scholarly journals Supporting community‐dwelling older people with cognitive impairment to stay at home: A modelled cost analysis

2020 ◽  
Vol 39 (4) ◽  
Author(s):  
Suzanne M. Dyer ◽  
Lachlan B. Standfield ◽  
Nicola Fairhall ◽  
Ian D. Cameron ◽  
Meredith Gresham ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cost Analysis ◽  
Older People ◽  
Community Dwelling ◽  
Community Dwelling Older People ◽  
At Home

33 Cognitive Domain Associations with Balance Performance in Community – Dwelling Older People with Cognitive Impairment

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Morag Taylor ◽  
Stephen Lord ◽  
Annika Toots ◽  
Close Jacqueline
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Older People ◽  
Verbal Fluency ◽  
Community Dwelling ◽  
Cognitive Domain ◽  
Balance Performance ◽  
Visuospatial Ability ◽  
Community Dwelling Older People ◽  
Attention Memory

Abstract Aims Investigate the relationship between global cognition and cognitive domain function and balance performance in a large sample of older people with cognitive impairment. Methods Three hundred and nine community-dwelling older people (mean age=82 years; 47% female) with cognitive impairment were recruited for the iFOCIS fall prevention randomised controlled trial. Baseline assessments completed before randomisation were used for analyses and included the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognitive function) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and executive function, further examined using the Frontal Assessment Battery (FAB). Balance performance was derived by averaging postural sway on floor and foam, maximal balance range (reverse z-score) and co-ordinated stability z-scores. With balance performance as the dependent variable, global cognition and each cognitive domain were entered into multivariate linear regression models. Results Mean (± standard deviation) ACE-III and FAB scores were 62.8±19.2 and 11.4±4.6 respectively. In linear regression analyses adjusted for covariates, global cognitive function and each cognitive domain were significantly associated with balance performance. Executive function (verbal fluency; β=-.248, p<0.001, adjusted R2=0.376) and visuospatial ability (β=-.250, p<0.001, adjusted R2=0.381) had the strongest and memory the weakest (β=-.119, p=0.018, adjusted R2=0.334) association with balance. Visuospatial ability remained significantly associated with balance performance when adjusted for attention, memory, language, verbal fluency and the FAB. Executive function (verbal fluency) remained significantly associated with balance when adjusted for attention, memory, language and visuospatial ability. Conversely, attention, memory, and language did not withstand adjustment for visuospatial ability or executive function. Conclusions Poorer global cognition and performance in each cognitive domain were associated with poorer balance performance in this large sample of community-dwelling older people with cognitive impairment. Visuospatial ability and executive function were independently associated with balance, highlighting the role higher-level cognitive processes and spatial perception and processing play in postural control.

Cognitive Domain Associations with Balance Performance in Community-Dwelling Older People with Cognitive Impairment

2021 ◽  
pp. 1-9
Author(s):  
Morag E. Taylor ◽  
Annika Toots ◽  
Stephen R. Lord ◽  
Narelle Payne ◽  
Jacqueline C.T. Close
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Verbal Fluency ◽  
Community Dwelling ◽  
Cognitive Domain ◽  
Balance Performance ◽  
Visuospatial Ability ◽  
Cognitive Domains ◽  
Community Dwelling Older People ◽  
Global Cognition

Background: In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited. Objective: To investigate the relationship between global cognition and cognitive domain function and balance performance in older people with CI. Methods: The iFOCIS randomized controlled trial recruited 309 community-dwelling older people with CI. Baseline assessments completed before randomization were used for analyses including the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognition) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and the Frontal Assessment Battery (FAB), a measure of EF. A composite balance score was derived from postural sway and leaning balance tests. Results: In linear regression analyses adjusted for covariates, global cognition and each cognitive domain were significantly associated with balance performance. EF (verbal fluency; β= –0.254, p <  0.001, adjusted R2 = 0.387) and visuospatial ability (β= –0.258, p <  0.001, adjusted R2 = 0.391) had the strongest associations with balance performance. In a comprehensively adjusted multivariable model including all of the ACE-III cognitive domains, visuospatial ability and EF (verbal fluency) were independently and significantly associated with balance performance. Conclusion: Poorer global cognition and cognitive domain function were associated with poorer balance performance in this sample of people with CI. Visuospatial ability and EF were independently associated with balance, highlighting potential shared neural networks and the role higher-level cognitive processes and spatial perception/processing play in postural control.

scholarly journals Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

2020 ◽  
Vol 14 (4) ◽  
pp. 394-402
Author(s):  
Anne Caroline Soares da Silva ◽  
Juliana Hotta Ansai ◽  
Natália Oiring de Castro Cezar ◽  
Francisco Assis Carvalho Vale ◽  
Julimara Gomes dos Santos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Home Visit ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Dwelling ◽  
Community Dwelling Older People

ABSTRACT. Background: Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. Objective: To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. Methods: One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. Results: Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show “other diagnoses” (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. Conclusions: Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.

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