162 Walking, Thinking and Daily-Life Activity in Older People with Dementia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Morag Taylor ◽  
Annika Toots ◽  
Jacqueline C T Close ◽  
Kim Van Schooten ◽  
Matthew Brodie ◽  
...  
Keyword(s):  
Older People ◽  
Gait Speed ◽  
Verbal Fluency ◽  
Walking Speed ◽  
Daily Life ◽  
Cognitive Domain ◽  
Visuospatial Ability ◽  
Effective Prevention ◽  
People With Dementia ◽  
Attention Memory

Abstract Gait has been linked with cognition in cognitively healthy and impaired older people. However, the studies in cognitively impaired people have been small, have not contrasted the strength of cognitive domain associations and have reported inconsistent findings. We examined baseline data of 309 older people with mild-moderate cognitive impairment (age 82±6 years; 47% female) who were participating in a large fall prevention randomised controlled trial. Gait speed was measured at usual pace over 2.4m and cognitive performance was assessed with the Addenbrooke’s Cognitive Examination-III (ACE-III). The ACE-III assesses cognitive domain performance (attention; memory; verbal fluency; language; visuospatial ability). Executive function (EF) was additionally examined using the Frontal Assessment Battery (FAB). Each cognitive domain was associated with gait speed in separate models adjusted for confounders. EF (verbal fluency and the FAB) demonstrated the strongest association which withstood adjustment for attention, memory, language and visuospatial ability. In contrast, visuospatial ability was the only cognitive domain to withstand adjustment for EF (verbal fluency, not the FAB). These findings support higher-order gait regulation. Characterising individuals at risk of negative health outcomes can assist in identifying effective prevention strategies. Forty-five older people with mild-moderate dementia were age-sex matched to two (n=90) healthy controls and all participants (age 81±6 years, 42% female) wore triaxial accelerometers (MoveMonitor, McRoberts) on their lower back for 7-days. Daily-life gait quantity and quality were estimated from the MoveMonitor. Steady-state clinical walking speed was assessed at usual pace over 2.4 to 10.0m. Participants with dementia had reduced gait quantity, slower clinical, habitual daily-life and maximum daily-life walking speeds and multi-domain gait impairment compared to controls. In participants with dementia, clinical walking speed more closely represented habitual daily-life walking speed, whereas in controls, it more closely represented maximum daily-life walking speed. These findings have assessment, functional (e.g. crossing roads) and training/treatment implications.

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.

Mobile phone apps’ support for people with mild dementia: A systematic review (Preprint)

2019 ◽  
Author(s):  
Leona Cilar ◽  
Lucija Gosak ◽  
Amanda Briggs ◽  
Klavdija Čuček Trifkovič ◽  
Tracy McClelland ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Thematic Analysis ◽  
Daily Life ◽  
General Term ◽  
Cognitive Domain ◽  
Mild Dementia ◽  
Daily Life Activities ◽  
Human Needs ◽  
People With Dementia ◽  
System Usability Scale

BACKGROUND Dementia is a general term for various disorders characterized by memory impairment and loss of at least one cognitive domain. People with dementia are faced with different difficulties in their daily life activities (DLA). With the use of modern technologies, such as mobile phone apps – often called health apps, their difficulties can be alleviated. OBJECTIVE The aim of this paper was to systematically search, analyze and synthetize mobile phone apps designed to support people with mild dementia in daily life activities in two apps bases: Apple App Store and Google Play Store. METHODS A search was conducted in May 2019 following PRISMA recommendations. Results were analyzed and displayed as tables and graphs. Results were synthetized using thematic analysis which was conducted from 14 components, based on human needs for categorized nursing activities. Mobile phone apps were assessed for quality using the System Usability Scale. RESULTS A total of 15 mobile phone apps were identified applying inclusion and exclusion criteria. Five major themes were identified with thematic analysis: multi-component DLA, communication and feelings, recreation, eating and drinking, and movement. Most of the apps (73%) of the apps were not mentioned in scientific literature. CONCLUSIONS There are many mobile phone apps available in mobile phone markets for the support for people with mild dementia; yet only a few of them are focused on challenges in daily life activities. Most of the available apps were not evaluated nor assessed for quality.

scholarly journals Association between Daily-Life Gait Quality Characteristics and Physiological Fall Risk in Older People

Sensors ◽  
2020 ◽  
Vol 20 (19) ◽  
pp. 5580
Author(s):  
Sabine Schootemeijer ◽  
Roel H.A. Weijer ◽  
Marco J.M. Hoozemans ◽  
Kimberley S. van Schooten ◽  
Kim Delbaere ◽  
...  
Keyword(s):  
Older People ◽  
Fall Risk ◽  
Walking Speed ◽  
Risk Group ◽  
Daily Life ◽  
Risk Groups ◽  
Sample Entropy ◽  
Quality Characteristics ◽  
Low Risk ◽  
Gait Quality

Gait quality characteristics obtained from accelerometry during daily life are predictive of falls in older people but it is unclear how they relate to fall risk. Our aim was to test whether these gait quality characteristics are associated with the severity of fall risk. We collected one week of trunk accelerometry data from 279 older people (aged 65–95 years; 69.5% female). We used linear regression to investigate the association between six daily-life gait quality characteristics and categorized physiological fall risk (QuickScreen). Logarithmic rate of divergence in the vertical (VT) and anteroposterior (AP) direction were significantly associated with the level of fall risk after correction for walking speed (both p < 0.01). Sample entropy in VT and the mediolateral direction and the gait quality composite were not significantly associated with the level of fall risk. We found significant differences between the high fall risk group and the very low- and low-risk groups, the moderate- and very low-risk and the moderate and low-risk groups for logarithmic rate of divergence in VT and AP (all p ≤ 0.01). We conclude that logarithmic rate of divergence in VT and AP are associated with fall risk, making them feasible to assess the physiological fall risk in older people.

scholarly journals Associations Between Declining Physical and Cognitive Functions in the Lothian Birth Cohort 1936

2020 ◽  
Vol 75 (7) ◽  
pp. 1393-1402 ◽  
Author(s):  
Judith A Okely ◽  
Ian J Deary
Keyword(s):  
Grip Strength ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Verbal Memory ◽  
Walking Speed ◽  
Cognitive Domain ◽  
Visuospatial Ability ◽  
Coupling Effects ◽  
Physical Functions ◽  
Linear Decline

Abstract Background The ageing process is characterized by declines in physical and cognitive function. However, the relationship between these trajectories remains a topic of investigation. Methods Using four data waves collected triennially between ages 70 and 79, we tested for associations between multiple cognitive ability domains (verbal memory, processing speed, and visuospatial ability) and physical functions (walking speed, grip strength, and lung function). We first tested for associations between linear declines in physical and cognitive functions over the entire 9-year study period, and then, for lead-lag coupling effects between 3-year changes in cognitive and physical functions. Results Steeper linear decline in walking speed was moderately correlated with steeper linear declines in each cognitive domain. Steeper linear decline in grip strength was moderately correlated with steeper linear declines in verbal memory and processing speed. Lead-lag coupling models showed that decline in verbal memory was preceded by declines in walking speed and grip strength. By contrast, decline in grip strength was preceded by declines in processing speed and visuospatial ability, and decline in walking speed was preceded by decline in visuospatial ability. Following additional adjustment for covariates, only coupling effects from earlier decline in processing speed to later decline in grip strength remained significant (β = 0.545, p = .006). Conclusion Our findings provide further evidence of an association between cognitive and physical declines and point to the potential order in which these changes occur. Decline in processing speed in particular may serve as a unique early marker of declining upper body strength.

Older People with Dementia Have Reduced Daily-Life Activity and Impaired Daily-Life Gait When Compared to Age-Sex Matched Controls

2019 ◽  
Vol 71 (s1) ◽  
pp. S125-S135 ◽  
Author(s):  
Morag E. Taylor ◽  
Matthew A. Brodie ◽  
Kimberley S. van Schooten ◽  
Kim Delbaere ◽  
Jacqueline C.T. Close ◽  
...  
Keyword(s):  
Older People ◽  
Daily Life ◽  
Life Activity ◽  
Daily Life Activity ◽  
People With Dementia

Dutch care environments for people with dementia: impressions from the perspectives of an architect and a gerontologist

2020 ◽  
Vol 24 (2) ◽  
pp. 143-147
Author(s):  
Kay Shannon ◽  
Birgit Jurgenhake
Keyword(s):  
Built Environment ◽  
Older People ◽  
Design Methodology ◽  
Daily Life ◽  
Innovative Approach ◽  
Social Aspects ◽  
Content Type ◽  
People With Dementia ◽  
External Community

Purpose The purpose of this paper is to discuss Dutch innovative care environments for older people, including those living with dementia, from the perspectives or an architect and a social gerontologist. Design/methodology/approach The authors visited three care environments for older people, each offering an innovative approach to living housing older people, including people with dementia. The settings are discussed from two disciplinary perspectives, facilitating an understanding of the influence of the built environment on daily life for residents. Findings The three facilities were all architecturally varied and resembled “real” homes to varying degrees. Additionally, each entrance offered a different welcome to the external community, ranging from full accessibility to a closed and fortified appearance. Within each facility, the built environment afforded residents opportunities to participate in valued activities, including interacting with members of the wider community. Originality/value The inclusion of two disciplinary perspectives offers a richer discussion of the physical and social aspects of the care environments that would be offered by one perspective alone.

scholarly journals Cognitive and Functional Differences in Aging with and without Intellectual Disabilities: Observational Study

2021 ◽  
Vol 13 (19) ◽  
pp. 10515
Author(s):  
Olga Tena-Bernal ◽  
Marta Sánchez-Peña ◽  
Alba Gómez-Cabello ◽  
Carlos Salavera ◽  
Pablo Usán ◽  
...  
Keyword(s):  
Older People ◽  
Intellectual Disabilities ◽  
Verbal Fluency ◽  
Short Term Memory ◽  
Functional Performance ◽  
Functional Results ◽  
Assessment Tools ◽  
Cognitive Domain ◽  
Short Term ◽  
Functional Differences

The lifespan of people with cognitive disabilities (ID) has increased significantly, but the cognitive aspects together with the functional ones comparing normal aging and those with intellectual disabilities had not been previously studied. Objective: This study analyzed the cognitive and functional differences in older adults aging with ID (and with DS), compared with their peers without disabilities, in order to identify the most adapted interventions. Methodology: This study evaluated the outcome variables of MEC, Set-Test, Barthel, Lawton–Brody, and Tinetti with 247 participants: 146 without ID and 101 ID (29 with DS and 72 without DS). Results: At the cognitive level, older people with ID presented lower scores both in MEC (p < 0.01), globally and in each cognitive domain (except in short-term memory), and in verbal fluency (Set-Test) than older people without ID; however, the diagnosis of cognitive impairment and dementia is higher in people without ID. At the functional level, there are no differences in ABDL, but there are in AIDL and Tinetti (p < 0.01), where participants without ID obtain higher scores. The most frequent pathologies in people with ID were obesity and epilepsy. Conclusions: The lower cognitive and functional performance in ID is associated with the disability itself, the low educational level, the neurocognitive underdiagnosis, and the use of poorly adapted assessment tools. The cognitive and functional results indicated the importance of interventions adapted to the characteristics of this population, in their aging process.

Effects of supporting facilities on memory loss among older people with dementia in care and attention homes

2019 ◽  
Vol 29 (3) ◽  
pp. 438-448
Author(s):  
Mei-yung Leung ◽  
Chendi Wang ◽  
Timothy CY Kwok
Keyword(s):  
Older People ◽  
Older Persons ◽  
Short Term Memory ◽  
Daily Life ◽  
Memory Loss ◽  
Long Term Memory ◽  
Term Memory ◽  
People With Dementia

Supporting facilities (SF) including handrails, signage, finishes, furniture and recreational facilities facilitate the daily life of older persons. Memory loss is one of the most common signs of dementia affecting the daily life of older persons. Therefore, they may need special SF in residential homes. In order to improve the quality of daily life of older people with dementia, this study aims to investigate the effects of SF on the memory loss of those living in care and attention (C&A) homes. A questionnaire survey was conducted among elderly C&A home residents aged 65 and above in Hong Kong. A Supporting Facilities-Memory Loss model was established based on correlation and regression analyses. The model confirmed the following: (1) none of the SF items affects long-term memory loss; (2) satisfaction with signage, finishes and furniture leads to a reduction of short-term memory loss; (3) satisfaction with handrails, signage and finishes enhances spatial memory and (4) satisfaction with the location of signage reduces time confusion. Practical recommendations are proposed, including using large and well-placed signage with pictograms and icons, avoiding the removal and modification of furniture, enhancing colour contrasts between different functional rooms, installing handrails with a consideration for orientation strategies, and so on.

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