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Brauner FDO, Oliveira M, Hausen DO, Schiavo A, Balbinot G, Mestriner RG. Association Between Depressive Symptoms, Cognitive Status, and the Dual-Task Performance Index in Older Adults: A Cross-Sectional Study. J Aging Phys Act 2024:1-9. [PMID: 38729617 DOI: 10.1123/japa.2023-0152] [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: 05/02/2023] [Revised: 02/03/2024] [Accepted: 03/19/2024] [Indexed: 05/12/2024]
Abstract
The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23 years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26-74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive-motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.
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Affiliation(s)
- Fabiane de Oliveira Brauner
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), PUCRS, Porto Alegre, RS, Brazil
| | - Mariana Oliveira
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), PUCRS, Porto Alegre, RS, Brazil
| | - Daiane Oliveira Hausen
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), PUCRS, Porto Alegre, RS, Brazil
| | - Aniuska Schiavo
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), PUCRS, Porto Alegre, RS, Brazil
| | - Gustavo Balbinot
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Régis Gemerasca Mestriner
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), PUCRS, Porto Alegre, RS, Brazil
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Chung J, Byun S. Motoric Cognitive Risk and Incident Dementia in Older Adults. JAMA Netw Open 2023; 6:e2338534. [PMID: 37856120 PMCID: PMC10587785 DOI: 10.1001/jamanetworkopen.2023.38534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Motoric cognitive risk (MCR) is a novel predementia syndrome; however, whether it can estimate dementia in a nationwide population or has additive estimation validity over cognitive or motoric components alone remains unknown. Objective To examine whether modified MCR, which incorporates the timed-up-and-go and one-leg-standing tests, improves estimation validity for incident dementia over using cognitive or motoric components alone. Design, Setting, and Participants This nationwide cohort study evaluated data from individuals aged 66 years who participated in the National Screening Program for Transitional Ages in Korea from January 1, 2009, to December 31, 2013, and examined the association between MCR and incident dementia using Cox proportional hazards regression analysis. Data were collected from the index date (the date on which the participant had the screening) until dementia onset, death, or the end of the follow-up period, whichever came first. The 2 subtypes were defined as subjective cognitive declines with timed-up-and-go impairment or one-leg-standing impairment. The data set was generated with permission from the Korean National Health Insurance Service, and data analysis was conducted from August 2, 2021, to January 31, 2022. Individuals diagnosed with dementia or psychotic disorders or those who had a documented history of dementia medication use before the index date were excluded. Main Outcomes and Measures The main outcome was incidence of dementia, defined as an individual receiving their first dementia medication with the relevant International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes after the index date. Results Among the 1 137 530 participants (53.7% women), 15 380 (1.4%) met the MCR criteria for the timed-up-and-go subtype, and 32 910 (2.9%) met the criteria for the one-leg-standing subtype. The mean (SD) follow-up period was 7.02 (1.38) years. Participants with MCR demonstrated an approximately 2-fold higher risk of incident dementia than those without MCR (timed-up-and-go subtype, adjusted hazard ratio, 2.03; 95% CI, 1.94-2.13; one-leg-standing subtype, adjusted hazard ratio, 2.05; 95% CI, 1.98-2.12). Conclusions and Relevance In this cohort study of participants aged 66 years of the National Screening Program for Transitional Ages, modified motoric cognitive risk had higher adjusted hazard ratios of incident dementia than individual cognitive or motoric components. Motoric cognitive risk may be a practical screening tool for estimating dementia among individuals in their mid-60s ; however, further investigation of the clinical and neurobiological aspects is necessary.
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Affiliation(s)
- Jeehae Chung
- Industry-Academic Cooperation Foundation, The Catholic University of Korea, Seoul, Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, Uijeongbu St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cho MH, Han K, Lee S, Jeong SM, Yoo JE, Kim S, Lee J, Chun S, Shin DW. Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study. Alzheimers Res Ther 2023; 15:56. [PMID: 36941727 PMCID: PMC10026431 DOI: 10.1186/s13195-023-01211-y] [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: 02/11/2022] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population. METHODS Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses. RESULTS The risks of Alzheimer's and vascular dementia increased from systolic BP ≥ 160 and 130-139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty. CONCLUSIONS High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.
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Affiliation(s)
- Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Seungwoo Lee
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul , Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Health System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jinkook Lee
- Department of Economics & Center for Economic & Social Research, University of Southern California, Los Angeles, CA, USA
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, 81 Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea.
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S, Richardson TK, Savatteri N, Wang Y, Tkachyk C. Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures. Psychogeriatrics 2022; 22:553-573. [PMID: 35535013 DOI: 10.1111/psyg.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Yimo Wang
- Myodetox Markham, Markham, Ontario, Canada
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Borda MG, Ferreira D, Selnes P, Tovar-Rios DA, Jaramillo-Jiménez A, Kirsebom BE, Garcia-Cifuentes E, Dalaker TO, Oppedal K, Sønnesyn H, Fladby T, Aarsland D. Timed Up and Go in People with Subjective Cognitive Decline Is Associated with Faster Cognitive Deterioration and Cortical Thickness. Dement Geriatr Cogn Disord 2022; 51:63-72. [PMID: 35339996 DOI: 10.1159/000522094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/14/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early markers of neurodegeneration provide an opportunity to detect, monitor, and initiate interventions in individuals who have an increased risk of developing dementia. Here, we investigated whether the Timed Up and Go (TUG) test is associated with early brain neurodegeneration and whether the TUG test could be a marker of cognitive decline in people with subjective cognitive decline (SCD). METHODS This is a longitudinal analysis of the Dementia Disease Initiation Study, a prospective, community-based, cohort study from Norway, designed to investigate early markers of cognitive impairment and dementia. Participants were classified as SCD and healthy controls (HC). The main studied variables were the TUG test and cognition as measured by the Mini-Mental State Examination and the Consortium to Establish a Registry for Alzheimer's Disease memory composite score. Additionally, we investigated the cross-sectional association of brain morphology with the TUG using 1.5T-MRI. RESULTS The sample included 45 participants (SCD = 21, HC = 24) followed during a mean time of 1.50 ± 0.70 years. At baseline, the cognitive performance did not differ between the groups, but TUG was longer in SCD. Slower baseline TUG was associated with a faster cognitive decline in both groups and it was also associated with reduced cortical thickness especially in motor, executive, associative, and somatosensory cortical regions in people with SCD. DISCUSSION/CONCLUSION TUG predicted cognitive change in individuals with SCD, and there was a negative association between TUG and cortical thickness. TUG is a promising cheap and noninvasive marker of early cognitive decline and may help initiate interventions in individuals who have an increased risk of dementia.
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Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School Pontificia Universidad Javeriana, Bogotá, Colombia.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Diego Alejandro Tovar-Rios
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Universidad Del Valle, Santiago De Cali, Colombia
| | - Alberto Jaramillo-Jiménez
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Grupo de Neurociencias de Antioquia, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Bjørn-Eivind Kirsebom
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elkin Garcia-Cifuentes
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School Pontificia Universidad Javeriana, Bogotá, Colombia.,Unidad de Neurologia, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Turi O Dalaker
- Stavanger Medical Imaging Laboratory, Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - Ketil Oppedal
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway
| | - Hogne Sønnesyn
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
| | - Tormod Fladby
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Universidad Del Valle, Santiago De Cali, Colombia
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Department of Old Age Psychiatry, King's College, London, United Kingdom
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Longitudinal Study on Sustained Attention to Response Task (SART): Clustering Approach for Mobility and Cognitive Decline. Geriatrics (Basel) 2022; 7:geriatrics7030051. [PMID: 35645274 PMCID: PMC9149848 DOI: 10.3390/geriatrics7030051] [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: 03/14/2022] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
The Sustained Attention to Response Task (SART) is a computer-based go/no-go task to measure neurocognitive function in older adults. However, simplified average features of this complex dataset lead to loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we combine a novel method to visualise individual trial (raw) information obtained from the SART test in a large population-based study of ageing in Ireland and an automatic clustering technique. We employed a thresholding method, based on the individual trial number of mistakes, to identify poorer SART performances and a fuzzy clusters algorithm to partition the dataset into 3 subgroups, based on the evolution of SART performance after 4 years. Raw SART data were available for 3468 participants aged 50 years and over at baseline. The previously reported SART visualisation-derived feature ‘bad performance’, indicating the number of SART trials with at least 4 mistakes, and its evolution over time, combined with the fuzzy c-mean (FCM) algorithm, individuated 3 clusters corresponding to 3 degrees of physiological dysregulation. The biggest cluster (94% of the cohort) was constituted by healthy participants, a smaller cluster (5% of the cohort) by participants who showed improvement in cognitive and psychological status, and the smallest cluster (1% of the cohort) by participants whose mobility and cognitive functions dramatically declined after 4 years. We were able to identify in a cohort of relatively high-functioning community-dwelling adults a very small group of participants who showed clinically significant decline. The selected smallest subset manifested not only mobility deterioration, but also cognitive decline, the latter being usually hard to detect in population-based studies. The employed techniques could identify at-risk participants with more specificity than current methods, and help clinicians better identify and manage the small proportion of community-dwelling older adults who are at significant risk of functional decline and loss of independence.
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Rizzo R, Knight SP, Davis JRC, Newman L, Duggan E, Kenny RA, Romero-Ortuno R. SART and Individual Trial Mistake Thresholds: Predictive Model for Mobility Decline. Geriatrics (Basel) 2021; 6:geriatrics6030085. [PMID: 34562986 PMCID: PMC8482118 DOI: 10.3390/geriatrics6030085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we describe a new method to visualise individual trial (raw) information obtained from the SART test, vis-à-vis age, and groups based on mobility status in a large population-based study of ageing in Ireland. A thresholding method, based on the individual trial number of mistakes, was employed to better visualise poorer SART performances, and was statistically validated with binary logistic regression models to predict mobility and cognitive decline after 4 years. Raw SART data were available for 4864 participants aged 50 years and over at baseline. The novel visualisation-derived feature bad performance, indicating the number of SART trials with at least 4 mistakes, was the most significant predictor of mobility decline expressed by the transition from Timed Up-and-Go (TUG) < 12 to TUG ≥ 12 s (OR = 1.29; 95% CI 1.14–1.46; p < 0.001), and the only significant predictor of new falls (OR = 1.11; 95% CI 1.03–1.21; p = 0.011), in models adjusted for multiple covariates. However, no SART-related variables resulted significant for the risk of cognitive decline, expressed by a decrease of ≥2 points in the Mini-Mental State Examination (MMSE) score. This novel multimodal visualisation could help clinicians easily develop clinical hypotheses. A threshold approach to the evaluation of SART performance in older adults may better identify subjects at higher risk of future mobility decline.
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Affiliation(s)
- Rossella Rizzo
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Correspondence:
| | - Silvin Paul Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - James R. C. Davis
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Eoin Duggan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 NHY1 Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
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Cedervall Y, Stenberg AM, Åhman HB, Giedraitis V, Tinmark F, Berglund L, Halvorsen K, Ingelsson M, Rosendahl E, Åberg AC. Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function: A Mixed Methods Observational Study for Development of the UDDGait Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1715. [PMID: 32150995 PMCID: PMC7084863 DOI: 10.3390/ijerph17051715] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/06/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023]
Abstract
New methods to screen for and identify early-stage dementia disorders are highly sought after. The purpose of this pilot study is to develop a study protocol for a dual-task test aimed at aiding the early detection of dementia disorders. We used the Timed Up-and-Go (TUG) test, which is a mobility task involving starting in a sitting position, standing up, walking three meters to cross a line on the floor, turning around, walking back and sitting down again. We combined TUG with the verbal task of naming different animals. Pilot study participants were 43 individuals with and without established dementia diagnoses who attended a clinic for memory assessment. Video-recorded test performances were systematically analysed. Deviant test performances concerning the interplay between test administration and participants' responses to the assessment instructions were revealed and led to refinements being made to the final study protocol. Exploration of the dual-task test outcome measures in a sub-sample of 22 persons, ten with and twelve without dementia, indicated that step-length and number of named animals after the turning point of the dual-task test might constitute appropriate measures for examining this kind of sample. We concluded that the refined study protocol is feasible for testing individuals undergoing initial memory assessments and healthy controls. Follow-up studies with larger samples are being carried out and will bring new knowledge to this area of research. It may also provide an opportunity for further studies exploring possibilities for broad clinical implementation.
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Affiliation(s)
- Ylva Cedervall
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
| | - Anna M. Stenberg
- Department of Geriatrics and Rehabilitation Medicine, Falu Hospital,. SE-70182 Falun, Sweden
| | - Hanna B. Åhman
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
| | - Fredrik Tinmark
- The Swedish School of Sports and Health Sciences, SE-11433 Stockholm, Sweden
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, SE-75007 Uppsala, Sweden
| | - Lars Berglund
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
| | - Kjartan Halvorsen
- Systems and Control, Department of Information Technology, Uppsala University, SE-75105 Uppsala, Sweden
- Department of Mechatronics, Campus Estado de Mexico, Tecnologico de Monterrey, Monterrey 64849, NL, Mexiko
| | - Martin Ingelsson
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187 Umeå, Sweden
| | - Anna Cristina Åberg
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, SE-75185 Uppsala, Sweden
- School of Education, Health and Social Studies, Dalarna University, SE-79188 Falun, Sweden
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9
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Yoon B, Choi SH, Jeong JH, Park KW, Kim EJ, Hwang J, Jang JW, Kim HJ, Hong JY, Lee JM, Kang JH, Yoon SJ. Balance and Mobility Performance Along the Alzheimer’s Disease Spectrum. J Alzheimers Dis 2020; 73:633-644. [DOI: 10.3233/jad-190601] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Jihye Hwang
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Ju-Hee Kang
- Department of Pharmacology, Inha University School of Medicine, Incheon, Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
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Aristotelous P, Stefanakis M, Pantzaris M, Pattichis C, Hadjigeorgiou GM, Giannaki CD. Associations between functional capacity, isokinetic leg strength, sleep quality and cognitive function in multiple sclerosis patients: a cross-sectional study. Postgrad Med 2019; 131:453-460. [DOI: 10.1080/00325481.2019.1662271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Manos Stefanakis
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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Lee JE, Shin DW, Jeong SM, Son KY, Cho B, Yoon JL, Park BJ, Kwon IS, Lee J, Kim S. Association Between Timed Up and Go Test and Future Dementia Onset. J Gerontol A Biol Sci Med Sci 2019; 73:1238-1243. [PMID: 29346523 DOI: 10.1093/gerona/glx261] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/11/2018] [Indexed: 02/01/2023] Open
Abstract
Background This study evaluated whether baseline results of the Timed Up and Go (TUG) test is associated with future dementia occurrence. Methods Using the Korean National Health Insurance Service-National Health Screening Cohort database, we identified 49,283 subjects without a dementia diagnosis who participated in the National Screening Program for Transitional Ages at 66 years of age during 2007-2012. Gait impairment was defined as taking longer than 10 seconds to perform the TUG test. Dementia occurrence was defined by the first prescription for acetylcholinesterase inhibitors or N-Methyl-D-Aspartate receptor antagonist with an International Classification of Diseases 10th Revision (ICD-10) code for dementia (F00, F01, F02, F03, G30, F051, or G311) during 2007-2013. Cox proportional hazard regression models were used to assess the hazard ratios for dementia occurrence according to baseline TUG test results. Results Mean follow-up period was 3.8 years. Incidence rates of dementia were 4.6 and 6.8 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. The impaired TUG group showed a higher risk of total dementia incidence (adjusted hazard ratio [aHR], 1.34; 95% confidence interval [95% CI], 1.14-1.57). Subtype analysis showed that the impaired TUG group had a higher risk of Alzheimer's disease (aHR, 1.26; 95% CI, 1.06-1.51) and vascular dementia (aHR, 1.65; 95% CI, 1.19-2.30). Conclusions The TUG test result was associated with future dementia occurrence. More vigilant follow-up and early intervention to prevent dementia would benefit elderly people with impaired TUG test result.
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Affiliation(s)
- Ji Eun Lee
- Department of Family Medicine, Seoul National University Hospital, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Family Medicine, Seoul National University Hospital, Republic of Korea
| | - Ki Young Son
- Department of Family Medicine, Seoul National University Hospital, Republic of Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, Republic of Korea
| | - Jong Lull Yoon
- Department of Family Medicine, Hallym University Medical Center, Seoul, Republic of Korea
| | - Byung Joo Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Republic of Korea
| | - In Soon Kwon
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Republic of Korea
| | - Jinkook Lee
- Department of Economics & Center for Economic & Social Research, University of Southern California, Los Angeles, & RAND Corporation, Santa Monica
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, Republic of Korea
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Lee HS, Ko M, Park SW, Braden H. Concurrent validity of the Groningen Meander Walking and Timed Up and Go tests in older adults with dementia. Physiother Theory Pract 2019; 36:1432-1437. [PMID: 30739570 DOI: 10.1080/09593985.2019.1579285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and Purpose: The Groningen Meander Walking time (GMW-sec) test has not been clinically validated as a feasible assessment to test functional mobility skills. The purpose of this study was to determine the concurrent validity of the GMW-sec test with the Timed Up and Go (TUG) test in older adults with dementia. Methods: This study included a cross-sectional and between subjects design with one factor, which had three different levels of group. Consecutive sampling was used to recruit 145 elderly participants in dementia and senior care facilities. Participants were divided into three groups based on the result of a Mini-Mental Status Exam for Dementia Screening: 57 older adults with dementia, 25 older adults with mild cognitive impairment, and 63 healthy older adults. Results: Spearman rank order correlation showed that the TUG test had moderate association with the GMW-sec test not only in older adults with dementia (r = 0.69; p < 0.01), but also for the mild cognitive group (r = 0.63; p = 0.01) and healthy group (r = 0.47; p < 0.01). Older adults with dementia had a significant functional reduction for both GMW-sec and TUG tests compared to other two groups (p < 0.01). Discussion and Conclusion: Turning motions with the TUG test may cause similar challenges that relate to a curved walking path for the GMW-sec test in older adults with dementia. Both the TUG and GMW-sec tests could be effective approaches for screening the severity of cognitive impairment on functional mobility in people with dementia.
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Affiliation(s)
- Han-Suk Lee
- Department of Physical Therapy, Eulji University , Seongnam-si, Gyeonggi-do, South Korea
| | - Mansoo Ko
- Department of Physical Therapy, University of Texas Medical Branch , Galveston, Texas, USA
| | - Sun-Wook Park
- Department of Physical Therapy, Samsung Medical Center , Gangnam-gu, Seoul, South Korea
| | - Heather Braden
- Department of Physical Therapy, Angelo State University , San Angelo, Texas, USA
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Donoghue O, Feeney J, O'Leary N, Kenny RA. 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). Am J Geriatr Psychiatry 2018; 26:438-448. [PMID: 29275903 DOI: 10.1016/j.jagp.2017.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 10/24/2017] [Accepted: 11/13/2017] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Orna Donoghue
- From The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland.
| | - Joanne Feeney
- Centre for Public Health, Queens University, Belfast, UK
| | - Neil O'Leary
- From The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland
| | - Rose Anne Kenny
- From The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland
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Nishiguchi S, Yorozu A, Adachi D, Takahashi M, Aoyama T. Association between mild cognitive impairment and trajectory-based spatial parameters during timed up and go test using a laser range sensor. J Neuroeng Rehabil 2017; 14:78. [PMID: 28789676 PMCID: PMC5549311 DOI: 10.1186/s12984-017-0289-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/01/2017] [Indexed: 11/16/2022] Open
Abstract
Background The Timed Up and Go (TUG) test may be a useful tool to detect not only mobility impairment but also possible cognitive impairment. In this cross-sectional study, we used the TUG test to investigate the associations between trajectory-based spatial parameters measured by laser range sensor (LRS) and cognitive impairment in community-dwelling older adults. Methods The participants were 63 community-dwelling older adults (mean age, 73.0 ± 6.3 years). The trajectory-based spatial parameters during the TUG test were measured using an LRS. In each forward and backward phase, we calculated the minimum distance from the marker, the maximum distance from the x-axis (center line), the length of the trajectories, and the area of region surrounded by the trajectory of the center of gravity and the x-axis (center line). We measured mild cognitive impairment using the Mini-Mental State Examination score (26/27 was the cut-off score for defining mild cognitive impairment). Results Compared with participants with normal cognitive function, those with mild cognitive impairment exhibited the following trajectory-based spatial parameters: short minimum distance from the marker (p = 0.044), narrow area of center of gravity in the forward phase (p = 0.012), and a large forward/whole phase ratio of the area of the center of gravity (p = 0.026) during the TUG test. In multivariate logistic regression analyses, a short minimum distance from the marker (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.69–0.98), narrow area of the center of gravity in the forward phase (OR: 0.01, 95% CI: 0.00–0.36), and large forward/whole phase ratio of the area of the center of gravity (OR: 0.94, 95% CI: 0.88–0.99) were independently associated with mild cognitive impairment. Conclusions In conclusion, our results indicate that some of the trajectory-based spatial parameters measured by LRS during the TUG test were independently associated with cognitive impairment in older adults. In particular, older adults with cognitive impairment exhibit shorter minimum distances from the marker and asymmetrical trajectories during the TUG test.
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Affiliation(s)
- Shu Nishiguchi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Ayanori Yorozu
- Graduate School of Science and Technology, Keio University, Yokohama, Japan
| | - Daiki Adachi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Takahashi
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku Yokohama, 223-8522, Japan.
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Demnitz N, Esser P, Dawes H, Valkanova V, Johansen-Berg H, Ebmeier KP, Sexton C. A systematic review and meta-analysis of cross-sectional studies examining the relationship between mobility and cognition in healthy older adults. Gait Posture 2016; 50:164-174. [PMID: 27621086 PMCID: PMC5081060 DOI: 10.1016/j.gaitpost.2016.08.028] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/15/2016] [Accepted: 08/25/2016] [Indexed: 02/02/2023]
Abstract
Ageing is associated with declines in cognitive function and mobility. The extent to which this relationship encompasses the subdomains of cognition and mobility remains unclear, however. We searched MEDLINE and EMBASE databases for cross-sectional studies examining the association between objective mobility measures (gait, lower-extremity function, balance) and cognitive function (global, executive function, memory, processing speed) in healthy older adults. Of the 642 studies identified, 26 studies met the inclusion criteria, with a total of 26,355 participants. For each feature of physical mobility, the relation to each aspect of cognition was reviewed. In the context of each association, we summarised the results to date and performed random-effects meta-analyses of published data. Reviewed findings suggest that individuals with better mobility perform better on assessments of global cognition, executive function, memory and processing speed. Not all measures of mobility were equally associated with cognitive function, however. Although there was a larger number of gait and lower-extremity function studies, and this may have driven findings, most studies examining balance and cognition measures reported no significant results. Meta-analyses on reported associations supported results by revealing significant, albeit small, effect sizes in favour of a positive association between performance on mobility measures and cognitive assessments. Future research should aim to establish the mechanisms driving this relationship, as this may identify predictors of age-related impairments.
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Affiliation(s)
- Naiara Demnitz
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, UK; Department of Psychiatry, Warneford Hospital, University of Oxford, OX3 7JX, UK
| | - Patrick Esser
- Movement Science Group, Oxford Brookes University, OX3 0BP, UK
| | - Helen Dawes
- Movement Science Group, Oxford Brookes University, OX3 0BP, UK
| | - Vyara Valkanova
- Department of Psychiatry, Warneford Hospital, University of Oxford, OX3 7JX, UK
| | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, UK
| | - Klaus P Ebmeier
- Department of Psychiatry, Warneford Hospital, University of Oxford, OX3 7JX, UK
| | - Claire Sexton
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, UK.
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Kikkert LHJ, Vuillerme N, van Campen JP, Hortobágyi T, Lamoth CJ. Walking ability to predict future cognitive decline in old adults: A scoping review. Ageing Res Rev 2016; 27:1-14. [PMID: 26861693 DOI: 10.1016/j.arr.2016.02.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 01/02/2023]
Abstract
Early identification of individuals at risk for cognitive decline may facilitate the selection of those who benefit most from interventions. Current models predicting cognitive decline include neuropsychological and/or biological markers. Additional markers based on walking ability might improve accuracy and specificity of these models because motor and cognitive functions share neuroanatomical structures and psychological processes. We reviewed the relationship between walking ability at one point of (mid) life and cognitive decline at follow-up. A systematic literature search identified 20 longitudinal studies. The average follow-up time was 4.5 years. Gait speed quantified walking ability in most studies (n=18). Additional gait measures (n=4) were step frequency, variability and step-length. Despite methodological weaknesses, results revealed that gait slowing (0.68-1.1 m/sec) preceded cognitive decline and the presence of dementia syndromes (maximal odds and hazard ratios of 10.4 and 11.1, respectively). The results indicate that measures of walking ability could serve as additional markers to predict cognitive decline. However, gait speed alone might lack specificity. We recommend gait analysis, including dynamic gait parameters, in clinical evaluations of patients with suspected cognitive decline. Future studies should focus on examining the specificity and accuracy of various gait characteristics to predict future cognitive decline.
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Affiliation(s)
- Lisette H J Kikkert
- University of Groningen, University Medical Centre Groningen, Center for Human Movement Sciences, A. Deusinglaan 1, 9700 AD Groningen, The Netherlands; Univ. Grenoble Alpes, EA AGEIS, La Tronche, France.
| | - Nicolas Vuillerme
- Univ. Grenoble Alpes, EA AGEIS, La Tronche, France; Institut Universitaire de France, Paris, France.
| | - Jos P van Campen
- MC Slotervaart Hospital, Department of Geriatric Medicine, Amsterdam, The Netherlands.
| | - Tibor Hortobágyi
- University of Groningen, University Medical Centre Groningen, Center for Human Movement Sciences, A. Deusinglaan 1, 9700 AD Groningen, The Netherlands; Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
| | - Claudine J Lamoth
- University of Groningen, University Medical Centre Groningen, Center for Human Movement Sciences, A. Deusinglaan 1, 9700 AD Groningen, The Netherlands.
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Townsend NT, Robinson TN. Surgical Risk and Comorbidity in Older Urologic Patients. Clin Geriatr Med 2015; 31:591-601. [DOI: 10.1016/j.cger.2015.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stegemöller EL, Nocera J, Malaty I, Shelley M, Okun MS, Hass CJ. Timed up and go, cognitive, and quality-of-life correlates in Parkinson's disease. Arch Phys Med Rehabil 2013; 95:649-55. [PMID: 24291596 DOI: 10.1016/j.apmr.2013.10.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 10/31/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the relationship between Timed Up and Go (TUG) performance, verbal executive function (EF) performance, and quality-of-life (QOL) measures in Parkinson's disease (PD). DESIGN Cross-sectional. SETTING Sixteen movement disorder centers from across the United States. PARTICIPANTS Patients with PD (N=1964). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES TUG test, immediate and delayed 5-word recall, verbal fluency, PD QOL Questionnaire. RESULTS TUG performance and verbal EF performance were significantly associated with, and predictors of, QOL measures, having the greatest association and predictability with the mobility domain of the QOL measures. CONCLUSIONS The TUG test and verbal EF tests have QOL correlates, making the combined evaluation of mobility, cognitive, and QOL decline a potential examination tool to evaluate the sequelae of PD.
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Affiliation(s)
- Elizabeth L Stegemöller
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL; Department of Kinesiology, Iowa State University, Ames, IA
| | - Joe Nocera
- VA Rehabilitation R&D Center of Excellence, Atlanta VA Medical Center, Atlanta, GA; Department of Neurology, Emory University, Atlanta, GA
| | - Irene Malaty
- Department of Neurology, Center for Movement Disorders & Neurorestoration, University of Florida, Gainesville, FL
| | - Mack Shelley
- Departments of Statistics and Political Science, Iowa State University, Ames, IA
| | - Michael S Okun
- Department of Neurology, Center for Movement Disorders & Neurorestoration, University of Florida, Gainesville, FL
| | - Chris J Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL.
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Robinson TN, Wu DS, Sauaia A, Dunn CL, Stevens-Lapsley JE, Moss M, Stiegmann GV, Gajdos C, Cleveland JC, Inouye SK. Slower walking speed forecasts increased postoperative morbidity and 1-year mortality across surgical specialties. Ann Surg 2013; 258:582-8; discussion 588-90. [PMID: 23979272 PMCID: PMC3771691 DOI: 10.1097/sla.0b013e3182a4e96c] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the relationship between the Timed Up and Go test and postoperative morbidity and 1-year mortality, and to compare the Timed Up and Go to the standard-of-care surgical risk calculators for prediction of postoperative complications. METHODS In this prospective cohort study, patients 65 years and older undergoing elective colorectal and cardiac operations with a minimum of 1-year follow-up were included. The Timed Up and Go test was performed preoperatively. This timed test starts with the subject standing from a chair, walking 10 feet, returning to the chair, and ends after the subject sits. Timed Up and Go results were grouped as fast ≤ 10 seconds, intermediate = 11-14 seconds, and slow ≥ 15 seconds. Receiver operating characteristic curves were used to compare the 3 Timed Up and Go groups to current standard-of-care surgical risk calculators at forecasting postoperative complications. RESULTS This study included 272 subjects (mean age of 74 ± 6 years). Slower Timed Up and Go was associated with increased postoperative complications after colorectal (fast 13%, intermediate 29%, and slow 77%; P < 0.001) and cardiac (fast 11%, intermediate 26%, and slow 52%; P < 0.001) operations. Slower Timed Up and Go was associated with increased 1-year mortality following both colorectal (fast 3%, intermediate 10%, and slow 31%; P = 0.006) and cardiac (fast 2%, intermediate 3%, and slow 12%; P = 0.039) operations. Receiver operating characteristic area under curve of the Timed Up and Go and the risk calculators for the colorectal group was 0.775 (95% CI: 0.670-0.880) and 0.554 (95% CI: 0.499-0.609), and for the cardiac group was 0.684 (95% CI: 0.603-0.766) and 0.552 (95% CI: 0.477-0.626). CONCLUSIONS Slower Timed Up and Go forecasted increased postoperative complications and 1-year mortality across surgical specialties. Regardless of operation performed, the Timed Up and Go compared favorably to the more complex risk calculators at forecasting postoperative complications.
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Affiliation(s)
- Thomas N Robinson
- *Department of Surgery †School of Public Health ‡Department of Physical Medicine and Rehabilitation Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO §Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School and Institute for Aging Research, Hebrew SeniorLife, Boston, MA ¶Department of Surgery, Denver Veteran Affairs Medical Center, Denver, CO
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