Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease

Ansai, Juliana Hotta; Andrade, Larissa Pires de; Masse, Fernando Arturo Arriagada; Gonçalves, Jessica; Takahashi, Anielle Cristhine de Medeiros; Vale, Francisco Assis Carvalho; Rebelatto, José Rubens

doi:10.1519/jpt.0000000000000135

Cited by 48 publications

(86 citation statements)

References 29 publications

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“…Previous studies also report a greater number of older women with MCI. 22,23 Moreover, the AD group had a lower calorie expenditure compared to the PC group, which is in line with data described by Pedroso et al, 24 who also found that older people with AD have low activity levels. Regarding the number of medications and diseases, higher numbers were found in individuals with cognitive impairment.…”

Section: Discussionsupporting

confidence: 87%

“…In a longitudinal study with a six-month follow-up using a fall calendar and monthly phone calls, 52.6% of the individuals with MCI and 51.4% of those with mild AD experienced falls. 22 The level of physical activity, participation in social activities and the supervision of caregivers can influence the exposure of older people to a variety of environmental stimuli that can exert an impact on the risk of falls. Moreover, the 32-month period increases the risk of recall bias and the prevalence of falls may actually be underestimated.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

Silva

Ansai

Cezar

et al. 2020

Dement. neuropsychol.

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ABSTRACT. Background: Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. Objective: To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. Methods: One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. Results: Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show “other diagnoses” (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. Conclusions: Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

Silva

Ansai

Cezar

et al. 2020

Dement. neuropsychol.

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“…[6][7][8][9] There is an increasing understanding that motor impairments contribute to overall AD severity, and that there is a need for ameliorating these impairments. For example, gait impairments can decrease quality of life by reducing mobility; increasing risk for injuries due to falling and increasing the likelihood of institutionalization once the ability to walk is lost 10,11 . Motor dysfunction is a reliable predictor for the development of AD, and can also predict levels of cognitive dysfunction and mortality risk.…”

Section: Introductionmentioning

confidence: 99%

Age‐related deterioration of motor function in male and female 5xFAD mice from 3 to 16 months of age

O’Leary

Mantolino

Stover

et al. 2018

Genes Brain and Behavior

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Alzheimer's disease (AD) is a neurodegenerative disorder that leads to age‐related cognitive and sensori‐motor dysfunction. There is an increased understanding that motor dysfunction contributes to overall AD severity, and a need to ameliorate these impairments. The 5xFAD mouse develops the neuropathology, cognitive and motor impairments observed in AD, and thus may be a valuable animal model to study motor deficits in AD. Therefore, we assessed age‐related changes in motor ability of male and female 5xFAD mice from 3 to 16 months of age, using a battery of behavioral tests. At 9‐10 months, 5xFAD mice showed reduced body weight, reduced rearing in the open‐field and impaired performance on the rotarod compared to wild‐type controls. At 12‐13 months, 5xFAD mice showed reduced locomotor activity on the open‐field, and impaired balance on the balance beam. At 15‐16 months, impairments were also seen in grip strength. Although sex differences were observed at specific ages, the development of motor dysfunction was similar in male and female mice. Given the 5xFAD mouse is commonly on a C57BL/6 × SJL hybrid background, a subset of mice may be homozygous recessive for the Dysf im mutant allele, which leads to muscular weakness in SJL mice and may exacerbate motor dysfunction. We found small effects of Dysf im on motor function, suggesting that Dysf im contributes little to motor dysfunction in 5xFAD mice. We conclude that the 5xFAD mouse may be a useful model to study mechanisms that produce motor dysfunction in AD, and to assess the efficacy of therapeutics on ameliorating motor impairment.

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“…MCi has been classified as one of the fall risk factors in older people [7]. According to estimates, more than half of the older population regularly experience falls [8,9]. However, the cause of the increased fall risk in this population is not entirely clear [10].…”

Section: Introductionmentioning

confidence: 99%

The relation between cognitive impairment severity and postural stability in the elderly

Cieślik¹,

Chamela-Bilińska²,

Ostrowska³

et al. 2019

Physiother Quart.

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Introduction. The purpose of this study was to evaluate the relationship between the severity of cognitive impairment and the results of stabilographic tests in elderly patients with cognitive impairment. Methods. The study involved 42 participants aged 62-84 (mean 73.4 ± 6.7) years. The assessment of cognitive status was carried out with the Mini-Mental State Examination (MMSE). included were subjects who obtained a score below 27, which is the cutoff score between the absence and presence of cognitive impairment. Postural stability was evaluated by using a force platform which registered the shifts of the centre of pressure (CoP) in the sagittal and frontal plane during two 32-second trials of quiet stance on a hard surface, with eyes open and with eyes closed. The CoP sway parameters were analysed. Results. in the eyes-open test, we obtained a weak negative correlation of the MMSE and the mean radius of the CoP sway (r =-0.37; p < 0.05). Considering the values achieved in each plane, a statistically significant correlation was observed in all the parameters analysed in the sagittal plane. The eyes-closed test revealed a clear negative correlation between the MMSE results and all the studied parameters. Conclusions. A significant relationship between the severity of cognitive impairment and the results of stabilographic parameters were noted. A negative correlation between the stabilographic parameters and the MMSE scores showed a linear deterioration of postural stability which progresses along with the decrease in cognitive functions.

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Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease

Abstract: Careful attention should be given to dual-task and turn-to-sit activities when detecting risk of falls among older people with MCI and mild AD.

Cited by 48 publications

References 29 publications

Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

Age‐related deterioration of motor function in male and female 5xFAD mice from 3 to 16 months of age

The relation between cognitive impairment severity and postural stability in the elderly

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