scholarly journals Relationship of Clinic-Based Gait Speed Measurement to Limitations in Community-Based Activities in Older Adults

2011 ◽  
Vol 92 (5) ◽  
pp. 844-846 ◽  
Author(s):  
Joe Verghese ◽  
Cuiling Wang ◽  
Roee Holtzer
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Based ◽  
Speed Measurement ◽  
Relationship Of

scholarly journals Taking prevention to the next step: implementation of a brief, sustainable frailty assessment in a cardiology clinic

2021 ◽  
Vol 10 (1) ◽  
pp. e001140
Author(s):  
Ariela R Orkaby ◽  
Kirstyn James ◽  
Jessica Leuchtenburg ◽  
Esther Solooki ◽  
J Michael Gaziano ◽  
...  
Keyword(s):  
Older Adults ◽  
Electronic Health Record ◽  
Gait Speed ◽  
Health Record ◽  
Speed Measurement ◽  
Frailty Assessment ◽  
Cardiology Clinic ◽  
Electronic Health ◽  
Usual Gait Speed ◽  
Clinic Visits

BackgroundFrailty measurement is recommended when assessing older adults with cardiovascular disease to individualise prevention and treatment. We sought to address this by incorporating routine gait speed measurement by clinicians into an outpatient preventive cardiology clinic.MethodsQuality improvement (QI) project initiated at VA Boston in January 2015 to measure usual gait speed in m/s over a 4 m distance for patients aged 70 and older. The primary outcome was completion and documentation of 4 m usual gait speed. Data were manually extracted from the electronic health record. Frequency distributions and descriptive statistics are presented.InterventionsSeveral change interventions were implemented over a 5-year period (January 2015–December 2019) addressing (1) stakeholder engagement and project champions, (2) staff education, (3) assessment space, (4) electronic health record template update and (5) sustaining the initiative. Statistical process control charts were used to monitor proportion of gait speed measurement and to detect shifts resulting from 5 phase change interventions.ResultsDuring this QI project, 178 patients aged 70 and older attended the clinic, accounting for 1042 individual clinic visits. Gait speed was measured at least once for 157 patients; 21 were never assessed. At the end of the first month (January 2015), gait speed was measured during 40% of clinic visits and rose to a median measurement rate of 78% at clinic visits during the 2018–2019 study period. An unanticipated result was the spread of the initiative to other cardiology clinics.ConclusionsGait speed measurement was successfully embedded into clinic assessments for older adults at a cardiology clinic following targeted interventions. This project highlights the feasibility of incorporating a brief frailty assessment such as gait speed, into non-geriatric medicine clinics.

scholarly journals Differential relationships between brain structure and dual task walking in young and older adults

2021 ◽  
Author(s):  
Kathleen Hupfeld ◽  
Justin Geraghty ◽  
Heather R McGregor ◽  
Chris J Hass ◽  
Ofer Pasternak ◽  
...  
Keyword(s):  
Older Adults ◽  
Age Differences ◽  
Dual Task ◽  
Brain Structure ◽  
Brain Atrophy ◽  
Gait Speed ◽  
Older Age ◽  
Superior Longitudinal Fasciculus ◽  
Relationship Of ◽  
Sulcal Depth

Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when performing a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underly dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18-34 years) and 23 older adults (66-86 years). We also collected T1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: 1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and 2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.

scholarly journals Relationship of Homocysteine Levels to Quadriceps Strength, Gait Speed, and Late-Life Disability in Older Adults

2007 ◽  
Vol 62 (4) ◽  
pp. 434-439 ◽  
Author(s):  
H.-K. Kuo ◽  
K.-C. Liao ◽  
S. G. Leveille ◽  
J. F. Bean ◽  
C.-J. Yen ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Late Life ◽  
Quadriceps Strength ◽  
Relationship Of

scholarly journals Effectiveness of a community-based brain-computer interface cognitive group training in healthy community-dwelling older adults: A randomized controlled implementation study (Preprint)

2020 ◽  
Author(s):  
Pei Shi Yeo ◽  
Tu Ngoc Nguyen ◽  
Mary Pei Ern Ng ◽  
Robin Wai Munn Choo ◽  
Philip Lin Kiat Yap ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Intervention Group ◽  
Community Dwelling ◽  
Community Based ◽  
Healthy Older Adults ◽  
Randomized Controlled ◽  
Visuospatial Abilities ◽  
Healthy Community

BACKGROUND Cognitive training can improve cognition in healthy older adults OBJECTIVE The objectives are to evaluate the implementation of a community-based computerized cognitive training (CCT) and its effectiveness on cognition, gait, and balance in healthy older adults. METHODS A single-blind randomized controlled trial with baseline and follow-up assessments was conducted in two community centers (CCs) in Singapore. A total of 94 healthy community-dwelling adults aged 55 and above participated in a ten-week CCT program with two-hour instructor-led group classes conducted twice a week. Participants used a mobile application to play games targeting attention, memory, decision making, visuospatial abilities, and cognitive flexibility. Implementation was assessed at the participant-, provider-, and community-level (e.g., reach, implementation, and facilitators & barriers). Effectiveness measures were the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Color Trails Test Part 2 (CTT2), Berg Balance Scale, and GAITRite® walkway measures (single & dual task gait speed, dual task cost, and single & dual task gait variability index (GVI)). RESULTS The data was based on Intention-to-treat (ITT) and Per-protocol (PP) analysis. In the ITT group, single task GVI increased (b = 2.32, P = .02, 95% CI [0.30, 4.35]) and RBANS List Recognition subtest deteriorated (b = -0.57, P = .01, 95% CI [-1.00, -0.14]) in both groups. In the PP group, time taken to complete CCT2 (b = -13.5, P = .01, 95% CI [-23.95, -3.14]) was faster in the intervention group. Single task gait speed was also marginally significantly maintained in the intervention group (b = 5.38, P = .063, 95% CI [-0.30, 11.36]) but declined in the control group. For RBANS subtests, Picture Naming (b = 0.43, P = .04, 95% CI [0.01, 0.85]) improved significantly in both groups while List Recognition subtests (b = -0.54, P = .02, 95% CI [-1.00, -0.08]) performance deteriorated. CONCLUSIONS CCT can be successfully implemented in community settings to improve attention, executive function, and visuospatial abilities while maintaining gait speed amongst healthy older adults. Findings help to identify suitable healthy ageing programs that can be implemented on a larger scale within communities. CLINICALTRIAL ClinicalTrials.gov Identifier NCT04439591

scholarly journals Cognition Moderates the Relationship Between Hearing and Mobility in Cognitively Normal Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 162-163
Author(s):  
Brent Small ◽  
Jennifer Deal ◽  
Nicole Armstrong ◽  
Susan Resnick ◽  
Frank Lin ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Impairment ◽  
Gait Speed ◽  
Sensorimotor Function ◽  
Cognitive Measures ◽  
Cognitively Normal ◽  
Cognitive Measure ◽  
Baltimore Longitudinal Study ◽  
Relationship Of ◽  
The Relationship

Abstract Recent data has shown a consistent but modest association between hearing impairment and poor mobility; both are strongly associated with cognition. Cognitive function may moderate the relationship between hearing and mobility. We analyzed 601 cognitively normal older participants from the Baltimore Longitudinal Study of Aging who had concurrent data on cognition (attention, executive function, sensorimotor function), hearing (pure-tone average, PTA), and mobility (6-meter gait speed, 400-meter time). We performed multivariable-adjusted linear regression to test two-way interactions between each cognitive measure and PTA. There were significant PTA interactions with all cognitive measures on 400-meter time. There was a significant interaction between PTA and sensorimotor function on 6-meter gait speed. Among cognitively normal older adults, poorer hearing is more strongly associated with poor mobility in those with low cognition, especially sensorimotor function. Future studies are needed to understand how cognition may moderate the relationship of hearing impairment with mobility decline over time.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

scholarly journals Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 287-288
Author(s):  
Jeffrey Hausdorff ◽  
Nofar Schneider ◽  
Marina Brozgol ◽  
Pablo Cornejo Thumm ◽  
Nir Giladi ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Executive Function ◽  
Dual Task ◽  
Gait Speed ◽  
Negative Impact ◽  
Virtual Reality Environment ◽  
Dual Tasking ◽  
Concurrent Performance ◽  
Dual Task Cost

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p<0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p>0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.

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