Concern About Falling Is Associated With Gait Speed, Independently From Physical and Cognitive Function

2019 ◽  
Vol 99 (8) ◽  
pp. 989-997 ◽  
Author(s):  
Kimberley S van Schooten ◽  
Ellen Freiberger ◽  
Myriam Sillevis Smitt ◽  
Veronika Keppner ◽  
Cornel Sieber ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Dual Task ◽  
Gait Speed ◽  
Fall Risk ◽  
Walking Speed ◽  
Community Dwelling ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional ◽  
Increased Risk

AbstractBackgroundHigher levels of concern about falling in older people have been associated with slower walking speed and an increased risk of falls. However, it is unclear whether this relationship is independent or confounded by other fall risk factors, such as physical and cognitive function.ObjectiveThe aim of this study was to examine the effects of concern about falling on gait speed, adjusted for physiological fall risk and cognitive function.DesignThis was an observational, cross-sectional study.MethodsA total of 204 community-dwelling older people aged 70 years or older were recruited from 2 sites (Germany, n = 94; Australia, n = 110). Walking speed was measured over 6 m under 4 conditions: preferred speed, fast speed, speed while carrying a tray (functional dual task), and speed while answering a question (cognitive dual task). The Falls Efficacy Scale–International was used to assess concern about falling, the Physiological Profile Assessment was used to assess physiological fall risk, and the Digit Symbol Substitution Test and Trail Making Test were used to assess attention and executive function.ResultsHigher levels of concern about falling were associated with slower gait speed. Following adjustment for age, history of falls, and female sex, and further adjustment for physical and cognitive function, the association between concern about falling and walking speed remained significant, with a considerable effect size (standardized β = 0.18 ± 0.08; P = .037).LimitationsThe use of walking speed as a sole measure of gait was a limitation of this study.ConclusionsGait speed, especially under dual-task conditions, was affected by concern about falling. Concern about falling was the strongest predictor of gait speed under all 4 conditions and should be included in routine geriatric assessments.

A 9-Week Jaques-Dalcroze Eurhythmics Intervention Improves Single and Dual-Task Gait Speed in Community-Dwelling Older People

2017 ◽  
Vol 14 (9) ◽  
pp. 740-744 ◽  
Author(s):  
Lisa Ferguson-Stegall ◽  
Mandy Vang ◽  
Anthony S. Wolfe ◽  
Kathy M. Thomsen
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Dual Task ◽  
Gait Speed ◽  
Fall Risk ◽  
Preliminary Investigation ◽  
Community Dwelling ◽  
Health Concern ◽  
Short Term ◽  
Movement Training

Background:Falls are a major public health concern among older adults, and most occur while walking, especially under dualtask conditions. Jaques-Dalcroze eurhythmics (JDE) is a music-based movement training program that emphasizes multitask coordinated movement. A previous 6-mo JDE study in older people demonstrated improved gait and balance; however, the effects of short-term JDE interventions on fall risk-related outcomes are largely unknown. We conducted a preliminary investigation on whether a 9-week JDE intervention improved gait and stability in a community-dwelling older cohort, hypothesizing that improvements would occur in all outcome measures.Methods:Nine participants (78.9 ± 12.3 y) completed the supervised JDE intervention (once/week for 60 min). Gait speed was determined by the 6-m timed walk test (6MTW); dual-task gait speed was determined by another 6MTW while counting backward from 50 aloud; and coordinated stability was assessed using a Swaymeter-like device.Results:Gait speed (0.92 ± 0.11 vs 1.04 ± 0.12 m/sec, P = .04) and dual-task gait speed (0.77 ± 0.09 vs 0.92 ± 0.11 m/sec, P = .0005) significantly improved.Conclusions:This novel intervention is an effective short-term physical activity option for those that plan physical activity or fall-risk reduction programs for the older people.

scholarly journals Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People

2019 ◽  
Vol 16 (4) ◽  
pp. 613 ◽  
Author(s):  
Yukie Nakajima ◽  
Steven Schmidt ◽  
Agneta Malmgren Fänge ◽  
Mari Ono ◽  
Toshiharu Ikaga
Keyword(s):  
Older People ◽  
Economic Status ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Indoor Temperature ◽  
Cross Sectional ◽  
Economic Satisfaction ◽  
Increased Risk ◽  
Community Dwelling Older People

This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.

scholarly journals Physical performance reflects cognitive function, fall risk, and quality of life in community-dwelling older people

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shota Ikegami ◽  
Jun Takahashi ◽  
Masashi Uehara ◽  
Ryosuke Tokida ◽  
Hikaru Nishimura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals The feasibility and effects of virtual-reality motor-cognitive training in community-dwelling older people with cognitive frailty: A pilot randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Rick Yiu Cho Kwan ◽  
Justina Yat Wa Liu ◽  
Kenneth Nai Kuen Fong ◽  
Harry Qin ◽  
Philip Kwok-Yuen Leung ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Cognitive Training ◽  
Walking Speed ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Physical Frailty ◽  
Cognitive Frailty

BACKGROUND Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment and is associated with many adverse health outcomes. While cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function We propose a virtual reality (VR) simultaneous motor-cognitive training program, which allows older people to practice performing daily activities in a virtual space mimicking real environments. OBJECTIVE We aimed 1) to explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and 2) to compare its effects with an existing motor-cognitive training program in the community on the cognitive function and physical function of older people with cognitive frailty. METHODS A two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for participants were: 1) age≥60 years, 2) community dwelling, and 3) with cognitive frailty. Those in the intervention group received cognitive training (i.e., cognitive games) and motor training (i.e., cycling on an ergometer) simultaneously on a VR platform, mimicking the daily living activities of older people. Those in the control group received cognitive training (i.e., cognitive games) on tablet computers and motor training (i.e., cycling on the ergometer) sequentially on a non-VR platform. Both groups received a 30-minute session twice a week for 8 weeks. Feasibility was measured by adherence, adverse outcomes, and successful learning. The outcomes were cognitive function, physical frailty level, and walking speed. RESULTS Seventeen participants were recruited and randomized into either the control group (n=8) or intervention group (n=9). At baseline, the median age was 74.0 years (IQR=9.5) and the median MoCA score was 20.0 (IQR=4.0). No significant between-group differences were found except in the number of chronic illnesses (P=0.043). At post-intervention, the intervention group (Z=-2.673, P=0.008) showed a significantly larger improvement in cognitive function than the control group (Z=-1.187, P=0.235). The reduction in physical frailty in the intervention group (Z=-1.730, P=0.084) was similar to that in the control group (Z=-1.890, P=0.059). The TUG-measured improvement in walking speed was moderate in the intervention group (Z=-0.159, P=0.110), and greater in the control group (Z=-2.521, P=0.012). The recruitment rate was acceptable (17/33, 51.5%). Both groups had a 100% attendance rate. The intervention group had a higher completion rate than the control group. Training was terminated for one participant (1/9, 11.1%) due to minimal VR sickness (VRSQ=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in both groups. CONCLUSIONS This study provides preliminary evidence that the VR simultaneous motor-cognitive training group experienced greater improvement in cognitive function than the control group, and reduced frailty and improved walking speed. VR training is feasible and safe for older people with cognitive frailty. CLINICALTRIAL ClinicalTrials.gov NCT0446726

scholarly journals The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Laurence Seematter-Bagnoud ◽  
Christophe Büla ◽  
Brigitte Santos-Eggimann
Keyword(s):  
Alcohol Use ◽  
Dual Task ◽  
Gait Speed ◽  
Older Persons ◽  
Heavy Drinking ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Single Task ◽  
Moderate Drinking

Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons.Methods. Community-dwelling persons aged 65–70 years (N=807). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards).Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: −.040, 95% CI: −.0.78 to −.002,p=.035). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories.Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status.

scholarly journals 01 Prediction of Falls in Community-Dwelling Older People using an Accelerometer: The Results of a 1-Year Prospective Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv1-iv2
Author(s):  
Hiroshi Osaka ◽  
Daisuke Fujita ◽  
Kenichi Kobara ◽  
Yosuke Yoshimura ◽  
Hiromi Matsumoto ◽  
...  
Keyword(s):  
Older People ◽  
Fall Risk ◽  
Walking Speed ◽  
Exercise Duration ◽  
Community Dwelling ◽  
Gait Parameters ◽  
Weight Shift ◽  
Trunk Acceleration ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Fall preventive exercise for community-dwelling older people in Japan has a certain effect. The purpose of this study was to examine the predictors of fall risk in older people engaging in preventive exercise. Methods In this prospective study, we recruited 162 community-dwelling older people. We had them complete a self-report questionnaire containing items on weekly exercise frequency, exercise duration, exercise efficacy, amount of pain, number of diagnosis chronic diseases, health anxiety level, vision impairment, difficulty using the stairs, insomnia, fear of falling, history of falls, and forgetfulness, as well as the Falls Efficacy Scale. Walking speed and trunk acceleration during walking were also measured in all participants. From trunk acceleration, we calculated five gait parameters: fluctuation, weight shift, lateral balance, anteroposterior balance, and rhythm. Participants were classified as fallers or non-fallers according to the incidence of falls over a 1-year period from baseline assessment. Results Of all participants, 19 (11.7%) were classified as fallers and 143 (88.3%) as non-fallers. In comparing the fallers and non-fallers, we found significant differences in their exercise duration, exercise efficacy, amount of pain, history of falls, walking speed, and the gait parameters of weight shift and anteroposterior balance. A logistic regression analysis revealed that walking speed (odds ratio: 0.049, 95% confidence interval [CI]: 0.005-0.265, p=0.008) and weight shift (odds ratio: 0.021, 95%CI: 0.000-0.877, p=0.043) were predictors of falls. Conclusion The gait parameter of weight shift is the amplitude ratio of the auto-correlation function from vertical acceleration. This gait parameter is an original metrics and might show the temporal structure around the terminal stance. Measurement of gait parameters, in addition to physical performance, using an accelerometer seems beneficial for fall risk identification among community-dwelling older people engaged in fall preventive exercise.

scholarly journals Sarcopenia is Associated Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

2019 ◽  
Author(s):  
Miji Kim ◽  
Chang Won Won
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Gait Speed ◽  
Final Analysis ◽  
Community Dwelling ◽  
Disease Assessment ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
Sectional Analysis

Cognitive impairment and sarcopenia may share common risk factors and pathophysiological pathways. This study was performed to examine the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in a large group of community-dwelling older adults. Cross-sectional analysis was performed on the baseline data of 3,014 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study (KFACS). The final analysis included 1,887 adults underwent dual-energy X-ray absorptiometry and cognitive function assessments. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.

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