Reducing Fall Risk with Combined Motor and Cognitive Training in Elderly Fallers

Abstract

Background. Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. Methods. In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). Results. Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES −0.25) restricted to the period after intervention. Conclusions. This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.

The Relationships Between Fall Risk, Depression, Executive Dysfunctions and Daily Life of Older Adults

“…With this information, clinicians may improve the choice of the best-adapted behavioral strategy [16,28]. For example, how to approach the activity in the certain environment, how to compensate the slow reaction time, or the physical di culties [3], what environmental adaptations should be performed to enhance the adaptive responds to environmental demands at home or in the community [50].…”

“…Based on the above, the aims of the present study were to: (1) examine fall risk prevalence among older adults living in the community. (2) compare depression, cognitive level/ executive functions, daily activity performance and QOL between high and low fall risk groups (3) Knowing that body functions such as cognitive level/ executive functions and depression may affect daily activity performance and QOL in the older age, this study aimed to explore what is the speci c contribution of fall risk as a mediator between these body functions, daily activities and QOL.…”

“…About half of them fall again in the following year and need long-term care [2]. The high health costs and the severe personal consequences -the injuries, immobilization, the reduced independence in daily activities, and death, turn falls to be a major concern for public health [3,4]. Based on studies found that some fallers show resilience and maintain or improve functioning [5], factors that underlie resiliency or vulnerability among fallers should be identi ed.…”

“…The frequent combination of reduced balance, impaired emotional status and executive dysfunctions may have far reaching impacts on older adults' daily life -they may decreased independence in Basic/Instrumental Activities of Daily Living (BADL/IADL) [21] and signi cantly reduce quality of life [3,[22][23][24]. Yet, a1 lack of information exists about the relationship between falls and depression in non-institutionalized older adults [2].…”

The correlation of specific medication groups and falls risk in elderly. A medication logbook survey

“…A medication logbook survey with ageing but certainly the underlying medical conditions, such as neurological or cardiac diseases, and the medications play an important role 8 . Although there is a clear correlation between falls and taking a large number of drugs, some drugs are considered to be more dangerous in causing falls.…”