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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 1/2015

01.01.2015 | Beiträge zum Themenschwerpunkt

Motor cognitive dual tasking

Early detection of gait impairment, fall risk and cognitive decline

verfasst von: MD Stephanie A. Bridenbaugh, MD Reto W. Kressig

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 1/2015

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Abstract

Background

Gait and cognition are closely associated. Older adults with gait deficits have an increased risk of developing cognitive deficits and cognitive deficits are associated with worsened gait. Both gait and cognitive impairments are risk factors for falls in older adults.

Objectives

The aims of this article are (1) to highlight the association between gait and cognition, particularly executive function, (2) to present motor cognitive dual tasking test paradigms and (3) to provide an algorithm for standardized mobility tests that can quickly and easily be performed in a private practice or on a hospital ward.

Materials and methods

A Pubmed review of current literature on the topic as well as the personal experience and recommendations of the authors are presented. Assessments summarized: clock drawing test, stops walking when talking test, normal walking speed, timed up and go test, regular, as a dual task and imagined.

Results

It is recommended that at least two of the presented assessments should be performed at each clinical visit in all patients age 65 years or older. If one of the assessments presented provides abnormal results, patients should be referred to a gait specialist for an in-depth quantitative gait analysis.

Conclusion

Assessments of functional mobility, fall risk and cognition should be an integral part of every comprehensive geriatric assessment. Quantitative gait analysis allows not only the early detection of gait deficits and fall risk, but also of cognitive deficits. Early detection allows for timely implementation of targeted interventions to improve gait and/or cognition.
Literatur
1.
Zurück zum Zitat Alexander BH, Rivara FP, Wolf ME (1992) The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health 82(7):1020–1023 PubMedCentralPubMedCrossRef Alexander BH, Rivara FP, Wolf ME (1992) The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health 82(7):1020–1023 PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Barry E et al (2014) Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr 14:14 PubMedCentralPubMedCrossRef Barry E et al (2014) Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr 14:14 PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Beauchet O et al (2010) Imagined Timed Up & Go test: a new tool to assess higher-level gait and balance disorders in older adults? J Neurol Sci 294(1–2):102–106 PubMedCrossRef Beauchet O et al (2010) Imagined Timed Up & Go test: a new tool to assess higher-level gait and balance disorders in older adults? J Neurol Sci 294(1–2):102–106 PubMedCrossRef
5.
Zurück zum Zitat Bridenbaugh SA, Kressig RW (2011) Laboratory review: the role of gait analysis in seniors’ mobility and fall prevention. Gerontology 57(3):256–264 PubMedCrossRef Bridenbaugh SA, Kressig RW (2011) Laboratory review: the role of gait analysis in seniors’ mobility and fall prevention. Gerontology 57(3):256–264 PubMedCrossRef
6.
Zurück zum Zitat Bridenbaugh SA, Kressig RW (2014) Quantitative gait disturbances in older adults with cognitive impairments. Curr Pharm Des 20(19):3165–3172 PubMedCrossRef Bridenbaugh SA, Kressig RW (2014) Quantitative gait disturbances in older adults with cognitive impairments. Curr Pharm Des 20(19):3165–3172 PubMedCrossRef
7.
Zurück zum Zitat Bridenbaugh SA et al (2013) Association between dual task-related decrease in walking speed and real versus imagined Timed Up and Go test performance. Aging Clin Exp Res 25(3):283–289 PubMedCrossRef Bridenbaugh SA et al (2013) Association between dual task-related decrease in walking speed and real versus imagined Timed Up and Go test performance. Aging Clin Exp Res 25(3):283–289 PubMedCrossRef
8.
Zurück zum Zitat Buracchio T et al (2010) The trajectory of gait speed preceding mild cognitive impairment. Arch Neurol 67(8):980–986 PubMedCentralPubMed Buracchio T et al (2010) The trajectory of gait speed preceding mild cognitive impairment. Arch Neurol 67(8):980–986 PubMedCentralPubMed
10.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198 PubMedCrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198 PubMedCrossRef
12.
Zurück zum Zitat Hausdorff JM, Rios DA, Edelberg HK (2001) Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 82(8):1050–1056 PubMedCrossRef Hausdorff JM, Rios DA, Edelberg HK (2001) Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 82(8):1050–1056 PubMedCrossRef
13.
Zurück zum Zitat Hornbrook MC et al (1994) Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist 34(1):16–23 PubMedCrossRef Hornbrook MC et al (1994) Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist 34(1):16–23 PubMedCrossRef
14.
Zurück zum Zitat Lundin-Olsson L, Nyberg L, Gustafson Y (1997) “Stops walking when talking” as a predictor of falls in elderly people. Lancet 349(9052):617 PubMedCrossRef Lundin-Olsson L, Nyberg L, Gustafson Y (1997) “Stops walking when talking” as a predictor of falls in elderly people. Lancet 349(9052):617 PubMedCrossRef
15.
Zurück zum Zitat Maki BE (1997) Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc 45(3):313–320 PubMed Maki BE (1997) Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc 45(3):313–320 PubMed
16.
Zurück zum Zitat Monsch AU, Kressig RW (2010) Specific care program for the older adults: memory clinics. Eur Geriatr Med 1:128–131 CrossRef Monsch AU, Kressig RW (2010) Specific care program for the older adults: memory clinics. Eur Geriatr Med 1:128–131 CrossRef
17.
Zurück zum Zitat Montero-Odasso M et al (2009) Can cognitive enhancers reduce the risk of falls in older people with mild cognitive impairment? A protocol for a randomised controlled double blind trial. BMC Neurol 9:42 PubMedCentralPubMedCrossRef Montero-Odasso M et al (2009) Can cognitive enhancers reduce the risk of falls in older people with mild cognitive impairment? A protocol for a randomised controlled double blind trial. BMC Neurol 9:42 PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Montero-Odasso M et al (2012) Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc 60(11):2127–2136 PubMedCentralPubMed Montero-Odasso M et al (2012) Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc 60(11):2127–2136 PubMedCentralPubMed
19.
Zurück zum Zitat Morris JC et al (1987) Senile dementia of the Alzheimer’s type: an important risk factor for serious falls. J Gerontol 42(4):412–417 PubMedCrossRef Morris JC et al (1987) Senile dementia of the Alzheimer’s type: an important risk factor for serious falls. J Gerontol 42(4):412–417 PubMedCrossRef
20.
Zurück zum Zitat Muhaidat J et al (2014) Validity of simple gait-related dual-task tests in predicting falls in community-dwelling older adults. Arch Phys Med Rehabil 95(1):58–64 PubMedCrossRef Muhaidat J et al (2014) Validity of simple gait-related dual-task tests in predicting falls in community-dwelling older adults. Arch Phys Med Rehabil 95(1):58–64 PubMedCrossRef
21.
Zurück zum Zitat Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148 PubMed Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148 PubMed
23.
Zurück zum Zitat Rubenstein LZ, Josephson KR (2002) The epidemiology of falls and syncope. Clin Geriatr Med 18(2):141–158 PubMedCrossRef Rubenstein LZ, Josephson KR (2002) The epidemiology of falls and syncope. Clin Geriatr Med 18(2):141–158 PubMedCrossRef
24.
Zurück zum Zitat Shulman KI (2000) Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry 15(6):548–561 PubMedCrossRef Shulman KI (2000) Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry 15(6):548–561 PubMedCrossRef
25.
Zurück zum Zitat Sterling DA, O’Connor JA, Bonadies J (2001) Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma 50(1):116–119 Sterling DA, O’Connor JA, Bonadies J (2001) Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma 50(1):116–119
27.
Zurück zum Zitat Theill N et al (2011) Simultaneously measuring gait and cognitive performance in cognitively healthy and cognitively impaired older adults: the Basel motor-cognition dual-task paradigm. J Am Geriatr Soc 59(6):1012–1018 PubMedCrossRef Theill N et al (2011) Simultaneously measuring gait and cognitive performance in cognitively healthy and cognitively impaired older adults: the Basel motor-cognition dual-task paradigm. J Am Geriatr Soc 59(6):1012–1018 PubMedCrossRef
28.
Zurück zum Zitat Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707 PubMedCrossRef Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707 PubMedCrossRef
29.
30.
Zurück zum Zitat Verghese J et al (2014) Motoric cognitive risk syndrome: multicountry prevalence and dementia risk. Neurology 83(8):718–726 PubMedCrossRef Verghese J et al (2014) Motoric cognitive risk syndrome: multicountry prevalence and dementia risk. Neurology 83(8):718–726 PubMedCrossRef
Metadaten
Titel
Motor cognitive dual tasking
Early detection of gait impairment, fall risk and cognitive decline
verfasst von
MD Stephanie A. Bridenbaugh
MD Reto W. Kressig
Publikationsdatum
01.01.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 1/2015
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-014-0845-0