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- Taylor, Morag E., et al.
(author)
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Cognitive Domain Associations with Balance Performance in Community-Dwelling Older People with Cognitive Impairment
- 2021
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In: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 81:2, s. 833-841
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Journal article (peer-reviewed)abstract
- Background: In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited.Objective: To investigate the relationship between global cognition and cognitive domain function and balance performance in older people with CI.Methods: The iFOCIS randomized controlled trial recruited 309 community-dwelling older people with CI. Baseline assessments completed before randomization were used for analyses including the Addenbrooke's Cognitive Examination-III (ACE-III; global cognition) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and the Frontal Assessment Battery (FAB), a measure of EF. A composite balance score was derived from postural sway and leaning balance tests.Results: In linear regression analyses adjusted for covariates, global cognition and each cognitive domain were significantly associated with balance performance. EF (verbal fluency; β=-0.254, p<0.001, adjusted R2=0.387) and visuospatial ability (β=-0.258, p<0.001, adjusted R2=0.391) had the strongest associations with balance performance. In a comprehensively adjusted multivariable model including all of the ACE-III cognitive domains, visuospatial ability and EF (verbal fluency) were independently and significantly associated with balance performance.Conclusion: Poorer global cognition and cognitive domain function were associated with poorer balance performance in this sample of people with CI. Visuospatial ability and EF were independently associated with balance, highlighting potential shared neural networks and the role higher-level cognitive processes and spatial perception/processing play in postural control.
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- Toots, Annika, et al.
(author)
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Associations Between Gait Speed and Cognitive Domains in Older People with Cognitive Impairment
- 2019
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In: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 71, s. S15-S21
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Journal article (peer-reviewed)abstract
- Background: While gait has been linked with cognition, few studies have contrasted the strength of the relationships between gait speed and cognitive domains in people with cognitive impairment (CI).Objectives: Investigate the association between gait speed and global cognitive function and cognitive domains in older people with CI.Method: Three-hundred-and-nine community-dwelling people with CI (mean age 82 years, 47% female, and mean gait speed 0.62 +/- 0.23 m/s) were included using baseline data from the Intervention-Falls in Older Cognitively Impaired Study (iFOCIS). Usual gait speed (m/s) was measured over 2.4 m. Global cognitive function and individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) were assessed using the Addenbrooke's Cognitive Examination-III (ACE-III). Additionally, executive function was assessed using the Frontal Assessment Battery (FAB).Results: Participants mean f standard deviation ACE-III and FAB scores were 62.8 +/- 19.3 and 11.4 +/- 4.6, respectively. In separate multiple linear regression analyses adjusting for confounders, global cognitive function, and each cognitive domain, was significantly associated with gait speed. Executive function demonstrated the strongest association (FAB: standardized (beta = 0.278, p< 0.001, adjusted R-2 = 0.431), and remained significantly associated with gait speed when adjusted for attention, memory, language, and visuospatial ability.Conclusion: In this large study of older people with CI, global cognition and each cognitive domain were associated with gait speed. Executive function had the strongest association, possibly reflecting the higher-level cognitive processes and complex motor task responses required for gait control. Future longitudinal studies are needed to explore the temporal relationships between declines in executive function and gait, and whether the facilitation of executive function lessens gait decline.
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