Mobility in Older Adults with Cognitive Impairment

Editorial

25 July 2023

Editorial: Mobility in older adults with cognitive impairment

Bård Bogen

Gro Gujord Tangen

and

Riona Mc Ardle

1,954 views

1 citations

Editors

Bård Bogen

Western Norway University of Applied Sciences

Riona Mc Ardle

Newcastle University

Gro Gujord Tangen

Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust

Impact

Review

18 May 2023

The association between cognitive impairment, gait speed, and Walk ratio

Mari Kalland Knapstad

, 1 more and

Bård Bogen

3,761 views

7 citations

Flow diagram of NuAge participants according to the presence or absence of Motoric cognitive risk syndrome at baseline and 1-year follow-up.

Original Research

19 January 2023

New onset, transient and stable motoric cognitive risk syndrome: Clinical characteristics and association with incidence of probable dementia in the NuAge cohort

Olivier Beauchet

, 2 more and

Gilles Allali

1,881 views

4 citations

Original Research

06 February 2023

Mobility and associations with levels of cerebrospinal fluid amyloid β and tau in a memory clinic cohort

Gro Gujord Tangen

, 5 more and

Anne-Brita Knapskog

1,904 views

3 citations

Correlation plots of the significant Regression models with the relevant model predictors for change in walking parameters. In (A) for single task fast pace walking condition (ST fast pace) the change (delta of measurement point T1 minus measurement point T2, Δ) in asymmetry (ASYM, in seconds, s) is shown on the ordinates, the delta of Trail Making Test (part B minus part A, ΔTMT, s) and the total score of the Depression im Alter-Scale (DIA-S) are on the abscissas. Sample size N is given as well as the adjusted coefficient of determination R2adj, Bayes factor BF10 and Spearman’s rank correlation (ρ) between ΔASYM and ΔTMT and between ΔASYM and DIA-S, significant correlation coefficients are marked with * (level of significance p ≤ 0.05) and ** (level of significance p p ≤ 0.01), non-significant ones are marked with (n.s.). Data points (gray dots), regression lines with confidence intervals (blue lines with surrounding gray boxes) are shown for the Δwalking parameter. The colored direction of the arrow indicated the direction of the change in walking parameters from T2 to T1 from longer/slower (orange) to shorter/faster (green). In (B) the same is shown for single task normal pace walking condition for the change in double limb support variability (ΔDLSV,s) with DIA-S as well as for ΔASYM (S) and ΔTMT and the total score of the Movement Disorder Society-revised version of the motor part of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III). In (C) the same is shown for DT motor-cognitive walking condition (DT walking-cognitive) for Δgait speed (in meter per seconds, m/s) and the total score of the Montreal cognitive Assessment (MoCA), for Δstride time (s) and ΔTMT and the total score of the Falls-Efficacy-Scale-International version (FES-I), for Δstep time (s) and MoCA, for Δdouble limb support (DLS, s) and ΔTMT, FES-I and gender (“1,” female) as well as for ΔASYM (s), and FES-I and gender.

Original Research

22 December 2022

Cognitive parameters can predict change of walking performance in advanced Parkinson’s disease – Chances and limits of early rehabilitation

Johanna Geritz

, 9 more and

Walter Maetzler

Introduction: Links between cognition and walking performance in patients with Parkinson’s disease (PD), which both decline with disease progression, are well known. There is lack of knowledge regarding the predictive value of cognition for changes in walking performance after individualized therapy. The aim of this study is to identify relevant predictive cognitive and affective parameters, measurable in daily clinical routines, for change in quantitative walking performance after early geriatric rehabilitation.

Methods: Forty-seven acutely hospitalized patients with advanced PD were assessed at baseline (T1) and at the end (T2) of a 2-week early rehabilitative geriatric complex treatment (ERGCT). Global cognitive performance (Montreal Cognitive Assessment, MoCA), EF and divided attention (Trail Making Test B minus A, delta TMT), depressive symptoms, and fear of falling were assessed at T1. Change in walking performance was determined by the difference in quantitative walking parameters extracted from a sensor-based movement analysis over 20 m straight walking in single (ST, fast and normal pace) and dual task (DT, with secondary cognitive, respectively, motor task) conditions between T1 and T2. Bayesian regression (using Bayes Factor BF₁₀) and multiple linear regression models were used to determine the association of non-motor characteristics for change in walking performance.

Results: Under ST, there was moderate evidence (BF₁₀ = 7.8, respectively, BF₁₀ = 4.4) that lower performance in the ∆TMT at baseline is associated with lower reduction of step time asymmetry after treatment (R²_adj = 0.26, p ≤ 0.008, respectively, R²_adj = 0.18, p ≤ 0.009). Under DT walking-cognitive, there was strong evidence (BF₁₀ = 29.9, respectively, BF₁₀ = 27.9) that lower performance in the ∆TMT is associated with more reduced stride time and double limb support (R²_adj = 0.62, p ≤ 0.002, respectively, R²_adj = 0.51, p ≤ 0.009). There was moderate evidence (BF₁₀ = 5.1) that a higher MoCA total score was associated with increased gait speed after treatment (R²_adj = 0.30, p ≤ 0.02).

Discussion: Our results indicate that the effect of ERGT on change in walking performance is limited for patients with deficits in EF and divided attention. However, these patients also seem to walk more cautiously after treatment in walking situations with additional cognitive demand. Therefore, future development of individualized treatment algorithms is required, which address individual needs of these vulnerable patients.

4,640 views

4 citations