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- Cedervall, Ylva, et al.
(författare)
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A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease
- 2014
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 39:4, s. 1022-1027
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Tidskriftsartikel (refereegranskat)abstract
- Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n = 21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p < 0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.
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| 3. |
- Cedervall, Ylva, et al.
(författare)
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Declining physical capacity but maintained aerobic activity in early Alzheimer's disease
- 2012
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Ingår i: American Journal of Alzheimer’s Disease and Other Dementia. - : SAGE Publications. - 1533-3175 .- 1938-2731. ; 27:3, s. 180-187
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Tidskriftsartikel (refereegranskat)abstract
- The longitudinal influences on physical capacity and habitual aerobic activity level in the early stages of Alzheimer's disease (AD) are unclear. Therefore, changes in physical capacity and aerobic activity level were evaluated. Twenty-five individuals with AD were assessed annually for 2 years, by 10-m walk test, 6-minute walk test, and timed up-and-go (TUG) single/dual tasks. Habitual aerobic activity was assessed by diary registrations. The AD group showed a lower physical capacity than controls at baseline but comparable levels of aerobic activity. During the follow-up period, physical capacity declined in the AD group, but the aerobic activity levels changed only marginally. Our results show that in the early stages of AD, people are capable of maintaining health-promoting aerobic activity levels, despite a decline in their physical capacity. Additionally, it appears that cognitive dysfunction contributes to an impaired physical capacity. The TUG tasks might, therefore, be useful for detecting early signs of cognitive impairment.
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| 8. |
- Cedervall, Ylva, et al.
(författare)
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Maintaining well-being and selfhood through physical activity : experiences of people with mild Alzheimer's disease
- 2015
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Ingår i: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 19:8, s. 679-688
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To contribute to furthering the understanding of how people with mild Alzheimer's disease (AD) reason about physical activity as part of everyday life, with a specific focus on the meanings attached to such activity. Method: In-depth interviews were conducted with 14 individuals with mild AD. Qualitative content analysis was used to interpret the data. Results: The analysis revealed three sub-themes reflecting interrelated perspectives on how people with mild AD reason about physical activity: (1) striving to be physically active, mirrors the concrete approaches used for handling the consequences of having AD in relation to being active; (2) perceptions of physical activity, reflect how their thoughts and beliefs regarding written and tacit norms encouraged them to remain physically active, and (3) physical activity as a means to well-being, alludes to feelings and emotions related to the performance of physical activity. Interpretation of the underlying patterns in these sub-themes revealed one overarching theme: Physical activity as a means to selfhood maintenance, which suggests that physical activity can help to shift the focus from the dementia diagnosis (i.e. ill health) to a more healthy and able self. Conclusion: The findings suggest that physical activity, apart from maintaining body functions, can be a way to sustain well-being and selfhood in mild AD. This aspect of physical activity is important to consider in research, policy and practice when addressing the needs of people with dementia.
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| 9. |
- Cedervall, Ylva
(författare)
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Physical Activity and Alzheimer's Disease : Measurements, Observations and Subjective Experiences
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gait disturbances such as slow walking speed and step-to-step variability have been reported among people with mild Alzheimer’s disease (AD) and as risk factors for functional decline, dependency, and falls. Additionally, AD-related emotional reactions and decreased initiative can lead to physical inactivity. The aims of this thesis, therefore, were to explore how the ability to be physically active is affected in the early years of AD, and how people with mild AD and their cohabitants reason about physical activity as part of their everyday life.To meet the aims, an approach inspired by mixed methods research was used, covering measurements, observations and subjective experiences. Data were collected from different sources in parallel. Participants with mild AD were recruited at the Memory Clinic, Uppsala University Hospital. In Study I, a case study with two couples in which one member had AD, in-depth interviews and participating interviews were performed. Physical activity such as walking was viewed as a meaningful routine improving well-being. Participants were positive about making adjustments to enable physical activity. In Study II, the 25 participants with AD showed a significant lower walking capacity (10 m comfortable walk test, 6-minute walk test, Timed-up-and-Go test) at baseline compared to controls. The decline continued during the subsequent two years. The influence of a cognitive task on walking was distinct, despite this, participants maintained a health-promoting level of physical activity during the two-year study-period. In Study III, gait testing in the motor laboratory of 21 participants with AD showed a marked impact on gait parameters (e.g. slowed speed, decreased step length) by a cognitive task. Additionally, specific dual-task gait disturbances were frequent. In Study IV, in-depth interviews with 14 participants with AD indicated that physical activity was viewed as a meaningful activity, used as a means to maintain well-being and selfhood, and contributed to continuity in life.In conclusion, walking capacity deteriorates and declines in the early stages of AD. A simple cognitive task can have a substantially negative impact on walking already in mild AD. In contrast, people with AD can also gain “self-promoting benefits” from physical activity beyond the common health-promoting benefits.
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| 10. |
- Cedervall, Ylva, et al.
(författare)
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Physical activity and implications on well-being in mild Alzheimer's disease : A qualitative case study on two men with dementia and their spouses.
- 2010
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 26:4, s. 226-39
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Tidskriftsartikel (refereegranskat)abstract
- To improve the understanding of experiences of people with mild Alzheimer's disease (AD) and their significant others, related to the physical activity of the afflicted persons and its perceived importance. A qualitative case study design was used. The study comprised two men with mild AD and their wives. Data were collected by qualitative interviews and participant observations. Data analysis followed a thematic guideline as described by Braun and Clarke ( 2006 ). Three central themes of experiences related to physical activity in AD were identified: 1) physical activity as health reinforcement; 2) barriers to physical activity; and 3) adaptation strategies. Important motivations for outdoor walks were enjoyable experiences of nature, body movement, and positive attitudes toward physical activity. Several factors were experienced as barriers to physical activity (e.g., tiredness, difficulties in finding one's way, and "peculiar behavior"). Significant others made considerable adjustments in everyday life to enable their partners to retain a physically active lifestyle. The findings indicate that in persons with AD, physical activities such as outdoor walking can play an important part in everyday life by creating meaningful routines and improving experienced well-being and health.
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