Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline1

2017 ◽  
Vol 57 (3) ◽  
pp. 747-763 ◽  
Author(s):  
Michael A. Gregory ◽  
Narlon C. Boa Sorte Silva ◽  
Dawn P. Gill ◽  
Cheri L. McGowan ◽  
Teresa Liu-Ambrose ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Aerobic Exercise ◽  
Dual Task ◽  
Gait Training ◽  
Community Dwelling ◽  
Vascular Health ◽  
Community Dwelling Older Adults

scholarly journals 94 Association between Dual-Task Timed “UP and GO” Test and Occurrence of Falls According to Age Group (Young-Older or Old-Older Adults): A Longitudinal Observation Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Tsuyoshi Asai ◽  
Kensuke Oshima ◽  
Yoshihiro Fukumoto ◽  
Shogo Misu
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Dual Task ◽  
Community Dwelling ◽  
Age Group ◽  
Adult Group ◽  
Observation Study ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

Abstract Aim To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults. Conclusions Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.

scholarly journals Longitudinal Associations Between Gait, Falls, and Disability in Community-Dwelling Older Adults With Type II Diabetes Mellitus: Findings From The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Author(s):  
Orna A Donoghue ◽  
Siobhan Leahy ◽  
Rose Anne Kenny
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Type Ii Diabetes ◽  
Step Length ◽  
Community Dwelling ◽  
Type Ii ◽  
Diabetes Status ◽  
Increased Risk ◽  
Community Dwelling Older Adults ◽  
Task Step

Abstract Background Diabetes is associated with gait deficits, future falls, and disability; however, it is unclear if associations remain after controlling for relevant confounders. This study investigated (i) the effects of type II diabetes on spatiotemporal gait parameters in community-dwelling older adults and (ii) if diabetes status was independently associated with future falls and disability, after controlling for gait and other confounders. Method Baseline data were obtained from 2608 community-dwelling adults (≥60 years) participating in The Irish Longitudinal Study on Ageing (TILDA). Diabetes was identified from self-reported doctors’ diagnosis, medications, and glycated hemoglobin levels. Gait characteristics were obtained during single- and dual-task walking using a GAITRite mat (n = 2560). Incident falls and disability were collected over 4 years follow-up (n = 2473). Associations between diabetes status and gait (cross-sectional) and falls and disability (longitudinal) were investigated using regression analysis, adjusting for medications, cardiovascular health, neuropsychological function, and fall-related factors. Results Diabetes (prevalence = 9.1%) was cross-sectionally associated with shorter dual-task step length after adjusting for covariates (β = −1.59, 95% CI: −3.10, −0.08, p < .05). Diabetes was independently associated with increased risk of future instrumental activity of daily living (IADL) difficulty in those with no prior difficulty (incidence rate ratio [IRR] = 1.51, 95% CI: 1.08, 2.11, p < .05) although dual-task step length was an important confounder in all disability models. No independent associations between diabetes and falls were observed. Conclusions Diabetes was independently associated with shorter dual-task step length and increased risk of future IADL difficulty. Multidimensional interventions addressing poor health and function in those with diabetes may help reduce the risk of gait deficits and future disability.

scholarly journals The Effect of Different Types of Walking on Dual-Task Performance and Task Prioritization among Community-Dwelling Older Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maayan Agmon ◽  
Einat Kodesh ◽  
Rachel Kizony
Keyword(s):  
Older Adults ◽  
Task Performance ◽  
Dual Task ◽  
Cognitive Task ◽  
Community Dwelling ◽  
Cognitive Tasks ◽  
Dual Task Performance ◽  
Different Types ◽  
Task Prioritization ◽  
Community Dwelling Older Adults

Background. The ability to safely conduct different types of walking concurrently with a cognitive task (i.e., dual task) is crucial for daily life. The contribution of different walking types to dual-task performance has not yet been determined, nor is there agreement on the strategies that older adults use to divide their attention between two tasks (task prioritization).Objectives. To compare the effect of walking in three different directions (forward, backward, and sideways) on dual-task performance and to explore the strategies of older adults to allocate their attention in response to different motor task demands.Design. A cross-sectional study.Subjects. Thirty-two (22 female) community-dwelling older adults (aged72.7±5.7years).Methods. Subjects randomly conducted single and dual task: walking to three directions separately, cognitive tasks separately, and combination of the two.Results. Walking forward was the least demanding task, during single (FW < BW, SW) (P<.001) and dual tasks (FW < BW < SW) (P<.001). The calculation of DTC revealed the same pattern (P<.001). DTC of the cognitive tasks was not significantly different among the three walking types.Conclusions. The decline mainly in the motor performance during dual task indicates that participants prioritized the cognitive task. These findings challenge the “posture first” paradigm for task prioritization.

Transfer Effects of Fall Training on Balance Performance and Spatiotemporal Gait Parameters in Healthy Community-Dwelling Older Adults: A Pilot Study

2014 ◽  
Vol 22 (3) ◽  
pp. 324-333 ◽  
Author(s):  
Lars Donath ◽  
Oliver Faude ◽  
Stephanie A. Bridenbaugh ◽  
Ralf Roth ◽  
Martin Soltermann ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Stride Length ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Stride Time ◽  
Balance Performance ◽  
Transfer Effects ◽  
Gait Parameters ◽  
Community Dwelling Older Adults

This study examined transfer effects of fall training on fear of falling (Falls Efficacy Scale—International [FES–I]), balance performance, and spatiotemporal gait characteristics in older adults. Eighteen community-dwelling older adults (ages 65–85) were randomly assigned to an intervention or control group. The intervention group completed 12 training sessions (60 min, 6 weeks). During pre- and posttesting, we measured FES–I, balance performance (double limb, closed eyes; single limb, open eyes; double limb, open eyes with motor-interfered task), and gait parameters (e.g., velocity; cadence; stride time, stride width, and stride length; variability of stride time and stride length) under single- and motor-interfered tasks. Dual tasks were applied to appraise improvements of cognitive processing during balance and gait. FES–I (p = .33) and postural sway did not significantly change (0.36 < p < .79). Trends toward significant interaction effects were found for step width during normal walking and stride length variability during the motor dual task (p = .05, ηp2 = .22). Fall training did not sufficiently improve fear of falling, balance, or gait performance under single- or dual-task conditions in healthy older adults.

scholarly journals LONELINESS AND PHYSICAL ACTIVITY IN OLDER AGE: RESULTS OF THE RANDOMISED CONTROLLED STUDY OF PHYSICAL ACTIVITY INTERVENTION FOR LONELINESS (PAIL) IN COMMUNITY-DWELLING OLDER ADULTS

2020 ◽  
Vol 8 (4) ◽  
pp. 99-107
Author(s):  
Anastasia Shvedko
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
At Risk ◽  
Physical Activity Intervention ◽  
Retention Rate ◽  
Community Dwelling ◽  
Feasibility Trial ◽  
Controlled Study ◽  
Study Objective ◽  
Community Dwelling Older Adults

Study objective. The aim of this study was to examine the feasibility of a Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults at risk of loneliness. Methods. Study design was a 12-week randomized controlled feasibility trial (RCT). Participants were 25 (mean age 68.5(8.05) years, range 60-92) healthy, inactive, community-dwelling older adults at risk for loneliness. The intervention consisted of group outdoor walking sessions with health education workshops once weekly, with a wait-list control condition. Estimation of recruitment, retention and adherence were feasibility outcomes. Body mass index, blood pressure, physical activity, and psychosocial variables were secondary outcomes. Results. Forty-eight participants were recruited over 4 months with a recruitment rate of 52.1% (25/48); 52% (25/48) met the inclusion criteria and 100% (25/25) were randomized into the intervention (N=12) and wait-listed (WL) control groups (N=13). At 12 weeks, 10/12 (83.3%; 95% CI 55.20 to 95.30) intervention and 10/13 (76.9%; 95% CI 49.74 to 91.82) control participants completed final assessments. The average attendance rate was 69.2% for the intervention group (range 25% – 91.7%) and 55% (range 25% – 91.7%) among controls. The a priori recruitment criteria for progression was not met. The retention rate satisfied the criteria of the study. No serious adverse events occurred. Conclusions. Community-dwelling older adults at risk of loneliness can safely participate in physical activity intervention for loneliness. However, to progress into a large-scale RCT, the design and methodology would need to be changed.

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