The Role of Higher-Level Cognitive Function in Gait: Executive Dysfunction Contributes to Fall Risk in Alzheimer’s Disease

Sheridan, Pamela L.; Hausdorff, Jeffrey M.

doi:10.1159/000105126

Cited by 270 publications

(210 citation statements)

References 183 publications

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“…Other studies also examined the role of executive function and gait stability or falls risk. (Ijmker and Lamoth 2011;Herman et al 2010;Sheridan and Hausdorff 2007). In a prospective study, participants who reported no previous falls, but were in the worst executive function quartile were three times more likely to fall during the 2 years of followup, and they were more likely to transition from non-fallers to faller sooner (Herman et al 2010).…”

Section: Discussionmentioning

confidence: 98%

Pilot study into impaired judgement, self-toileting behaviour in fallers and non-fallers

et al. 2013

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Falls are a significant cause of morbidity and mortality in older people. There is an increased frequency of falls in older adults with cognitive impairment and dementia which may be due to impaired judgement of self capability to mobilise safely. This case control study assessed 53 Aged Care subjects aged 75? years that were hospitalised post fall, from January 2008-December 2009, and compared these subjects' responses to those of 26 non-fallers to a standard question: 'While you are in the hospital, what would you do if you need to go to the toilet later?' This hypothetical scenario question was designed to assess judgement based on selftoileting behaviour and mobility. The study group and control group were similar in age (83.9 ± 4.7 vs. 82.0 ± 4.6 years respectively, p = 0.081) but the study group had statistically lower MMSE results when compared to controls (median 23 vs. 26.5 respectively, p = 0.031). Impaired judgement, defined as an unsafe/inappropriate response to the scenario question, was significantly more prevalent in the study group (fallers) compared to the control group (nonfallers) (41.5 vs. 15.4 %, p = 0.020). Impaired judgement was also more common with lower MMSE scores with 80.9 % of unsafe/inappropriate responses given by participants with MMSE of B20. The authors suggest there may be an association between impaired judgement, evidenced by responses to a standardised question, and falls history in older subjects, particularly in those with cognitive impairment or dementia. Ultimately, this may lead to identification of people at increased risk of falls and possibly effective falls prevention strategies in this population.

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Section: Discussionmentioning

confidence: 98%

Pilot study into impaired judgement, self-toileting behaviour in fallers and non-fallers

et al. 2013

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“…Also, they fail tasks requiring relatively complex brain communication, such as under dual-task conditions; these tasks depending substantially on executive attention control (Nordahl et al 2006;Mayda et al 2011). Interestingly, cognitive impairment in AD, specifically executive attention control deficits, and the hyperexcitability of the motor cortex affect gait (van Iersel et al 2004;Sheridan and Hausdorff 2007;Beauchet et al 2008;Coelho et al 2012). Overall, AD patients present a lower gait speed (Verghese et al 2007;Rucco et al 2017), shorter stride length (Coelho et al 2012;Rucco et al 2017) and cadence (Sheridan and Hausdorff 2007), and greater stride time variability (Beauchet et al 2008(Beauchet et al , 2014.…”

Section: Changes In Gait Control Under Single-task Condition In Alzhementioning

confidence: 99%

“…Interestingly, cognitive impairment in AD, specifically executive attention control deficits, and the hyperexcitability of the motor cortex affect gait (van Iersel et al 2004;Sheridan and Hausdorff 2007;Beauchet et al 2008;Coelho et al 2012). Overall, AD patients present a lower gait speed (Verghese et al 2007;Rucco et al 2017), shorter stride length (Coelho et al 2012;Rucco et al 2017) and cadence (Sheridan and Hausdorff 2007), and greater stride time variability (Beauchet et al 2008(Beauchet et al , 2014. Stride length variability has rarely been studied but appear to be increased compared to healthy older adults (van Iersel et al 2004;Coelho et al 2012).…”

Section: Changes In Gait Control Under Single-task Condition In Alzhementioning

confidence: 99%

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

Belghali¹,

Chastan²,

Cignetti³

et al. 2017

GeroScience

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Alzheimer's and Parkinson's diseases are age-related progressive neurodegenerative diseases of increasing prevalence worldwide. In the absence of curative therapy, current research is interested in prevention, by identifying subtle signs of earlystage neurodegeneration. Today, the field of behavioral neuroscience has emerged as one of the most promising areas of research on this topic. Recently, it has been shown that the exacerbation of gait disorders under dual-task conditions (i.e., simultaneous performance of cognitive and motor tasks) could be a characteristic feature of Alzheimer's and Parkinson's diseases. The cognitive-motor dual-task paradigm during walking allows to assess whether (i) executive attention is abnormally impaired in prodromal Alzheimer's disease or (ii) compensation strategies are used in order to preserve gait function when the basal ganglia system is altered in prodromal Parkinson's disease. This review aims at (i) identifying patterns of dual-taskrelated gait changes that are specific to Alzheimer's and Parkinson's diseases, respectively, (ii) demonstrating that these changes could potentially be used as prediagnostic markers for disease onset, (iii) reviewing pros and cons of existing dual-task studies, and (iv) proposing future directions for clinical research.

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“…These improvements shown in the 6MWT by the intervention group imply cardiovascular and general physical function benefits (Enright & Sherrill, 1998 . Furthermore, if the person develops a dementia, it usually has as a consequence a higher deterioration of gait, and as the severity of the dementia progresses gait will also continue to deteriorate (Sheridan & Hausdorff, 2007). In our sample, the experimental group improved significantly the performance in the 8-meter walk test after the exercise program, which represents an improvement in their physical functionality.…”

Section: Main Characteristics Of the Samplementioning

confidence: 99%

Group-based exercise for people with mild cognitive impairment: a pilot study

Tortosa-Martínez¹,

Caus-Pertegaz²,

Martínez-Canales³

2013

JHSE

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Tortosa-Martínez J, Caus-Pertegaz N, Martínez-Canales C. Group-based exercise for people with mild cognitive impairment: a pilot study. J. Hum. Sport Exerc. Vol. 8, No.Proc3, pp. S702-S710, 2013.The number of neurodegenerative diseases associated to aging, such as Alzheimer´s disease (AD), is rapidly increasing. Mild cognitive impairment (MCI) is diagnosed when a person presents cognitive deficits, usually memory related, but still does not meet criteria for a diagnosis of dementia. It is usually considered a transitional phase between normal aging and dementia. The benefits of exercise for people with mild cognitive impairment are not fully clear and deserve further research. The aim of this pilot study was to analyse the physical benefits of a group-based exercise program for people with mild cognitive impairment. Using a pre-post design, twenty people with MCI were recruited and divided into an experimental group (10), who followed a three-month exercise program, and a control group (10) who followed routine care. The results of this study show that engaging in a supervised exercise program was effective for improving performance in the Six Minute Walk Test (6MWT), the Timed Get Up and Go Test (TGUP), and the 8-meter walk test, implying gains in cardiovascular capacity, gait and dynamic balance. After the intervention period, the control group not only did not improve in any of the fitness tests, but also showed significant worse performance in the (6MWT) and the Tinetti total score. Thus, a supervised group-based exercise program can represent a feasible and effective strategy for improving physical function in people with MCI.

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The Role of Higher-Level Cognitive Function in Gait: Executive Dysfunction Contributes to Fall Risk in Alzheimer’s Disease

Cited by 270 publications

References 183 publications

Pilot study into impaired judgement, self-toileting behaviour in fallers and non-fallers

Pilot study into impaired judgement, self-toileting behaviour in fallers and non-fallers

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

Group-based exercise for people with mild cognitive impairment: a pilot study

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