Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part I – Cane

Hunter, Susan; Divine, Alison; Omaña, Humberto; Wittich, Walter; Johnson, Andrew M.; Holmes, Jeffrey D.

doi:10.3233/jad-181169

Cited by 18 publications

(22 citation statements)

References 30 publications

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“…Our findings underscore the importance of monitoring home care clients with a neurological health condition and who use an assistive device for locomotion indoors. Research on the use of a cane and gait changes among older adults with and without Alzheimer's disease found that learning to use this assistive device required increased cognition and resulted in poorer gait performance [38]. Previous studies identified people with multiple sclerosis or who use a wheelchair or scooter for locomotion indoors to be susceptible to fall, including sustaining injuries as a result of falling [36].…”

Section: Implications For Policies and Practices Pertaining To Home Carementioning

confidence: 99%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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Background: Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients. Methods: We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1-March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument-Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls. Results: Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism. Conclusions: Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.

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Section: Implications For Policies and Practices Pertaining To Home Carementioning

confidence: 99%

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

2020

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“…The item deleted as a result of the exploratory factor analysis (EFA) (loadings < 0.40) was "Walking and using an aid such as a cane or a crutch". Although not often considered as such, the use of a mobility aid is a complex motor task that can result in an increased cognitive load (Bateni and Maki, 2005) and has been previously assessed as a DT measure (Hunter et al, 2019). However, higher levels of attention are required during the learning process of the aid correct use, whereas it might convert into an automatic task when users become more experienced.…”

Section: Discussionmentioning

confidence: 99%

The patients’ perspective on the perceived difficulties of dual-tasking: development and validation of the Dual-task Impact on Daily-living Activities Questionnaire (DIDA-Q)

Pedullà

Tacchino

Podda

et al. 2020

Multiple Sclerosis and Related Disorders

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Background: Everyday-life activities often require performing dual tasks (DT), with consequent possible occurrence of motor-cognitive or motor-motor interference. This could reduce quality of life, in particular in people with neurological diseases. However, there is lack of validated tools to assess the patients' perspective on DT difficulties in this population. Therefore, we developed the Dual-task Impact on Daily-living Activities-Questionnaire (DIDA-Q) and tested its psychometric properties in people with multiple sclerosis (PwMS). Methods: Items were generated based on existing scales, DT paradigms used in previous studies and the opinion of a multi-stakeholder group, including both experts and PwMS. Twenty DT constituted the preliminary version of the DIDA-Q which was administered to 230 PwMS. The psychometric properties of the scale were evaluated including internal consistency, validity and reliability. Results: Nineteen items survived after exploratory factor analysis, showing a three-factor solution which identifies the components mostly contributing to DT perceived difficulty (i.e., balance and mobility, cognition and upper-limb ability). The DIDA-Q appropriately fits the graded response model, with first evaluations supporting internal consistency (Cronbach's alpha=0.95), validity (70% of the hypotheses for convergent and discriminant constructs confirmed) and reliability (intraclass correlation coefficients=0.95) of this tool. Conclusion: The DIDA-Q could be used in research and clinical settings to discriminate individuals with low vs. high cognitive-motor or motor-motor interference, and to develop and evaluate the efficacy of personalized DT rehabilitative treatments in PwMS.

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“…The use of a mobility aid in people with dementia results in increased cognitive demands for walking, due to heightened attentional processing and the greater need for neuromotor control, which results in an unstable gait [10,[13][14][15]. Other possibilities for the increased risk include unsafe use of the equipment due to limited insight and lack of training.…”

Section: Introductionmentioning

confidence: 99%

The experiences of people with Alzheimer’s dementia and their caregivers in acquiring and using a mobility aid: a qualitative study

Hunter

Meyer²,

Divine

et al. 2020

Disability and Rehabilitation

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Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part I – Cane

Cited by 18 publications

References 30 publications

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

The patients’ perspective on the perceived difficulties of dual-tasking: development and validation of the Dual-task Impact on Daily-living Activities Questionnaire (DIDA-Q)

The experiences of people with Alzheimer’s dementia and their caregivers in acquiring and using a mobility aid: a qualitative study

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