Relationship between cognition and gait performance in older adults receiving physical therapy interventions in the home

Abstract

Abstract-Persons undergoing physical therapy home services often have difficulty with mobility and gait. The purpose of this study was to determine whether there was a relationship between gait and a rating of cognitive functioning in persons undergoing home-care physical therapy services. Patients over the age of 65 (n = 11,601) seen by a home-care agency between 2007 and 2008 were included in the retrospective analysis, and 10,953 (mean +/-standard deviation age 83.2 +/-7.1; 31%) met the criteria of being able to ambulate independently or with an assistive device. All patients attempted to perform the modified Clinical Test of Sensory Integration and Balance plus either the Performance Oriented Measurement Assessment (POMA) or the Dynamic Gait Index (DGI). Mental function was scored as part of the Outcome and Assessment Information Set. A multivariate model with adjustment for age and sex identified gait performance as measured by the DGI to be independently associated with the likelihood that a patient required cognitive prompting (p = 0.03). Both the DGI and POMA scores were independently associated with requiring assistance/dependence with cognitive tasks. There was a strong relationship between cognition and gait performance in persons undergoing physical therapy interventions in the home. Changes in gait may be related to cognitive decline.

Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus

“… 24 Although physical and mental function decrease with aging, the coexistence of DM and diabetic complications could accelerate the process or make the physical and mental conditions even worse. 28 Previous studies have shown that both declining physical 29 and cognitive function 30 might affect balance function. Pijpers 7 found risk factors that partly increase fall incidents in older diabetic patients included limitations in ADLs, impaired physical performance (including balance and gait), and cognitive impairment.…”

A Multidimensional Exercise Program in the Home for Older Adults Designed to Improve Function

“…The Safe Strides plus Zōntago program resulted in better overall functional changes at the end of the episode of care. The Safe Strides program has already been shown to improve patient outcomes in a large cohort of persons with mixed diagnoses, 5,6 yet the Safe Strides plus Zōntago program was more effective in demonstrating ADL changes over the older adult's course of care. Time spent with the patients was similar.…”

“…There is emerging evidence that older adults benefit from rehabilitative services after discharge from the hospital via exercise programs. [1][2][3][4][5][6][7][8] Strength and balance interventions in the home have resulted in functional changes in persons post stroke, with heart failure, at fall risk, and other disorders. 2,3,6,7 Functional status is a strong predictor of readmission rates in persons discharged from inpatient rehabilitation based on over 4,000,000 inpatient rehab admissions.…”