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.

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&lt;0.001, adjusted R2=0.376) and visuospatial ability (β=-.250, p&lt;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.

scholarly journals Relationships between Gait Regularity and Cognitive Function, including Cognitive Domains and Mild Cognitive Impairment, in Community-Dwelling Older People

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1571
Author(s):  
Takasuke Miyazaki ◽  
Ryoji Kiyama ◽  
Yuki Nakai ◽  
Masayuki Kawada ◽  
Yasufumi Takeshita ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Older People ◽  
Processing Speed ◽  
Vertical Component ◽  
Community Dwelling ◽  
Cognitive Domains ◽  
Community Dwelling Older People

The aim of this cross-sectional study was to examine the correlations between gait regularity, cognitive functions including cognitive domains, and the mild cognitive impairment (MCI) in community-dwelling older people. This study included 463 older adults (63.4% women, mean age: 74.1), and their step and stride regularity along the three-axis components was estimated from trunk acceleration, which was measured by inertial measurement units during a comfortable gait. Four aspects of cognitive function were assessed using a tablet computer: attention, executive function, processing speed, and memory, and participants were classified into those with or without MCI. The vertical component of stride and step regularity was associated with attention and executive function (r = −0.176–−0.109, p ≤ 0.019), and processing speed (r = 0.152, p < 0.001), after it was adjusted for age and gait speed. The low vertical component of step regularity was related to the MCI after it was adjusted for covariates (OR 0.019; p = 0.016). The results revealed that cognitive function could affect gait regularity, and the vertical component of gait regularity, as measured by a wearable sensor, could play an important role in investigating cognitive decline in older people.

scholarly journals Orientation and verbal fluency in the English Longitudinal Study of Ageing: modifiable risk factors for falls?

2018 ◽  
Vol 31 (10) ◽  
pp. 1491-1498 ◽  
Author(s):  
T. O. Smith ◽  
S. R. Neal ◽  
G. Peryer ◽  
K. J. Sheehan ◽  
M. P. Tan ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Verbal Fluency ◽  
Functional Performance ◽  
Community Dwelling ◽  
Cognitive Domain ◽  
Cognitive Domains ◽  
Risk Factors For Falls ◽  
Prospective Longitudinal ◽  
English Longitudinal Study

ABSTRACTObjectives:To determine the relationship between falls and deficits in specific cognitive domains in older adults.Design:An analysis of the English Longitudinal Study of Ageing (ELSA) cohort.Setting:United Kingdom community-based.Participants:5197 community-dwelling older adults recruited to a prospective longitudinal cohort study.Measurements:Data on the occurrence of falls and number of falls, which occurred during a 12-month follow-up period, were assessed against the specific cognitive domains of memory, numeracy skills, and executive function. Binomial logistic regression was performed to evaluate the association between each cognitive domain and the dichotomous outcome of falls in the preceding 12 months using unadjusted and adjusted models.Results:Of the 5197 participants included in the analysis, 1308 (25%) reported a fall in the preceding 12 months. There was no significant association between the occurrence of a fall and specific forms of cognitive dysfunction after adjusting for self-reported hearing, self-reported eyesight, and functional performance. After adjustment, only orientation (odds ratio [OR]: 0.80; 95% confidence intervals [CI]: 0.65–0.98, p = 0.03) and verbal fluency (adjusted OR: 0.98; 95% CI: 0.96–1.00; p = 0.05) remained significant for predicting recurrent falls.Conclusions:The cognitive phenotype rather than cognitive impairmentper semay predict future falls in those presenting with more than one fall.

scholarly journals Supporting community‐dwelling older people with cognitive impairment to stay at home: A modelled cost analysis

2020 ◽  
Vol 39 (4) ◽  
Author(s):  
Suzanne M. Dyer ◽  
Lachlan B. Standfield ◽  
Nicola Fairhall ◽  
Ian D. Cameron ◽  
Meredith Gresham ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cost Analysis ◽  
Older People ◽  
Community Dwelling ◽  
Community Dwelling Older People ◽  
At Home

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.

scholarly journals The association of Lewy bodies with limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes and their role in cognition and Alzheimer’s dementia in older persons

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sonal Agrawal ◽  
Lei Yu ◽  
Sukriti Nag ◽  
Konstantinos Arfanakis ◽  
Lisa L. Barnes ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Older Persons ◽  
Lewy Bodies ◽  
Alzheimer’S Dementia ◽  
Community Dwelling ◽  
Alzheimer's Dementia ◽  
Cognitive Domains ◽  
Age Related ◽  
Global Cognition

AbstractLewy bodies (LBs) and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) are common in older persons and associated with cognitive impairment. However, little is known about the relationship between LBs and LATE-NC and their combined roles in cognitive impairment and Alzheimer’s dementia in community-dwelling participants. The study included 1670 community-based participants (mean age-at-death, 89.5 years (SD = 6.65); 69% females) who underwent annual assessments of cognition to create summary measures of global cognition and cognitive domains and evaluation for Alzheimer’s dementia. Systematic neuropathologic evaluations were performed to assess LBs, LATE-NC, and Alzheimer’s disease (AD) pathology. We excluded cases with pathologically confirmed frontotemporal lobar degeneration in this study. Logistic and linear regression analyses were used, adjusted for demographics and AD pathology. LBs were present in 428 (25.6%) decedents (29 nigra-predominant, 165 limbic-type, and 234 neocortical-type) while 865 (51.7%) decedents exhibited LATE-NC (307 stage 1, 167 stage 2, and 391 stage 3). LBs combined with LATE-NC were common (15% of all participants) and in those with Alzheimer’s dementia (25%). Neocortical-type, but not nigral-predominant or limbic-type LBs increased the odds of stage 2/3 LATE-NC (odds ratio = 1.70; 95% confidence interval = 1.26–2.30). The association between neocortical-type LBs and stage 2/3 LATE-NC was stronger in those under 90 years of age and in women. In analyses of cognition and Alzheimer’s dementia, LATE-NC and neocortical-type LBs, separately, were related to lower global cognition, five specific cognitive domains, and an increased odds of Alzheimer’s dementia, above and beyond the AD pathology. Limbic-type LBs were related to lower global cognition, and the domains of episodic, working, and semantic memory, and increased odds of Alzheimer’s dementia. Furthermore, there was no interaction between limbic/neocortical-type LBs and LATE-NC on cognitive function, cognitive domains, or Alzheimer’s dementia. These findings suggest that neocortical-type LBs are associated with LATE-NC, specifically in the younger old and in women. Limbic/neocortical-type LBs and LATE-NC have separate and additive effects on cognitive function and odds of Alzheimer’s dementia.

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