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Divandari N, Bird ML, Vakili M, Jaberzadeh S. The association between dynamic balance and executive function: Which dynamic balance test has the strongest association with executive function? A systematic review and meta-analysis. Curr Neurol Neurosci Rep 2024; 24:151-161. [PMID: 38730213 PMCID: PMC11143012 DOI: 10.1007/s11910-024-01340-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/12/2024]
Abstract
AIM The aging global population poses increasing challenges related to falls and dementia. Early identification of cognitive decline, particularly before noticeable symptoms manifest, is crucial for effective intervention. This review aims to determine the dynamic balance test most closely associated with executive function, potentially serving as a biomarker for cognitive decline. RECENT FINDINGS Based on recent reviews, inhibitory control, a component of executive function, holds significance in influencing balance performance. Studies suggest that the strength of the correlation between cognition and balance tends to be domain-specific and task-specific. Despite these findings, inconclusive evidence remains regarding the connection between executive function and various dynamic balance assessments. Our review identifies a significant association between all dynamic balance tests and executive function, albeit with varying strengths. Notably, a medium effect size is observed for the Timed Up and Go and Functional Reach Test, a small effect size for balance scales, and a strong effect size for postural sway. This review underscores a clear relationship between dynamic balance task performance and executive function. Dynamic posturography holds potential as a clinical biomarker for early detection of cognitive decline, with a note of caution due to observed heterogeneity and limited studies.
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Affiliation(s)
- Nahid Divandari
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia.
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Newnham Tasmania, 7248, Australia
| | | | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, PO Box 527, Melbourne, Frankston, VIC, 3199, Australia
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Adzhar MA, Manlapaz D, Singh DKA, Mesbah N. Exercise to Improve Postural Stability in Older Adults with Alzheimer's Disease: A Systematic Review of Randomized Control Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10350. [PMID: 36011984 PMCID: PMC9408145 DOI: 10.3390/ijerph191610350] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
In this systematic review, we aim to synthesize published evidence on the effects of exercise in improving postural stability among older adults with Alzheimer's Disease (AD). A systematic electronic literature search was undertaken in Pedro, Cochrane, MEDLINE, ProQuest, Science direct and Clinical trial databases involving human participants published from year 2000-2022. This search was updated in June 2022. The studies chosen were based on predetermined criteria. Data relating to the contents and parameters of exercise in persons with AD were gathered and analyzed. A total of 8 experimental studies met the inclusion criteria. Overall, the selected studies were of a medium quality. In these studies, information and physical exercises were used to improve postural stability in older adults with AD. The findings of the review suggest that performing combined strength, balance and executive function training can improve postural stability. However, we are unable to conclude the specific dose for specific type of exercise. More high-quality studies are required pertaining to exercise prescription for older adults with AD. Mostly, information and physical exercise were delivered via face-to-face sessions conducted by health professionals. The structure of exercises summarized in this review may be beneficial for older adults with AD to improve postural stability and as a result reduce falls.
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Affiliation(s)
- Mohamad Asyraf Adzhar
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Donald Manlapaz
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila 1008, Philippines
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Normala Mesbah
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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The Physical Activity Type Most Related to Cognitive Function and Quality of Life. BIOMED RESEARCH INTERNATIONAL 2021; 2020:8856284. [PMID: 33381590 PMCID: PMC7765724 DOI: 10.1155/2020/8856284] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/08/2020] [Accepted: 12/13/2020] [Indexed: 01/12/2023]
Abstract
Background Physical activity has been found to maintain and improve cognitive function and consequently improve health-related quality of life (HRQoL). The relationships between different types of physical activities, cognitive function, and HRQoL have not been studied sufficiently and compared in different age and gender groups. This study is aimed at examining the relationship between different types of physical activity (high-intensity, moderate-intensity, and walking exercise), cognitive function, and HRQoL. In addition, this study is aimed at examining these relationships in different age and gender groups. Methods This cross-sectional study included 150 adults with a mean age of 50 ± 8.8 years. Participants completed the International Physical Activity Questionnaire (IPAQ) to assess the level of the physical activity types and the Short-Form Health Survey (SF-36) questionnaire to assess HRQoL. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) screening instrument. Spearman correlation analysis was used to explore the relationships between the different variables of the study. Results There were significant positive relationships between all types of physical activities, cognitive ability, and HRQoL. The relationships between moderate-intensity physical activities and cognitive function (r = 0.38) and HRQoL (r = 0.33) were higher than the relationships with walking exercise and high-intensity physical activity. The middle-aged group had a significantly higher cognitive function compared to the senior adults (p < 0.001), while there was no significant difference between the age groups in HRQoL (p = 0.18). Conclusion The cognitive function and HRQoL were more related to moderate-intensity physical activities compared to walking exercise or high-intensity physical activities. These relationships were more pronounced in the senior adult population compared to the middle-aged group.
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Quigley A, Brouillette MJ, Gahagan J, O’Brien KK, MacKay-Lyons M. Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial. J Int Assoc Provid AIDS Care 2020; 19:2325958220935698. [PMID: 32583707 PMCID: PMC7318828 DOI: 10.1177/2325958220935698] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/07/2020] [Accepted: 05/26/2020] [Indexed: 12/30/2022] Open
Abstract
The purpose of this pilot randomized controlled trial is to assess the feasibility and impact of a triweekly 12-week yoga intervention among people living with HIV (PLWH). Additional objectives included evaluating cognition, physical function, medication adherence, health-related quality of life (HRQoL), and mental health among yoga participants versus controls using blinded assessors. We recruited 22 medically stable PLWH aged ≥35 years. A priori feasibility criteria were ≥70% yoga session attendance and ≥70% of participants satisfied with the intervention using a postparticipation questionnaire. Two participants withdrew from the yoga group. Mean yoga class attendance was 82%, with 100% satisfaction. Intention-to-treat analyses (yoga n = 11, control n = 11) showed no within- or between-group differences in cognitive and physical function. The yoga group improved over time in HRQoL cognition (P = .047) with trends toward improvements in HRQoL health transition (P =.063) and depression (P = .055). This pilot study provides preliminary evidence of feasibility and benefits of yoga for PLWH.
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Affiliation(s)
- Adria Quigley
- Department of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jacqueline Gahagan
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kelly Kathleen O’Brien
- Department of Physiotherapy, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Marilyn MacKay-Lyons
- Department of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Canada
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Zuo M, Gan C, Liu T, Tang J, Dai J, Hu X. Physical Predictors of Cognitive Function in Individuals With Hypertension: Evidence from the CHARLS Basline Survey. West J Nurs Res 2018; 41:592-614. [PMID: 29742988 DOI: 10.1177/0193945918770794] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The purpose of the study was to examine the independent associations of each individual physical performance measure (i.e., grip strength, walking speed, repeated chair stands, and balance test) with subdomains of cognitive function and to determine predictors for each subdomain of cognitive function. A secondary data analysis was performed using a nationally representative middle-aged and older sample of hypertensive population. The findings showed that after adding all four physical performance measures, stronger grip strength was significantly associated with better visuospatial abilities, episodic memory, orientation/attention, and overall cognitive function. In addition, faster walking speed and faster repeated chair stands were strongly associated with better episodic memory and overall cognitive function, respectively. Because grip strength was significantly associated with several subdomains of cognitive functioning, it seems conceivable that increasing physical activity would improve both grip strength and cognitive function in patients with hypertension.
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Affiliation(s)
- Manhua Zuo
- Hubei University for Nationalities Medical College, Enshi, Hubei Province, China
- Sichuan University, Chengdu, Sichuan Province, China
| | - Changping Gan
- Sichuan University, Chengdu, Sichuan Province, China
| | - Tingting Liu
- University of Arkansas Eleanor Mann School of Nursing, Fayetteville, AR, USA
| | - Jun Tang
- The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei Province, China
| | - Jianping Dai
- The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei Province, China
| | - Xiuying Hu
- Sichuan University, Chengdu, Sichuan Province, China
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The cognitive complexity of concurrent cognitive-motor tasks reveals age-related deficits in motor performance. Sci Rep 2018; 8:6094. [PMID: 29666388 PMCID: PMC5904104 DOI: 10.1038/s41598-018-24346-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/29/2018] [Indexed: 01/16/2023] Open
Abstract
Aging reduces cognitive functions, and such impairments have implications in mental and motor performance. Cognitive function has been recently linked to the risk of falls in older adults. Physical activities have been used to attenuate the declines in cognitive functions and reduce fall incidence, but little is known whether a physically active lifestyle can maintain physical performance under cognitively demanding conditions. The aim of this study was to verify whether physically active older adults present similar performance deficits during upper limb response time and precision stepping walking tasks when compared to younger adults. Both upper limb and walking tasks involved simple and complex cognitive demands through decision-making. For both tasks, decision-making was assessed by including a distracting factor to the execution. The results showed that older adults were substantially slower than younger individuals in the response time tasks involving decision-making. Similarly, older adults walked slower and extended the double support periods when precision stepping involved decision-making. These results suggest that physically active older adults present greater influence of cognitive demanding contexts to perform a motor task when compared to younger adults. These results underpin the need to develop interventions combining cognitive and motor contexts.
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Spedden ME, Malling ASB, Andersen KK, Jensen BR. Association Between Gross-Motor and Executive Function Depends on Age and Motor Task Complexity. Dev Neuropsychol 2017; 42:495-506. [PMID: 29161178 DOI: 10.1080/87565641.2017.1399129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective was to examine associations between motor and executive function across the adult lifespan and to investigate the role of motor complexity in these associations. Young, middle-aged and older adults (n = 82; 19-83y) performed two gross-motor tasks with different levels of complexity and a Stroop-like computer task. Performance was decreased in older adults. The association between motor and cognitive performance was significant for older adults in the complex motor task (p = 0.03, rs = -0.41), whereas no significant associations were found for young or middle-aged groups, suggesting that the link between gross-motor and executive function emerges with age and depends on motor complexity.
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Affiliation(s)
- Meaghan E Spedden
- a Section of Integrated Physiology, Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark.,b Department of Neurology, Odense University Hospital , University of Southern Denmark , Odense , Denmark
| | - Anne Sofie B Malling
- b Department of Neurology, Odense University Hospital , University of Southern Denmark , Odense , Denmark.,c Department of Clinical Research , University of Southern Denmark , Odense , Denmark
| | - Ken K Andersen
- a Section of Integrated Physiology, Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark
| | - Bente R Jensen
- a Section of Integrated Physiology, Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark.,b Department of Neurology, Odense University Hospital , University of Southern Denmark , Odense , Denmark
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Banerjee T, Peterson M, Oliver Q, Froehle A, Lawhorne L. Validating a Commercial Device for Continuous Activity Measurement in the Older Adult Population for Dementia Management. ACTA ACUST UNITED AC 2017; 5-6:51-62. [PMID: 29915807 DOI: 10.1016/j.smhl.2017.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
With the introduction of the large number of fitness devices on the market, there are numerous possibilities for their use in managing chronic diseases in older adults. For example, monitoring people with dementia using commercially available devices that measure heart rate, breathing rate, lung volume, step count, and activity level could be used to predict episodic behavioral and psychological symptoms before they become distressing or disruptive. However, since these devices are designed primarily for fitness assessment, validation of the sensors in a controlled environment with the target cohort population is needed. In this study, we present validation results using a commercial fitness tracker, the Hexoskin sensor vest, with thirty-one participants aged 65 and older. Estimated physiological measures investigated in this study are heart rate, breathing rate, lung volume, step count, and activity level of the participants. Findings indicate that while the processed step count, heart rate, and breathing rate show strong correlations to the clinically accepted gold standard values, lung volume and activity level do not. This indicates the need to proceed cautiously when making clinical decisions using such sensors, and suggests that users should focus on the three strongly correlated parameters for further analysis, at least in the older population. The use of physiological measurement devices such as the Hexoskin may eventually become a non-intrusive way to continuously assess physiological measures in older adults with dementia who are at risk for distressing behavioral and psychological symptoms.
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Affiliation(s)
- Tanvi Banerjee
- Department of Computer Science and Engineering, Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA
| | - Matthew Peterson
- Boonshoft School of Medicine, Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA
| | - Quintin Oliver
- Department of Computer Science and Engineering, Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA
| | - Andrew Froehle
- Boonshoft School of Medicine, Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA.,Department of Kinesiology and Health,Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA
| | - Larry Lawhorne
- Boonshoft School of Medicine, Wright State University, 303 Russ Engineering Building, 3640 Colonel Glenn Highway, Dayton, Ohio 45435 USA
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Abe T, Soma Y, Kitano N, Jindo T, Sato A, Tsunoda K, Tsuji T, Okura T. Change in hand dexterity and habitual gait speed reflects cognitive decline over time in healthy older adults: a longitudinal study. J Phys Ther Sci 2017; 29:1737-1741. [PMID: 29184280 PMCID: PMC5684001 DOI: 10.1589/jpts.29.1737] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/26/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] There is a relationship between physical and cognitive functions; therefore,
impairment of physical function would mean cognitive decline. This study aimed to
investigate the association between change in physical and cognitive functions. [Subjects
and Methods] Participants were 169 healthy community-dwelling older adults who attend the
survey after three years from baseline (mean age, 72.4 ± 4.8 years). Grip strength,
one-leg standing balance, five-times-sit-to-stand test, timed up and go, 5-m habitual
walk, and a peg-moving task were used to evaluate physical performance. Five cognitive
function tests were used to assess attention, memory, visuospatial function, verbal
fluency, and reasoning. Cognitive function was defined as the cumulative score of these
tests. [Results] At baseline, five-times-sit-to-stand test, timed up and go, and hand
dexterity were independently associated with cognitive function. In longitudinal analyses,
changes in habitual walking speed and hand dexterity were significantly associated with
change in cognitive function. [Conclusion] Deterioration of specific physical function,
such as hand dexterity and walking ability, may be associated with progression of
cognitive decline. Decreasing extent of daily functions, such as hand dexterity and
walking ability, can be useful indices to grasp changes in cognitive function.
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Affiliation(s)
- Takumi Abe
- Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577 Japan.,Japan Society for the Promotion of Science, Japan
| | - Yuki Soma
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan
| | - Naruki Kitano
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Japan
| | - Takashi Jindo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Japan
| | - Ayane Sato
- Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577 Japan
| | - Kenji Tsunoda
- Faculty of Social Welfare, Yamaguchi Prefectural University, Japan
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, Japan
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Chen SP, Bhattacharya J, Pershing S. Association of Vision Loss With Cognition in Older Adults. JAMA Ophthalmol 2017; 135:963-970. [PMID: 28817745 DOI: 10.1001/jamaophthalmol.2017.2838] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Importance Visual dysfunction and poor cognition are highly prevalent among older adults; however, the relationship is not well defined. Objective To evaluate the association of measured and self-reported visual impairment (VI) with cognition in older US adults. Design, Setting, and Participants Cross-sectional analysis of 2 national data sets: the National Health and Nutrition Examination Survey (NHANES), 1999-2002, and the National Health and Aging Trends Study (NHATS), 2011-2015. The NHANES was composed of a civilian, noninstitutionalized community, and the NHATS comprised Medicare beneficiaries in the contiguous United States. Vision was measured at distance, near, and by self-report in the NHANES and by self-report alone in the NHATS. Sample weights were used to ensure result generalizability. Main Outcomes and Measures The NHANES measured Digit Symbol Substitution Test (DSST) score and relative DSST impairment (DSST score ≤28, lowest quartile in study cohort), and the NHATS measured probable or possible dementia, classified per NHATS protocol. Results The NHANES comprised 2975 respondents aged 60 years and older who completed the DSST measuring cognitive performance. Mean (SD) age was 72 (8) years, 52% of participants were women (n = 1527), and 61% were non-Hispanic white (n = 1818). The NHATS included 30 202 respondents aged 65 years and older with dementia status assessment. The largest proportion (40%; n = 12 212) were between 75 and 84 years of age. Fifty-eight percent were women (n = 17 659), and 69% were non-Hispanic white (n = 20 842). In the NHANES, distance VI (β = -5.1; 95% CI, -8.6 to -1.6; odds ratio [OR], 2.8; 95% CI, 1.1-6.7) and subjective VI (β = -5.3; 95% CI, -8.0 to -2.6; OR, 2.7; 95% CI, 1.6-4.8) were both associated with lower DSST scores and higher odds of DSST impairment after full adjustment with covariates. Near VI was associated with lower DSST scores but not higher odds of DSST impairment. The NHATS data corroborated these results, with all vision variables associated with higher odds of dementia after full adjustment (distance VI: OR, 1.9; 95% CI, 1.6-2.2; near VI: OR, 2.6; 95% CI, 2.2-3.1; either distance or near VI: OR, 2.1; 95% CI, 1.8-2.4). Conclusions and Relevance In a nationally representative sample of older US adults, vision dysfunction at distance and based on self-reports was associated with poor cognitive function. This was substantiated by a representative sample of US Medicare beneficiaries using self-reported visual function, reinforcing the value of identifying patients with visual compromise. Further study of longitudinal interactions between vision and cognition is warranted.
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Affiliation(s)
| | - Jay Bhattacharya
- Center for Health Policy/Primary Care Outcomes Research, Stanford University, Palo Alto, California.,Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Suzann Pershing
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.,Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Singh DKA, Pillai SGK, Tan ST, Tai CC, Shahar S. Association between physiological falls risk and physical performance tests among community-dwelling older adults. Clin Interv Aging 2015; 10:1319-26. [PMID: 26316727 PMCID: PMC4541555 DOI: 10.2147/cia.s79398] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. METHODS One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). RESULTS Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). CONCLUSION The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments.
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Affiliation(s)
- Devinder K A Singh
- Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Sharmila G K Pillai
- Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Sin Thien Tan
- Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Chu Chiau Tai
- Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Nutrition and Dietetics Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
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