Intraindividual variability and falls in older adults.

Bauermeister, Sarah; Sutton, Graham; Mon-Williams, Mark; Wilkie, Richard M.; Graveson, Jack; Cracknell, Alison; Wilkinson, Charles W.; Holt, R. Glynn; Bunce, David

doi:10.1037/neu0000328

Cited by 19 publications

(8 citation statements)

References 49 publications

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“…Older persons often exhibit impairment in balance, muscle strength, cognition, and physical activity which can limit normal functions [ 1 ] and may lead to fall [ 2 ]. The use of several different exercises such as aerobic exercise, balance exercise, resistance exercise, exergames, and complex sports like martial arts can enhance physical function and cognition [ 3 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

Htut

Hiengkaew

Jalayondeja

et al. 2018

Eur Rev Aging Phys Act

110

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BackgroundPhysical exercise (PE), virtual reality-based exercise (VRE), and brain exercise (BE) can influence physical and cognitive conditions in older persons. However, it is not known which of the three types of exercises provide the best effects on physical and cognitive status, and which exercise is preferred by older persons. This study compared the effects of PE, VRE, and BE on balance, muscle strength, cognition, and fall concern. In addition, exercise effort perception and contentment in older persons was evaluated.MethodsEighty-four older persons (n = 84) were randomly selected for PE, VRE, BE, and control groups. The exercise groups received 8-week training, whereas the control group did not. Balance was assessed by Berg Balance Scale (BBS) and Timed Up and Go test (TUG), muscle strength by 5 Times Sit to Stand (5TSTS) and left and right hand grip strength (HGS), cognition by Montreal Cognitive Assessment (MoCA) and Timed Up and Go test Cognition (TUG-cog), fall concern by Fall Efficacy Scale International (FES-I), exercise effort perception by Borg category ratio scale (Borg CR-10), and exercise contentment by a questionnaire.ResultsAfter exercise, PE significantly enhanced TUG and 5TSTS to a greater extent than VRE (TUG; p = 0.004, 5TSTS; p = 0.027) and BE (TUG; p = 0,012, 5TSTS; p < 0.001). VRE significantly improved MoCA (p < 0.001) and FES-I (p = 0.036) compared to PE, and 5TSTS (p < 0.001) and FES-I (p = 0.011) were improved relative to BE. MoCA was significantly enhanced by BE compared to PE (p < 0.001) and both MoCA and TUG-cog were improved compared to VRE (p = 0.04). PE and VRE significantly (p < 0.001) increased Borg CR-10 in all exercise sessions, whereas BE showed a significant improvement (p < 0.001) in the first 4 sessions. Participants had a significantly greater satisfaction with BE than controls (p = 0.006), and enjoyed VRE and BE more than PE (p < 0.001). Subjects in all exercise groups exhibited benefits compared to the control group (p < 0.001).ConclusionsPE provided the best results in physical tests, VRE produced measurable improvements in physical and cognition scores, while BE enhanced cognition ability in older persons. Older persons preferred VRE and BE compared to PE. Both exercises are suggested to older persons to improve physical and cognitive conditions.

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Section: Introductionmentioning

confidence: 99%

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

Htut

Hiengkaew

Jalayondeja

et al. 2018

Eur Rev Aging Phys Act

110

View full text Add to dashboard Cite

show abstract

“…Although all eight highest priority factors correspond to commonly identified predictors of fall risk [19] , [36] , [37] , many factors known to be significant independent predictors of falls in PWD were not ranked high priority despite reaching consensus for importance. One explanation for this finding is that priority ratings were influenced by the feasibility of assessing a particular factor in people with advanced dementia, which participants were instructed to consider alongside its importance.…”

Section: Discussionmentioning

confidence: 99%

Key factors for the assessment of mobility in advanced dementia: A consensus approach

Ooteghem

Musselman

Mansfield

et al. 2019

A&D Transl Res & Clin Interv

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Introduction Loss of mobility is common in advanced dementia and has important negative consequences related to fall risk, loss of independence, and lack of participation in meaningful activities. The causes of decline are multifactorial, including disease-specific changes in motor function, behavior, and cognition. To optimize clinical management of mobility, there is a need to better characterize capacity for safe and independent mobility. This study aimed to identify key factors that impact on mobility in dementia. Methods Expert input was gathered using a modified Delphi consensus approach. The primary criterion for participation was specialist knowledge in mobility or dementia, either as a clinician or a researcher. Participants rated elements of mobility for importance and feasibility of assessment in advanced dementia and prioritized items for inclusion in a mobility staging tool. Descriptive statistics and qualitative content analysis were used to summarize responses. Results Thirty-six experts completed the first survey with an 80% retention rate over three rounds. One-third of 61 items reached consensus for being both important and feasible to assess, representing five categories of elements. Items reaching agreement for a staging tool included walking, parkinsonism, gait, impulsivity, fall history, agitation, transfers, and posture control. Discussion This study highlights the need for a multidimensional, dementia-specific approach to mobility assessment. Results have implications for development of assessment methods and management guidelines to support the clinical care of mobility impairment in people with dementia.

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“…constant bias). Intra-individual variability has been championed as a possible metric of decline (Bunce et al, 2012) and seems to be related to a variety of other measures of perceptual, motor and cognitive performance (Bauermeister et al, 2016). In Raw et al, 2012 the consistency of performance was calculated using the standard deviation of steering error (RMSE) across trials for each individual within each condition ( Figure 3E).…”

Section: Figure 3: A) An Older Driver Steering Along a Sinusoidal Roamentioning

confidence: 99%

Looking to the future of visual assessment using driving simulation

Wilkie

Mole

2017

Scand J Optom Vis Sci

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Visual function is considered uniquely important for driving because it provides multiple critical sources of information that when combined ensures successful steering. There are, however, additional cognitive functions that are essential for the driver to be able to dynamically respond to the world and make predictions about the scene, as well as the behaviour of other road users. Given the complexity of driving through a busy urban environment it should be no surprise that simple tests of visual acuity seem to have weak explanatory power in terms of increased crash risk when driving. Despite this, fitness to drive still includes a formal assessment of visual acuity, with poor scores being used to revoke the driving licence. The "gold standard" measure of driving ability remains the on-road driving test but compared to visual tests they are fairly uncontrolled, susceptible to great variation depending on the road conditions, and are unable to reliably detect subtle visual deficits. To address some of the limitations of these existing tests we use examples from two simulator settings (steering control and hazard detection) that highlight the merits of using driving simulation in order to control the visual conditions and probe specific functional capabilities of drivers. When used in conjunction with visual tests these methods will not only determine whether the core functions of driving are intact but also be able to provide richer feedback to individuals about the nature of their deficits. There are many exciting possibilities using simulation techniques to establish predictive relationships between routine visual testing and driving performance, ultimately aiming for better, more reliable assessment of fitness to drive. SammendragSynsfunksjonen betraktes som enestående viktig for bilkjøring fordi den bidrar til flere kritiske informasjonskilder som sammen sikrer trygg kontroll av bilen. Men det finnes i tillegg andre kognitive funksjoner som er nødvendige for at en bilfører skal kunne reagere dynamisk og kunne forutse både hendelser i trafikkbildet og andre trafikanters handlinger. Tatt i betraktning kompleksiteten av å kjøre i trafikkerte, tettbygde strøk, er det ikke overraskende at en enkel test av synsstyrke sjelden kan forklare fullstendig risikoen for kollisjoner ved bilkjøring. Til tross for dette brukes fortsatt synsstyrke som et mål i den formelle undersøkelsen når man skal avgjøre om en person er egnet til å føre motorvogn, og dårlige resultater på synstesten fører til inndragelse av førerkortet. Kjøreevne måles fortsatt med praktisk prøve, men sammenlignet med tester av synsfunksjonen er disse prøvene vanskelige å kontrollere, sterkt varierende avhengig av veiforholdene, og ikke i stand til å avsløre små synsdefekter. For å studere noen av begrensningene ved disse eksisterende prøvene bruker vi eksempler fra to simulatorsettinger (styrekontroll og evne til å oppdage fare) som viser fordelene med å bruke kjøresimulator for å kontrollere synsforholdene og teste bestemte funkjonelle ferdighet...

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Intraindividual variability and falls in older adults.

Cited by 19 publications

References 49 publications

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

Key factors for the assessment of mobility in advanced dementia: A consensus approach

Looking to the future of visual assessment using driving simulation

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