1. Falls, gait and dual-tasking in older adults with mild dementia: A cross-sectional study.
Vicky Booth1, Pip Logan1, Tahir Masud2, Victoria Hood3, Veronika van der Wardt1, Rachael Taylor2 and Rowan Harwood2.
1Division of Rehabilitation and Aging, University of Nottingham, 2Nottingham University Hospitals (NUH) NHS Trust, 3Physiotherapy and Rehabilitation Sciences, University of Nottingham.
Older adults with cognitive impairment have an increased risk of falls. Gait speed and step variability, particularly in a dual-task paradigm, are considered quantifiable measures to evaluate the role of cognition on gait. The dual-task paradigm provides insight into the influence of cognition on gait. Previous literature is limited and inconsistent in reporting dual-task assessments, particularly in older adults with mild dementia.
INTRODUCTION
The 69 participants (mean age=80.75 years;38 women) with mild dementia had an increased risk of falls (median falls in previous 6 months=1.5; mean PPA falls risk score=2.48) and poor gait pattern (Table 1).
There is a statistically significant relationship between gait parameters, falls risk (all p<0.05) and global cognition (all p<0.05). .
RESULTS
mDTC was identified during both cognitive task gait conditions, with verbal-fluency producing the greatest cost to gait speed (26.62%).
The aim was to investigate the relationship between falls risk and gait measures in single and dual-task conditions in older adults with mild dementia.
AIM
Falls risk [Physiological Profile Assessment (PPA); previous 6 months fall history] and global cognition (MOCA) were measured in a cross-sectional study of older adults with mild dementia (MOCA 15-25) recruited from memory and falls services (Balance and the Mind study).
Spatiotemporal gait parameters using the GAITRite system were recorded in:
single task (normal gait)
dual-task counting backwards (from 50 to 0 in 1’s)
dual-task verbal fluency (words beginning with letter)
Dual-task cost (DTC) was calculated for both the motor (gait speed [m/s]) and cognitive (counting time [secs] or total number of words given) components to calculate the mean DTC (mDTC) for each dual-task condition.
After testing for normal distribution and linear relationships between pairs, Pearson’s r coefficients were undertaken.
METHOD
Negative changes to gait pattern are evident and are associated with an increased risk of falls and global cognition in older adults with mild dementia. A mDTC exceeding levels for healthy older adults is present suggesting a benefit of such measures in falls intervention research with this population.
CONCLUSIONS
This study was completed as part of the Balance and the Mind PDG with funding from the NIHR and NUH NHS Trust. The author is funded through a Clinical Training Fellowship from the Alzheimer’s Society with support from the Healthcare Management Trust, and in association with the University of Nottingham and NUH NHS Trust.
ACKNOWLEDGEMENTS