Memory and physical mobility in physically and cognitively-independent elderly people

Possible Association between Physical and Cognitive Function and Stumbling and Falling in Elderly Workers

The aim of this paper is to examine the association between physical and cognitive function and stumbling and falling in elderly workers by conducting work-related questionnaire surveys and physical and cognitive function measurements. A total of 611 men and 121 women aged 40-69 years who participated in physical function measurements between June 2017 and June 2021 were included in the study. The general physical function measurements of upper and lower limb muscle strength, dynamic and static balance, and agility and cognitive function included grip strength, Repeated Rise Test, Trail Making test (TMT), and Three-Meter Time Up Go Test (TUG). We also asked the men and women about their experience of falling and stumbling. Logistic regression analysis showed significant odds ratios (OR) for the associations between stumbling in men and age (OR: 1.98), mental burden (OR: 2.44), frequency of field work (OR: 1.74), seated stepping test count (OR: 0.95), and TMTB time (OR: 0.99). Significant ORs were found between falling in men and age (OR: 2.55), mental burden (OR: 2.40), exercise habits (OR: 2.55), and smoking (OR: 2.00). Significant ORs were found between stumbling in women and d_TUG (OR: 1.59) and mental burden (OR: 6.42). The study suggests that there may be an association between cognitive and physical decline and stumbling and falling in elderly workers.

Prevalence and factors associated with frailty in hospitalized older patients

Background

Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters.

Methods

A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n = 19), frail (n = 25) and severely frail patients (n = 80).

Results

The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA.

score was negatively correlated to albumin levels (r = − 0.30; p < 0.001) and positively correlated to CRP, polypharmacy and age (r = 0.28, r = 0.37, r = 0.33 and p < 0.01 respectively). Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home.

Conclusion

Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.

Physical performance is more strongly associated with cognition in schizophrenia than psychiatric symptoms

BACKGROUND

Although neurocognitive dysfunction and physical performance are known to be impaired in patients with schizophrenia, evidence regarding the relationship between these two domains remains insufficient. Thus, we aimed to investigate the relationship between various physical performance domains and cognitive domains in individuals with schizophrenia, while considering other disorder-related clinical symptoms.

METHODS

Sixty patients with schizophrenia participated in the study. Cardiorespiratory fitness and functional mobility were evaluated using the step test and supine-to-standing (STS) test, respectively. Executive function and working memory were assessed using the Stroop task and Sternberg working memory (SWM) task, respectively. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Multivariate analyses were performed to adjust for relevant covariates and identify predictive factors associated with neurocognition.

RESULTS

Multiple regression analysis revealed that the step test index was most strongly associated with reaction time in the Stroop task (β = 0.434, p = 0.001) and SWM task (β = 0.331, p = 0.026), while STS test time was most strongly associated with accuracy on the Stoop task (β=-0.418, p = 0.001) and SWM task (β=-0.383, p = 0.007). Total cholesterol levels were positively associated with Stroop task accuracy (β=-0.307, p = 0.018) after controlling for other clinical correlates. However, clinical symptoms were not associated with any variables in Stroop or SWM task.

CONCLUSIONS

The present findings demonstrate the relationship between physical performance and neurocognition in patients with schizophrenia. Considering that these factors are modifiable, exercise intervention may help to improve cognitive symptoms in patients with schizophrenia, thereby leading to improvements in function and prognosis.

Baseline Mobility is Not Associated with Decline in Cognitive Function in Healthy Community-Dwelling Older Adults: Findings From The Irish Longitudinal Study on Ageing (TILDA)

OBJECTIVES

Few studies examine the relationship between Timed Up-and-Go (TUG), a commonly used clinical test, and cognitive decline. This study examines whether TUG, usual gait speed (UGS), and dual-task gait speed (DTGS) predict decline in global cognition, executive function, processing speed, memory, and attention with follow-up of up to 5.9 years.

DESIGN

Longitudinal study.

SETTING

The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort study.

PARTICIPANTS

Community-dwelling adults aged ≥65 years, with Mini-Mental State Examination (MMSE) score ≥18 and no known history of memory impairment, dementia, Alzheimer's disease or Parkinson's disease were included (N = 2,250).

MEASUREMENTS

Participants completed mobility tasks during the baseline health assessment and cognitive tasks during interviews conducted at 2 year intervals (waves 1, 2, and 3) and health assessments (waves 1 and 3). Linear and Poisson mixed effects regression models were used to examine longitudinal associations between mobility and each cognitive test, adjusting for sociodemographics and physical and mental health.

RESULTS

There was little evidence of an association between TUG, UGS, or DTGS with decline in cognitive function after adjusting for confounders.

CONCLUSIONS

These mobility tasks are not sensitive predictors of cognitive decline in this high-functioning, community-dwelling sample; nonetheless, limited decline in cognitive function was observed during follow-up. Further work with longer follow-up and/or analysis of more specific and comprehensive measures associated with gait is required.

Association between timed up-and-go and memory, executive function, and processing speed

OBJECTIVES

To determine which cognitive tests are independently associated with performance on the Timed Up-and-Go Test (TUG).

DESIGN

Data were obtained from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study assessing health, economic, and social aspects of aging.

SETTING

Community-dwelling adults completed a home based interview and a health center-based assessment.

PARTICIPANTS

TILDA participants aged 50 and older with a Mini-Mental State Examination (MMSE) score of 10 or greater (N = 4,998).

MEASUREMENTS

Participants completed a battery of cognitive assessments including the Montreal Cognitive Assessment (MoCA), Color Trails Test, word and letter fluency, choice reaction time, sustained attention, prospective memory, word recall, and picture memory. Linear regression was used to determine univariate and multivariate associations between TUG and each cognitive test.

RESULTS

Slower TUG time was associated with poorer performance on all cognitive tests in univariate analysis (P < .05). In multivariate analysis, poorer performance on the MoCA, letter fluency, Color Trail 1, cognitive reaction time, mean sustained attention response time, and prospective memory were independently associated with slower TUG time (P < .05).

CONCLUSION

Slower TUG time is independently associated with poorer performance on global cognition, executive function, and memory tests and slower processing speed. This highlights that TUG is more than just a simple mobility task and suggests that a comprehensive cognitive assessment is important for individuals with mobility difficulties.

Mejoras cognitivas y perceptivo-motrices en personas mayores participantes en un programa de estimulación integral cognitivo-motriz

Este artículo tiene como objetivo mostrar los efectos cognitivos y perceptivo-motrices obtenidos tras la aplicación de un programa de estimulación cognitiva a través de la motricidad para personas mayores llamado "Memoria en Movimiento". Se trata de una investigación cuasi-experimental en la que participaron 234 personas mayores con una media de edad de 69.92±7.23 distribuidas en grupo experimental inactivo físicamente y grupo control praticantes de Tai-chi y Gimnasia. La evaluación se realizó antes de la aplicación del programa y tras su finalización. Se utilizaron el Mini Examen Cognoscitivo, el Test de Dígitos - Total, Directo e Inverso -, una Prueba de Memoria Motriz y una Prueba de Orientación Espacial - Total, 1 y 2 -. Se constató una mejoría significativa (p<0.05) del grupo experimental en todas las mediciones de estudio excepto en Dígitos Directo y Orientación Espacial 2. El grupo control consigue mejoras significativas (p<0.05) exclusivamente en Orientación Espacial Total y Espacial 1 y deterioro significativo (p<0.05) en Memoria Motriz. El programa "Memoria en Movimiento" mejora la atención, la memoria, la conciencia corporal y la estructuración espacial de las personas mayores mediante tareas cognitivas con implicación motriz integral.

Reference values for the Timed Up and Go test in healthy Japanese elderly people: determination using the methodology of meta-analysis

AIM

The purpose of this study was to determine the reference value for the Timed Up and Go test (TUG) in healthy Japanese elderly people using the methodology of meta-analysis, and to determine the value for different measurement protocols.

METHODS

Relevant research articles were identified from electronic databases: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Igaku-cyuouzasshi. The search was conducted from January 1991 to June 2010, and the terms "timed up and go" and "elderly" were used in combination in the search. Furthermore, the searches were limited to articles involving Japanese healthy elderly people aged 60years and older. Weighted means of TUG were calculated by a fixed effect model and a random effect model to estimate reference values. Furthermore, the 95% confidence interval (CI) for the weighted mean of TUG was also estimated.

RESULTS

Twelve studies fulfilled the inclusion criteria: eight provided data for maximum effort, and five provided data related to usual pace. When weighted means of TUG were estimated by the fixed effect model, there was significant heterogeneity. Therefore, a random effect model was used for re-estimation. As a result, the weighted mean of TUG with maximum effort was 6.60s (95% CI=6.18-7.02s), and that at usual pace was 8.86s (95% CI=7.99-9.72s).

CONCLUSION

The reference values of TUG in Japanese healthy elderly people calculated in this study are certainly shorter than in African-Americans and Caucasians. The reference values of TUG estimated by our study appear to be specific for healthy, elderly, Japanese people.

Global cerebral hypoperfusion in preclinical stage of idiopathic normal pressure hydrocephalus

In patients with idiopathic normal pressure hydrocephalus (iNPH), ventriculomegaly and narrowed subarachnoid spaces at the high convexity appear in magnetic resonance (MR) images before the occurrence of objective symptoms. In addition, quantitative regional cerebral blood flow (rCBF) has been reported to be reduced in iNPH patients with objective symptoms. To determine whether reduced rCBF is responsible for the appearance of symptoms, we compared rCBF in patients with suspected iNPH with no objective triad symptoms (NOS), iNPH patients with apparent objective triad symptoms (AOS) and normal control subjects (NC). Regional CBF was quantified in 35 Regions-of-interest (ROIs) by 123I-IMP single photon emission computed tomography (SPECT) using the autoradiography (ARG) method. Multiple comparisons showed that, in all brain regions examined except for in the frontal white matter, rCBF in the NOS group was significantly lower than that in the NC group, but in all brain regions, not significantly different from that of the AOS group. These results suggest that factors other than rCBF in the resting state are responsible for the occurrence of objective symptoms of iNPH.

Association between the Trail Making Test and physical performance in elderly Japanese

AIM

The Trail Making Test (TMT) is used in Western countries as an indicator of executive function, but there is little information regarding its use in Japan. Our previous initial study showed that the TMT was significantly associated with mobility-related functions among elderly Japanese living in the community and in this study, we increased the number of participants to clarify that result.

METHODS

The TMT, comprised of two parts (part A and part B), was administered to 493 subjects aged 65 years or older (164 men, 329 women). Our assessment used the time difference (DeltaTMT) between parts B and A, and eight physical performance indicators: four of preventive care (usual walking speed, timed Up & Go [TUG], one-leg standing balance and handgrip strength) and four movement parameters (maximum walking speed, dual-task TUG, stair climbing and obstacle-negotiating gait).

RESULTS

The median DeltaTMT score was 64.01 s for men and 65.56 s for women. The DeltaTMT score increased with age, and there was no difference between sexes. Multinomial logistic regression analysis showed that a poor DeltaTMT was related to low tertiles for all physical performances. It related to the intermediate tertile of TUG and maximum walking speed, dual-task TUG, stair climbing and obstacle-negotiating gait.

CONCLUSION

The TMT reflects complex walking performance, so it can be a useful synthetic indicator for health programs promoting independence in elderly Japanese.