of ten elderly patients with DLB have high FoF, which is much higher than those with AD and without dementia. Therefore, clinicians should be aware of FoF and its related consequences in the management of DLB in older adults.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
| | - Semen Gokce Tan
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK
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Grede N, Rieckert A, Muth J, Steinbuck J, Weissbach S, Schneider A, Weber-Schicker B, Freiberger E, Jegan N, Donner-Banzhoff N, Sönnichsen A. A volunteer-supported walking programme to improve physical function in older people (the POWER Study): study protocol for a randomised controlled trial. BMC Geriatr 2021; 21:45. [PMID: 33435878 PMCID: PMC7805201 DOI: 10.1186/s12877-020-01988-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Currently 21% of the German population is older than 65 years. Above this age, the risk of suffering from chronic disease and mental disorders increases rapidly. Therefore, physical inactivity is one of the most important public health concerns among older people. To address this issue, we have conceptualised and evaluated a simple and low-threshold intervention, which requires only minimal demand on the participants, targeting older people with inadequate activity levels. The aim of the POWER Study is to investigate whether volunteer-supported outdoor-walking improves physical function and quality of life in older people. METHODS/DESIGN In a randomised, controlled interventional superiority-trial, individuals older than 65 years of age living in the community or nursing homes will be randomised into two groups. The study will be conducted in two study centres with assessments at baseline, 6 and 12 months. The intervention group will participate in a supported physical activity intervention for 6 months. An assigned volunteer will visit them three times a week for an outdoor walk between 30 and 50 min, or equivalent indoor activity. Persons in the control group will be invited to two lectures covering topics related to health. Primary endpoint is the physical function measured by the Short Physical Performance Battery (SPPB) at baseline, after 6 and 12 months. Secondary and safety endpoints will be quality of life (EQ. 5D), fear of falling (Falls Efficacy Scale), physical activity (activity diary), cognitive executive function (clock drawing test), falls requiring medical attention, hospitalisation and death. Primary analysis will be carried out by intention to treat. DISCUSSION We expect the intervention to improve the overall health status of the participants in a wide range of health-related outcomes. If effectiveness can be shown, the intervention will close an important gap in current services for older people. We will disseminate our experiences and results in the form of informational documents (training manual) to allow municipalities and health care organisations to implement a similar intervention. TRIAL REGISTRATION The trial was registered on 31 Aug 2018; German Clinical Trials Register (www.germanctr.de), Deutsches Register Klinischer Studien: DRKS00015188 .
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Affiliation(s)
- Nina Grede
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany.
| | - Anja Rieckert
- Department of Human Medicine, Institute of General Practice and Family Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Julia Muth
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Joana Steinbuck
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Sabine Weissbach
- Department of Human Medicine, Institute of General Practice and Family Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Annika Schneider
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Beate Weber-Schicker
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany
| | - Nikita Jegan
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Norbert Donner-Banzhoff
- Department of General Practice/Family Medicine, Philipps-University of Marburg, Marburg, Germany
| | - Andreas Sönnichsen
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
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Smith L, Jacob L, Kostev K, Butler L, Barnett Y, Pfeifer B, Soysal P, Grabovac I, López-Sánchez GF, Veronese N, Yang L, Oh H, Koyanagi A. Mild cognitive impairment is associated with fall-related injury among adults aged ≥65 years in low- and middle-income countries. Exp Gerontol 2020; 146:111222. [PMID: 33385480 DOI: 10.1016/j.exger.2020.111222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/10/2020] [Accepted: 12/21/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES There is a scarcity of data on the association between mild cognitive impairment (MCI) and falls, especially from low- and middle-income countries (LMICs) where 70% of all older adults reside. Thus, we investigated the association between MCI and fall-related injury among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa). DESIGN Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. METHODS The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria, and information on past 12-month fall-related injury was also collected. Multivariable logistic regression analysis was conducted to assess associations. RESULTS The analytical sample consisted of 13,623 individuals aged ≥65 years [mean (SD) age 72.3 (10.9) years; 45.6% males]. The prevalence of fall-related injury was higher among those with MCI (6.3%) vs. no MCI (4.1%). After adjustment for potential confounders, MCI was associated with a 1.53 (95%CI = 1.12-2.07) times higher odds for fall-related injury. CONCLUSIONS MCI was associated with higher odds for fall-related injury among older adults in LMICs. Future studies are warranted to investigate the mechanisms underlying this association and to elucidate whether targeting those with MCI can lead to reduced risk for falls among older adults.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.
| | - Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain
| | | | - Laurie Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | | | - Briona Pfeifer
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Hans Oh
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
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Salisbury DL, Yu F. A Comparison of Cardiopulmonary Exercise Testing and Field Walking Tests in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer's Dementia. J Aging Phys Act 2020; 28:911-919. [PMID: 32498039 DOI: 10.1123/japa.2019-0387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/13/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to investigate the relationships among peak exercise parameters on 6-min walk test, shuttle walk test, and laboratory-based cardiopulmonary exercise testing in persons with Alzheimer's dementia. This study is a cross-sectional analysis of the baseline data of 90 participants (age 77.1 [6.6] years, 43% female) from the FIT-AD trial. Cardiopulmonary exercise testing produced significantly higher peak heart rate (118.6 [17.5] vs. 106 [22.8] vs. 106 [18.8] beats/min), rating of perceived exertion (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]), and systolic blood pressure (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared with the shuttle walk test and 6-min walk test, respectively. Peak walking distance on shuttle walk test (241.3 [127.3] m) and 6-min walk test (365.0 [107.9] m) significantly correlated with peak oxygen consumption (17.1 [4.3] ml·kg-1·min-1) on cardiopulmonary exercise testing (r = .449, p ≤ .001 and r = .435, p ≤ .001), respectively, which is considerably lower than what is seen in older adults and persons with cardiopulmonary diseases.
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Physical Therapy for Gait, Balance, and Cognition in Individuals with Cognitive Impairment: A Retrospective Analysis. Rehabil Res Pract 2020; 2020:8861004. [PMID: 33204533 PMCID: PMC7655244 DOI: 10.1155/2020/8861004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/08/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objectives The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The mean number of PT sessions over a month was 3.4 (±1.8). Outcomes covered the domains of gait, balance, and cognition with multiple outcomes used to measure different constructs within the balance and gait domains. Results All groups showed improvements in balance and at least one gait outcome measure. Those with MCI improved in every measure of gait and balance performance. Lastly, cognition as measured by Montreal Cognitive Assessment improved in individuals in the AD, VaD, and MCI groups. Conclusion While this retrospective analysis is not appropriate for causal inference, results of one month of physical therapy were associated with decreases in gait, balance, and cognitive impairment in individuals with AD, VaD, DLB<, and MCI. Clinical Implications. While physical therapy is not typically a primary treatment strategy for individuals with cognitive impairment, the results of this study are consistent with the literature that demonstrates improvement from physical therapy for other neurodegenerative diseases. Further clinical and research exploration for physical therapy as a primary treatment strategy in these populations is warranted.
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Hauer K, Schwenk M, Englert S, Zijlstra R, Tuerner S, Dutzi I. Mismatch of Subjective and Objective Risk of Falling in Patients with Dementia. J Alzheimers Dis 2020; 78:557-572. [PMID: 33016908 DOI: 10.3233/jad-200572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Match or mismatch of objective physiological and subjectively perceived fall risk may have serious consequences in patients with dementia (PwD) while research is lacking. OBJECTIVE To analyze mismatch of objective and subjective fall risk and associated factors in PwD. METHOD Cohort study in a geriatric rehabilitation center. Objective and subjective risk of falling were operationalized by Tinetti's Performance Oriented Mobility Assessment and the Falls Efficacy Scale-International. Four sub-groups according to objective and subjective fall risk were classified. Subgroups were compared for differences in clinical, cognitive, psychological, and behavioral variables. RESULTS In geriatric rehab patients with mild to moderate dementia (n = 173), two-thirds showed a mismatch of subjective versus objective risk of falling, independently associated with previous falls. Underestimation of objective fall risk (37.6%) was determined by lower activity avoidance (OR 0.39), less concerns about falling due to previous falls (OR 0.25), and higher quality of life (OR 1.10), while overestimation (28.9%) was determined by higher rate of support seeking strategies (OR 50.3), activity avoidance (OR 15.2), better executive (OR 21.0) and memory functions (OR 21.5), and lower quality of life (OR.75) in multivariate logistic regression. CONCLUSION The majority of patients showed a mismatch between objective and subjective falls risk. Underestimation as well as overestimation of fall risk was associated with specific profiles based on cognitive- and psychological status, falls and fall-related behavioral consequences which should be included in the comprehensive assessment of fall risk, and planning of individualized fall prevention programs for this population.
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Affiliation(s)
- Klaus Hauer
- AGAPLESION Bethanien Hospital / Geriatric Centre at the University of Heidelberg, Heidelberg, Germany
| | - Michael Schwenk
- AGAPLESION Bethanien Hospital / Geriatric Centre at the University of Heidelberg, Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Stefan Englert
- Institute of Medical Biometry und Informatics; Department of Medical Biometry at the University of Heidelberg, Heidelberg, Germany
| | - Rixt Zijlstra
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, Netherlands
| | - Sabine Tuerner
- AGAPLESION Bethanien Hospital / Geriatric Centre at the University of Heidelberg, Heidelberg, Germany
| | - Ilona Dutzi
- AGAPLESION Bethanien Hospital / Geriatric Centre at the University of Heidelberg, Heidelberg, Germany
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Dove E, Wang R, Zabjek K, Astell A. Impacts of Motion-Based Technology on Balance, Movement Confidence, and Cognitive Function Among People With Dementia or Mild Cognitive Impairment: Protocol for a Quasi-Experimental Pre- and Posttest Study. JMIR Res Protoc 2020; 9:e18209. [PMID: 32945780 PMCID: PMC7532457 DOI: 10.2196/18209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/21/2022] Open
Abstract
Background While exercise can benefit the health and well-being of people with dementia or mild cognitive impairment, many exercise programs offered to this population are passive, unengaging, and inaccessible, resulting in poor adherence. Motion-based technologies are increasingly being explored to encourage exercise participation among people with dementia or mild cognitive impairment. However, the impacts of using motion-based technologies with people with dementia or mild cognitive impairment on variables including balance, movement confidence, and cognitive function have yet to be determined. Objective The purpose of this study is to examine the impacts of a group motion-based technology intervention on balance, movement confidence, and cognitive function among people with dementia or mild cognitive impairment. Methods In this quasi-experimental pre- and posttest design, we will recruit 24 people with dementia or mild cognitive impairment from 4 adult day programs and invite them to play Xbox Kinect bowling in a group setting, twice weekly for 10 weeks. We will require participants to speak and understand English, be without visual impairment, and be able to stand and walk. At pretest, participants will complete the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Montreal Cognitive Assessment (MoCA). We will video record participants during weeks 1, 5, and 10 of the intervention to capture behavioral indicators of movement confidence (eg, fluency of motion) through coding. At posttest, the Mini-BESTest and MoCA will be repeated. We will analyze quantitative data collected through the Mini-BESTest and the MoCA using an intent-to-treat analysis, with study site and number of intervention sessions attended as covariates. To analyze the videos, we will extract count and percentage data from the coded recordings. Results This study will address the question of whether a group motion-based technology intervention, delivered in an adult day program context, has the potential to impact balance, movement confidence, and cognitive function among people with dementia or mild cognitive impairment. The project was funded in 2019 and enrollment was completed on February 28, 2020. Data analysis is underway and the first results are expected to be submitted for publication in 2021. Conclusions This study will assess the feasibility and potential benefits of using motion-based technology to deliver exercise interventions to people with dementia or mild cognitive impairment. This work can also be used as the basis for developing specific software and future exercise programs using motion-based technology for people with dementia or mild cognitive impairment, as well as understanding some of the conditions in which these programs can be delivered. International Registered Report Identifier (IRRID) DERR1-10.2196/18209
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Affiliation(s)
- Erica Dove
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Rosalie Wang
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Karl Zabjek
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Arlene Astell
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Casey CM, Caulley J, Phelan EA. The Intersection of Falls and Dementia in Primary Care: Evaluation and Management Considerations. Med Clin North Am 2020; 104:791-806. [PMID: 32773046 DOI: 10.1016/j.mcna.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A large body of research has addressed the assessment and management of fall risk among community-dwelling older adults. Persons with dementia are at higher risk for falls and fall-related injuries, yet less is known about effective strategies for reducing falls and injuries among those with dementia. Falls and dementia are regularly considered to be discrete conditions and are often managed separately. Increasing evidence shows that these conditions frequently co-occur, and one may precede the other. This article explores the relationship between falls and dementia, including the importance of rehabilitation strategies for reducing fall risk in these individuals.
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Affiliation(s)
- Colleen M Casey
- Senior Health Program, Providence Health & Services, 4400 NE Halsey, Fifth Floor, Portland, OR 97213, USA.
| | - Jamie Caulley
- Senior Health Program, Providence Health & Services, 4400 NE Halsey, Fifth Floor, Portland, OR 97213, USA
| | - Elizabeth A Phelan
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499, USA
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Peeters G, Bennett M, Donoghue OA, Kennelly S, Kenny RA. Understanding the aetiology of fear of falling from the perspective of a fear-avoidance model – A narrative review. Clin Psychol Rev 2020; 79:101862. [DOI: 10.1016/j.cpr.2020.101862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 12/14/2022]
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Hayashi T, Umegaki H, Makino T, Huang CH, Inoue A, Shimada H, Kuzuya M. Combined Impact of Physical Frailty and Social Isolation on Rate of Falls in Older Adults. J Nutr Health Aging 2020; 24:312-318. [PMID: 32115613 DOI: 10.1007/s12603-020-1316-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study was to examine the impact of the combination of physical frailty and social isolation on falling in community-dwelling older adults. DESIGN A cross-sectional study of data obtained at registration in a randomized control trial. SETTING Community-based study of participants recruited from Toyota, Japan. PARTICIPANTS 380 community-dwelling older adults (47.9% women, mean age = 72.3 ± 4.6 years). MEASUREMENTS Participants were categorized as non-frail or pre-frail/frail based on the Fried frailty criteria (slowness, weakness, exhaustion, low activity, and weight loss). Social isolation was examined using the Lubben Social Network Scale (LSNS-6), and scores lower than 12 points indicated social isolation. Participants were divided into four groups depending on pre-frail/frail status and social isolation, and experiences of multiple falls over the past year were compared between the groups. RESULTS Participants were classified into robust (n = 193), physical frailty (PF; n = 108), social isolation (SI; n = 43), and PF with SI (PF+SI; n = 36) groups. A total of 38 (10.0%) participants reported multiple falls. Logistic regression analysis showed that PF and SI groups were not independently associated with falling (PF: OR 1.64, 95% CI 0.65-4.16, SI: OR 2.25, 95% CI 0.77-6.58), while PF+SI group was significantly associated with falling compared with the robust group (OR 3.06, 95% CI 1.00-9.34, p = 0.049) after controlling for confounding factors. CONCLUSION Our findings support the assertion that coexistence with physical frailty and social isolation were associated with falling in the older adults.
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Affiliation(s)
- T Hayashi
- Hiroyuki Umegaki, Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan, Tel: +81-52-741-2364, Fax: +81-52-744-2371,
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Ansai JH, Vassimon-Barroso V, Farche ACS, Buto MSDS, Andrade LPD, Rebelatto JR. Accuracy of mobility tests for screening the risk of falls in patients with mild cognitive impairment and alzheimer’s disease. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18006726032019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Identifying gait and balance disorders in the earlier stages of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) could reduce or prevent falls in older adults. This cross-sectional study aimed to determine which mobility tests best discriminate the risk of falls in MCI and mild AD. Functional mobility was assessed by the timed up and go test (TUG) and 10-meter walk test (10MWT). A calendar of falls was produced, with follow-up via telephone calls during 6 months. For the MCI Group (n=38), time spent on the 10MWT was the best variable for discriminating fallers, with a cut-off point of 10.69 seconds associated with the highest accuracy (76.3%). In the AD Group (n=37), 10MWT cadence was the best variable for discriminating fallers, with a cut-off point of 101.39 steps per minute associated with an accuracy of 81.1%. As a conclusion, 10MWT time and cadence were the most accurate variables for screening the risk of falls in MCI and mild AD, respectively. The 10MWT is a functional, simple and easy test and it should be widely used in clinical practice.
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Ansai JH, Andrade LPD, Masse FAA, Gonçalves J, Takahashi ACDM, Vale FAC, Rebelatto JR. Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease. J Geriatr Phys Ther 2019; 42:E116-E121. [DOI: 10.1519/jpt.0000000000000135] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Objectives: Fear of falling (FOF) causes excess disability in nursing home (NH) residents and is associated with vision and hearing impairment. We explored factors associated with FOF in 225 NH residents with vision, hearing or dual sensory impairment.Methods: We explored age, gender, cognition, depression, social engagement, illness burden, falls, physical function, mobility, falls self-efficacy and outcome expectancy as predictors of FOF using univariate logistic regression modeling, followed by multivariate analysis by group (visual, hearing, dual, total sample).Results: Fifty-one percent of residents had FOF. Residents who had FOF reported better cognition, lower falls self-efficacy, and higher outcome expectancy in the total sample and in most impairment groups. Falls outcome expectancy predictedFOF in the total sample and in the visual and hearing sensory impairment groups.Conclusion: When addressing FOF in NH residents it is important to address sensory status along with fears about falling to promote function.
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Araújo RS, Nascimento ÉRD, Barros RDS, Ritter SRF, Abreu AMS, Garcia PA. Can clinical and physical-functional factors predict falls in cognitively impaired older adults? REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to investigate the frequency of falls and clinical and physical-functional factors associated with falls, and the accuracy of such factors to identify the risk of falling in cognitively impaired older adults. Method: a cross-sectional study with cognitively impaired older adults was carried out using the Mini-Mental State Examination. The dependent variable was a history of falls in the previous six months. The independent variables were self-reported mental confusion, hearing and visual impairment, physical fatigue, muscle weakness, dizziness, body imbalance, insecurity when walking, diagnosed depression, hospitalizations, continuous use medications (form from study used), muscle mass (calf circumference) and handgrip strength (dynamometry), functional capacity (Pfeffer) and mobility (SAM-Br). Descriptive statistics were applied. The groups were compared using the Mann Whitney U test, the risk factors were identified by univariate and multivariate logistic regression, and the area under the ROC curve (AUC) was calculated for the associated factors. Results: 216 cognitively impaired older adults were included in the analysis, 41.7% of whom were fallers. Multivariate regression analyzes indicated that complaints of visual impairment (OR=2.8; p=0.015) and body imbalance (OR=2.7; p=0.004), and greater medication use (OR=1.1; p=0.038) were associated with a history of falls. The AUC found poor accuracy for quantity of medications as a screening tool for fallers (AUC=0.6 [0.5; 0.7]; p=0.028). Conclusion: cognitively impaired older adults had a high frequency of falls. Complaints of visual impairment, body imbalance and polypharmacy were predictors of falls. The early assessment of these factors can contribute to the identification of cognitively-impaired older adults at risk of falling in clinical practice and research.
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Williams JM, Nyman SR. Association between the instrumented timed up and go test and cognitive function, fear of falling and quality of life in community dwelling people with dementia. J Frailty Sarcopenia Falls 2018; 3:185-193. [PMID: 32300707 PMCID: PMC7155353 DOI: 10.22540/jfsf-03-185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To explore relationships between the instrumented timed up and go test (iTUG) and the following risk factors for falls: cognitive functioning, fear of falling (FoF), and quality of life (QoL) in people with dementia. METHODS 83 community-dwelling older adults with dementia (mean±sd age 78.00±7.96 years; 60.2% male) completed an interview to capture global cognition (Mini-Addenbrooke's Cognitive Evaluation), FoF (Iconographical Falls Efficacy Scale) and QoL (ICEpopCAPability measure for Older people). Participants completed an iTUG whilst wearing an inertial sensor on their trunk. Linear accelerations and rotational velocities demarcated sub-phases of the iTUG. Relationships were explored through correlations and regression modelling. RESULTS Cognition was related to duration of walking sub-phases and total time to complete iTUG (r=0.25-0.28) suggesting gait speed was related to cognition. FoF was most strongly related to turning velocity (r=0.39-0.44), but also to sit-to-stand, gait sub-phases and total time to complete iTUG. Sub-phases explained 27% of the variance in FoF. There were no correlations between iTUG and QoL. CONCLUSIONS Cognition and FoF were related to time to complete walking sub-phases but FoF was more closely related to turning velocity and standing acceleration. iTUG may offer unique insights into motor behaviour in people with dementia.
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Affiliation(s)
- Jonathan M. Williams
- Department of Human Sciences and Public Health, Faculty of Health and Social Sciences, Bournemouth University, UK
| | - Samuel R. Nyman
- Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, UK
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Chomiak T, Watts A, Burt J, Camicioli R, Tan SN, McKeown MJ, Hu B. Differentiating cognitive or motor dimensions associated with the perception of fall-related self-efficacy in Parkinson's disease. NPJ Parkinsons Dis 2018; 4:26. [PMID: 30155514 PMCID: PMC6102294 DOI: 10.1038/s41531-018-0059-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/28/2018] [Accepted: 06/07/2018] [Indexed: 12/18/2022] Open
Abstract
In Parkinson's disease (PD), concurrent declines in cognitive and motor domain function can severely limit an individual's ability to conduct daily tasks. Current diagnostic methods, however, lack precision in differentiating domain-specific contributions of cognitive or motor impairments based on a patients' clinical manifestation. Fear of falling (FOF) is a common clinical manifestation among the elderly, in which both cognitive and motor impairments can lead to significant barriers to a patients' physical and social activities. The present study evaluated whether a set of analytical and machine-learning approaches could be used to help delineate boundary conditions and separate cognitive and motor contributions to a patient's own perception of self-efficacy and FOF. Cognitive and motor clinical scores, in conjunction with FOF, were collected from 57 Parkinson's patients during a multi-center rehabilitation intervention trial. Statistical methodology was used to extract a subset of uncorrelated cognitive and motor components associated with cognitive and motor predictors, which were then used to independently identify and visualize cognitive and motor dimensions associated with FOF. We found that a central cognitive process, extracted from tests of executive, attentional, and visuoperceptive function, was a unique and significant independent cognitive predictor of FOF in PD. In addition, we provide evidence that the approaches described here may be used to computationally discern specific types of FOF based on separable cognitive or motor models. Our results are consistent with a contemporary model that the deterioration of a central cognitive mechanism that modulates self-efficacy also plays a critical role in FOF in PD.
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Affiliation(s)
- Taylor Chomiak
- Division of Translational Neuroscience, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1 Canada
| | - Alexander Watts
- Division of Translational Neuroscience, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1 Canada
| | - Jacqueline Burt
- Department of Medicine, Division of Neurology, Clinical Sciences Building, University of Alberta, Edmonton, AB T6G 2R7 Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, Clinical Sciences Building, University of Alberta, Edmonton, AB T6G 2R7 Canada
| | - Sun Nee Tan
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
| | - Martin J. McKeown
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
| | - Bin Hu
- Division of Translational Neuroscience, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1 Canada
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Makino K, Makizako H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, Suzuki T, Shimada H. Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study. Int J Geriatr Psychiatry 2018; 33:658-662. [PMID: 29231272 DOI: 10.1002/gps.4837] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/09/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. METHODS A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. RESULTS During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). CONCLUSIONS Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Ryo Hotta
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takao Suzuki
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Department of Gerontology, J.F. Oberlin University Graduate School, Tokyo, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Kasai M, Meguro K, Ozawa H, Kumai K, Imaizumi H, Minegishi H, Oi H, Oizumi A, Yamashiro M, Matsuda M, Tanaka M, Itoi E. Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures. Dement Geriatr Cogn Dis Extra 2017; 7:386-394. [PMID: 29282411 PMCID: PMC5731173 DOI: 10.1159/000480497] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/07/2017] [Indexed: 11/20/2022] Open
Abstract
Background/Aim The purpose of this study was to investigate the estimated prevalence of dementia and the relationship between cognitive impairment and fear of falling in patients with hip fractures. Methods Analysis 1 included 100 patients with hip fractures. Analysis 2 included a subgroup of subjects with ≥75 years of functional independence: 46 patients with hip fractures and 46 control subjects without hip fractures, and presence or absence of dementia. We used an informant-rated questionnaire including the AD8 for screening for dementia, the Barthel Index for assessing activities of daily living, and the Short Falls Efficacy Scale-International (FES-I) for assessing fear of falling. Results The estimated prevalence of dementia was 66% in patients with hip fractures. There were significant fracture and dementia effects, with significant covariate effects of age and gender on the Short FES-I scores. Conclusion Our results suggested that more than two-thirds of patients with hip fractures had dementia. Fear of falling may reflect not only physical functions but also cognitive impairments.
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Affiliation(s)
- Mari Kasai
- Geriatric Behavioral Neurology, Tohoku University CYRIC, Sendai, Japan
| | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University CYRIC, Sendai, Japan
| | - Hiroshi Ozawa
- Department of Orthopaedic Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Keiichi Kumai
- Geriatric Behavioral Neurology, Tohoku University CYRIC, Sendai, Japan
| | - Hideki Imaizumi
- Department of Orthopaedic Surgery, Osaki Citizen Hospital, Osaki, Japan
| | - Hanae Minegishi
- Department of Orthopaedic Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideki Oi
- Department of Orthopaedic Surgery, Tome Citizen Hospital, Tome, Japan
| | - Akira Oizumi
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Kurihara, Japan
| | | | | | - Masahiko Tanaka
- Department of Orthopaedic Surgery, Kesen-numa City Hospital, Kesen-numa, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Bayen E, Jacquemot J, Netscher G, Agrawal P, Tabb Noyce L, Bayen A. Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study. J Med Internet Res 2017; 19:e339. [PMID: 29042342 PMCID: PMC5663952 DOI: 10.2196/jmir.8095] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 11/15/2022] Open
Abstract
Background Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. Objective The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. Methods A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents’ falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Results Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Conclusions Video monitoring offers high potential to support conventional care in memory care facilities.
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Affiliation(s)
- Eleonore Bayen
- Pitie-Salpetriere Hospital - Assistance Publique Hôpitaux de Paris (APHP) & University Pierre et Marie Curie, Department of Neuro-Rehabilitation, Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, Paris, France
| | - Julien Jacquemot
- SafelyYou Inc. at SkyDeck (Chief Technology Officer), Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, United States
| | - George Netscher
- SafelyYou Inc. at SkyDeck (Chief Technology Officer), Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, United States
| | - Pulkit Agrawal
- SafelyYou Inc. at SkyDeck (Chief Architect), Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, United States
| | | | - Alexandre Bayen
- Center for Information Technology Research in the Interest of Society and SafelyYou Inc. at SkyDeck (Chief Scientist), Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, United States
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Khalil H, Al-Shorman A, El-Salem K, Abdo N, Alghwiri AA, Aburub A, Shalabi S, Al-Mustafa F. Fear of Falling in People With Multiple Sclerosis: Which Clinical Characteristics Are Important? Phys Ther 2017; 97:698-706. [PMID: 28444253 DOI: 10.1093/ptj/pzx044] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/11/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Fear of falling (FOF) is an important risk indicator for health-related outcomes and quality of life in patients with multiple sclerosis (MS). However, factors associated with FOF in MS are not well investigated. OBJECTIVES This study was done to explore predictors of FOF in this population. METHODS Seventy relapsing remitting patients with MS were evaluated. Fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Motor outcomes included: 30-second chair stand test (30s-CST), Berg Balance Scale (BBS), 10-Meter Walk Test (10MWT), and 6-Minute Walk Test (6MWT). Cognitive status was determined using the Montréal Cognitive Assessment (MOCA) and Symbol Digit Modalities Test (SDMT). Affective factors including depression, fatigue, and sleep were also assessed using the Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), and Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS Fear of falling was significantly correlated with all motor and affective measures used. However, a stepwise regression found that only BBS from motor measures, MOCA from cognitive measures, and sleep disorders from affective factors were significantly predictive of the FOF. CONCLUSIONS Fear of falling in patients with MS is multifactorial and includes motor and nonmotor factors. Thus, therapies that aim to reduce risk of falling in this population should address motor functions, cognitive abilities, and sleep quality.
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Affiliation(s)
- Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Alham Al-Shorman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology
| | - Nour Abdo
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology
| | - Alia A Alghwiri
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Aseel Aburub
- Department of Physical Therapy, Fatima College for Health Sciences, Abu Dhabi, United Arab -Emirates
| | - Sarah Shalabi
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology
| | - Firas Al-Mustafa
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology
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Lipardo DS, Aseron AMC, Kwan MM, Tsang WW. Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review. Arch Phys Med Rehabil 2017; 98:2079-2096. [PMID: 28554873 DOI: 10.1016/j.apmr.2017.04.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/09/2017] [Accepted: 04/18/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI). DATA SOURCES Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched. STUDY SELECTION Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included. DATA EXTRACTION Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument. DATA SYNTHESIS Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included. CONCLUSIONS This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended.
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Affiliation(s)
- Donald S Lipardo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Anne Marie C Aseron
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Marcella M Kwan
- Rural Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - William W Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Ansai JH, Andrade LP, Rossi PG, Takahashi ACM, Vale FAC, Rebelatto JR. Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease. Braz J Phys Ther 2017; 21:144-151. [PMID: 28460713 PMCID: PMC5537456 DOI: 10.1016/j.bjpt.2017.03.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 11/25/2022] Open
Abstract
Dual tasks can be applicable to assess elderly with mild Alzheimer's disease. Patients with preserved cognition and mild cognitive impairment presented with similar mobility. Specific local and consequences of falls were identified for each cognitive group.
Background Studies with functional and applicable methods and new cognitive demands involving executive function are needed to improve screening, prevention and rehabilitation of cognitive impairment and falls. Objective to identify differences in gait, dual task performances, and history of falls between elderly people with preserved cognition, mild cognitive impairment and mild Alzheimer's disease. Method A cross-sectional study was conducted. The sample consisted of 40 community-dwelling older adults with preserved cognition, 40 older adults with mild cognitive impairment, and 38 older adults with mild Alzheimer's disease. The assessment consisted of anamneses, gait (measured by the 10-meter walk test), dual task (measured by the Timed Up and Go Test associated with the motor-cognitive task of calling a phone number), and history of falls in the past year. Results There were no differences among all groups for all variables. However, the Alzheimer's disease Group performed significantly worse in the dual task than the other groups. No item of dual task could distinguish people with preserved cognition from those with mild cognitive impairment. The groups with cognitive impairment included more fallers, and specific characteristics in history of falls between groups were identified. Conclusion Dual task could distinguish Alzheimer's disease patients specifically from other cognitive profiles.
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Affiliation(s)
- Juliana H Ansai
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Larissa P Andrade
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Paulo G Rossi
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Anielle C M Takahashi
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Francisco A C Vale
- Departmento de Medicina, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - José R Rebelatto
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
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Lach HW, Harrison BE, Phongphanngam S. Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review. Res Gerontol Nurs 2016; 10:139-148. [PMID: 27665756 DOI: 10.3928/19404921-20160908-01] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/12/2016] [Indexed: 11/20/2022]
Abstract
Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.].
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Berton B, Cê A, Sanches VS, Medola FO, Tarnhovi EG, Christofoletti G. Postural balance in Alzheimer's disease patients undergoing sensory pitfalls. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Andressa Cê
- Universidade Federal de Mato Grosso do Sul, Brazil
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Mild cognitive impairment is associated with falls among older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA). Exp Gerontol 2016; 75:42-7. [DOI: 10.1016/j.exger.2015.12.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 11/16/2022]
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Shirooka H, Nishiguchi S, Fukutani N, Tashiro Y, Nozaki Y, Hirata H, Yamaguchi M, Tasaka S, Matsushita T, Matsubara K, Aoyama T. Cognitive impairment is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 2016; 17:232-238. [DOI: 10.1111/ggi.12702] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Hidehiko Shirooka
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Shu Nishiguchi
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
- Japan Society for the Promotion of Science; Tokyo Japan
| | - Naoto Fukutani
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Yuto Tashiro
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Yuma Nozaki
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Hinako Hirata
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Moe Yamaguchi
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Seishiro Tasaka
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Tomofumi Matsushita
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Keisuke Matsubara
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Tomoki Aoyama
- Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
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