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Elshorbagy R, Alkhaldi H, Alshammari N, El Semary M. Influence of Sex on Cognitive and Motor Dual-Task Performance Among Young Adults: A Cross-Sectional Study. Ann Rehabil Med 2024; 48:163-170. [PMID: 38575372 PMCID: PMC11058369 DOI: 10.5535/arm.23150] [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: 10/13/2023] [Revised: 02/17/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE To investigate the sex-related differences in single-task performance through motor torque, cognitive tasks and walking speed, and the combined dual-task costs (DTCs) considering both motor and cognitive performance in young adults. METHODS Sixty-seven non-athletic subjects 37 females and 30 males were enrolled. The study measured their knee extension muscle torque using an isokinetic strength dynamometer and their walking speed using the one step app. these assessments were performed both with and without a cognitive task, and the DTCs were calculated. RESULTS The females exhibited significantly larger motor performance dual task effect through (torque-DTC, speed-DTC) compared with males while exhibiting smaller cognitive dual task effect with muscle torque and speed. CONCLUSION Deterioration in motor performance during muscle force production and speed during dual tasks was large in females compared to males, whereas males experience a decline in cognitive ability when performing dual tasks compared with females.
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Affiliation(s)
- Radwa Elshorbagy
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
- Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hanin Alkhaldi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Njoud Alshammari
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Moataz El Semary
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
- Department of Physical Therapy for Neurology and Neurosurgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Effects of age, sex, frailty and falls on cognitive and motor performance during dual-task walking in older adults. Exp Gerontol 2023; 171:112022. [PMID: 36371049 DOI: 10.1016/j.exger.2022.112022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/26/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dual-task (DT) walking is of great interest in clinical evaluation to evaluate the risk of falling or cognitive declines in older adults. However, it appears necessary to investigate deeply the confounding factors to better understand their impact on dual-task performance. OBJECTIVE To evaluate the effect of age, sex, falls and frailty on cognitive and motor parameters in dual-task walking. SUBJECTS 66 older participants (mean age = 75.5 ± 6.3; mean height = 165.8 ± 8.4 cm; mean weight = 68.4 ± 14 kgs) were split into groups based on their age, sex, fall and frailty status. METHODS Participants performed single-task walking, single-task cognitive (serial subtraction of 3), and dual-task walking (subtraction + walking) for 1 min at their fast pace. Gait speed, step length, step length variability, stance and swing phase time, single and double support, cadence, step time variability and gait speed variability were recorded in single- and dual-task walking and used to calculate the dual-task effect (DTE) as ((DT - ST) / ST) ∗ 100). The cognitive score (DTEcog) was calculated as the number of correct responses minus errors. Generalized linear mixed models (GLMM) were used to compare the effects of falls, frailty, age and sex on gait and cognitive variables. RESULTS The interaction frailty*sex and frailty*age were the major effect on the DTEs. Specifically, the DTE was higher in women than men and in the frail group compared to non-frail. CONCLUSIONS The present findings provide a better understanding on the confounding factors explaining the behavior in DT that could be used to develop more effective dual-task clinical programs for community-living older adults.
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Taguchi CK, Menezes PDL, Melo ACS, de Santana LS, Conceição WRS, de Souza GF, Araújo BCL, da Silva AR. Frailty syndrome and risks for falling in the elderly community. Codas 2022; 34:e20210025. [PMID: 35946721 PMCID: PMC9886293 DOI: 10.1590/2317-1782/20212021025pt] [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: 02/14/2021] [Accepted: 01/31/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To identify the prevalence of Frailty Syndrome in the elderly and the relationship with risk of falling. METHODS Descriptive, cross-sectional, and analytical clinical study. One hundred and one volunteers over 60 years old were submitted to audiological evaluation, Dynamic Gait Index - Brazilian brief (DGI), Timed Up and Go (TUG) and Edmonton Fragility Scale (EFE) that verified, respectively, hearing thresholds, frailty syndrome, functional and dynamic balance, and risk of falling. The simple percentual distribution, the Wilcoxon´s test and the Bivariate Correlation with Pearson's coefficient were used for statistical analysis. Limits equal to or less than 1.0 and 5.0% were adopted. RESULTS EFE identified 22.8% of volunteers as fragile and 22.8% as vulnerable. DGI and TUG found 34.6% and 84.1% of at risk for falls, respectively. Significant correlations between EFE and DGI (p <0.01), EFE and TUG (p <0.01), and DGI and TUG (p <0.01) were observed. Pearson's coefficient between EFE and DGI, EFE and TUG, and DGI and TUG were -0.26, -0.41, and 0.46, respectively. An association between DGI and TUG and age (p <0.01) was identified. No correlation between EFE and sex or age was found. CONCLUSION Frailty and pre-frailty were identified in a significant segment of the volunteers, especially in the oldest subjects. Functional and dynamic balance were moderately correlated with frailty, which demonstrated that frailty syndrome increases the risk of falls.
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Taguchi CK, Menezes PDL, Melo ACS, Santana LSD, Conceição WRS, Souza GFD, Araújo BCL, Silva ARD. Frailty syndrome and risks for falling in the elderly community. Codas 2022. [DOI: 10.1590/2317-1782/20212021025en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Purpose To identify the prevalence of Frailty Syndrome in the elderly and the relationship with risk of falling. Methods Descriptive, cross-sectional, and analytical clinical study. One hundred and one volunteers over 60 years old were submitted to audiological evaluation, Dynamic Gait Index - Brazilian brief (DGI), Timed Up and Go (TUG) and Edmonton Fragility Scale (EFE) that verified, respectively, hearing thresholds, frailty syndrome, functional and dynamic balance, and risk of falling. The simple percentual distribution, the Wilcoxon´s test and the Bivariate Correlation with Pearson's coefficient were used for statistical analysis. Limits equal to or less than 1.0 and 5.0% were adopted. Results EFE identified 22.8% of volunteers as fragile and 22.8% as vulnerable. DGI and TUG found 34.6% and 84.1% of at risk for falls, respectively. Significant correlations between EFE and DGI (p <0.01), EFE and TUG (p <0.01), and DGI and TUG (p <0.01) were observed. Pearson's coefficient between EFE and DGI, EFE and TUG, and DGI and TUG were -0.26, -0.41, and 0.46, respectively. An association between DGI and TUG and age (p <0.01) was identified. No correlation between EFE and sex or age was found. Conclusion Frailty and pre-frailty were identified in a significant segment of the volunteers, especially in the oldest subjects. Functional and dynamic balance were moderately correlated with frailty, which demonstrated that frailty syndrome increases the risk of falls.
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A Cross-Sectional Study of the Relationship of Timed Up & Go Test with Physical Characteristics and Physical Activity in Healthy Japanese: The Toon Health Study. Healthcare (Basel) 2021; 9:healthcare9080933. [PMID: 34442070 PMCID: PMC8391555 DOI: 10.3390/healthcare9080933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/24/2022] Open
Abstract
This study evaluated the Timed Up & Go test (TUG) among healthy Japanese individuals without walking problems to clarify the relationship of TUG performance with physical characteristics and physical activity according to sex and age groups. In total, 797 men and women (30–84 years old) in Toon City, Ehime Prefecture, were assessed from 2016 to 2017. The survey data for physical characteristics, TUG performance, and physical activity measures were used. After adjusting for age according to TUG time and categorization into sex and age groups (30–64 and 65–84 years), the relationship of TUG performance with physical characteristics and physical activities was confirmed using multiple regression analysis. In men, TUG performance was associated with work and household chores in the 30–64-year age group, whereas it was only associated with skeletal muscle mass among those older than 65 years. In women, TUG performance was associated with height and amount of exercise, regardless of age. In conclusion, TUG performance may be maintained by increasing the amount of physical activity for men through work and housework, and increasing the amount of exercise for women, which may prevent the need for long-term care in the future.
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Tolley APL, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review. J Clin Epidemiol 2021; 137:218-230. [PMID: 33915264 DOI: 10.1016/j.jclinepi.2021.04.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults. STUDY DESIGN AND SETTING Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots. RESULTS The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively. CONCLUSION Objective measures of physical activity are associated with frailty, regardless of frailty definition.
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Affiliation(s)
- Alec P L Tolley
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Keenan A Ramsey
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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Bortone I, Sardone R, Lampignano L, Castellana F, Zupo R, Lozupone M, Moretti B, Giannelli G, Panza F. How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review. J Cachexia Sarcopenia Muscle 2021; 12:274-297. [PMID: 33590975 PMCID: PMC8061366 DOI: 10.1002/jcsm.12667] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
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Affiliation(s)
- Ilaria Bortone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Rodolfo Sardone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Luisa Lampignano
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Fabio Castellana
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Roberta Zupo
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Madia Lozupone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Biagio Moretti
- Orthopaedics and Trauma Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Gianluigi Giannelli
- Scientific DirectionNational Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Francesco Panza
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
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Lorenzo-López L, Campos-Magdaleno M, López-López R, Facal D, Pereiro AX, Maseda A, Blanco-Fandiño J, Millán-Calenti JC. Dual and triple tasks performance in institutionalized prefrail and frail older adults. Int J Geriatr Psychiatry 2020; 35:1358-1366. [PMID: 32662207 DOI: 10.1002/gps.5375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/17/2020] [Accepted: 07/06/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this pilot study was to investigate differences on dual- and triple-task performance in institutionalized prefrail and frail older adults. Performance on these tasks is relevant since many activities of daily living involve simultaneous motor and cognitive tasks. METHODS We used a phenotypic description of frailty based on the presence or absence of five criteria related to physical fitness and metabolism (unintentional weight loss, self-reported exhaustion, muscle weakness, low gait speed, and low physical activity). Thirty-three institutionalized older adults (≥ 65 years, 78.8% females) were divided according to their frailty status. Participants completed cognitive tasks (a phonemic verbal fluency task and a visuospatial tracking task) while cycling on a stationary cycle (upper- and lower-extremity function was assessed). Cycling (number of arm and foot cycles) and cognitive (number of correct answers) performances were measured during single-, dual-, and triple-task conditions. Performances and costs of dual -and triple- tasking on cycling and cognitive performances were compared between prefrail and frail groups. RESULTS Prefrail and frail older adults did not differ in their performance in dual-tasks; however, frail older adults showed a poorer performance in the triple-task. CONCLUSIONS Although future studies need to confirm our observations in larger samples, this pilot study suggests that developing new tools based on triple tasking could be useful for the comprehensive assessment of frailty.
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Affiliation(s)
- Laura Lorenzo-López
- Gerontology and Geriatrics Research Group, Instituto de Investigación biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - María Campos-Magdaleno
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rocío López-López
- Gerontology and Geriatrics Research Group, Instituto de Investigación biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo X Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Maseda
- Gerontology and Geriatrics Research Group, Instituto de Investigación biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Julia Blanco-Fandiño
- Gerontology and Geriatrics Research Group, Instituto de Investigación biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - José Carlos Millán-Calenti
- Gerontology and Geriatrics Research Group, Instituto de Investigación biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
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