Accuracy of mobility tests for screening the risk of falls in patients with mild cognitive impairment and alzheimer’s disease

Abstract

Identifying gait and balance disorders in the earlier stages of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) could reduce or prevent falls in older adults. This cross-sectional study aimed to determine which mobility tests best discriminate the risk of falls in MCI and mild AD. Functional mobility was assessed by the timed up and go test (TUG) and 10-meter walk test (10MWT). A calendar of falls was produced, with follow-up via telephone calls during 6 months. For the MCI Group (n=38), time spent on the 10MWT was the best variable for discriminating fallers, with a cut-off point of 10.69 seconds associated with the highest accuracy (76.3%). In the AD Group (n=37), 10MWT cadence was the best variable for discriminating fallers, with a cut-off point of 101.39 steps per minute associated with an accuracy of 81.1%. As a conclusion, 10MWT time and cadence were the most accurate variables for screening the risk of falls in MCI and mild AD, respectively. The 10MWT is a functional, simple and easy test and it should be widely used in clinical practice.

Functional Mobility and postural balance in older adults with Alzheimer's disease: comparative study between mild and moderate stages

“…Older adults with AD have a high fall risk, which can be reliably screened using TUGT (Allali & Verghese, 2020;Allali, et al, 2017;Ansai, Andrade & Rossi, et al, 2017;Borges, et al, 2015;Cruz, et al, 2015;Dyer, et al, 2020;Kato-Narita & Radanovic, 2009). We found a higher time to complete the test than previous studies (Alexandre, et al, 2012;Ansai, et al, 2019). Alexandre et al (2012) and Ansai et al (2019) presented a TUGT cutoff point of 12.47 and 17.56 seconds, respectively, for Brazilian older adults with AD.…”

“…Alexandre et al (2012) and Ansai et al (2019) presented a TUGT cutoff point of 12.47 and 17.56 seconds, respectively, for Brazilian older adults with AD. Patients with CDR2 completed the TUGT with median times above these cutoff points (Ansai, et al, 2019;Bortoli, et al, 2015;Podsiadlo & Richardson, 1991).…”

Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis

“…Gait speed was the most investigated falls risk factor with all studies reporting a statistically significant association between falls and slow gait speed in people with Mild Cognitive Impairment. 26,27,37,39,48,52 Dual-task gait performance 24,25,41 and non-amnesic Mild Cognitive Impairment 48,64 were also found to be significantly associated with falls in people with Mild Cognitive Impairment living in the community.…”

“…previous 12-months) 28 and only once for the other four studies that all reported the same number of falls in the 6-month prospective data collection period. [24][25][26][27] The same occurred for two other studies, 29,30 where the first published study was the only falls prevalence data utilized in the analysis. 30 For another two studies that used the same participant cohort, 31,32 No single included study answered all three research questions.…”

“… BLSMotorCD: Brazilian longitudinal study about motor alterations in older people with cognitive disorders; COGNET: Clinical Pathological Study of Cognitive Impairment in Essential Tremor; GAIT: Gait and Alzheimer Interaction Tracking; GOOD: Gait, cOgnitiOn and Decline; KLoSA: Korean Longitudinal Study of Aging; LGRS TUA: Longitudinal Study on Neuroprotective Model for Health Longevity; MAS: Sydney Memory and Aging Study; MCI: Mild Cognitive Impairment; TILDA: The Irish Longitudinal Study on Aging; MRI CODE: Magnetic Resonance Imaging of COgnitive DEcline study; NB: Note; OSHPE: Obu Study of Health Promotion for the Elderly. a Same population used for all studies, data from Ansai et al 26 was not used in the fall prevalence analysis as it is the same data used in other studies included in this table. 24,25,27 b Same population used for both studies. c Both baseline and prospective falls data collected for these studies. d Same population used for both studies. …”