@article {11787, title = {Associations Between Cognitive Function, Balance, and Gait Speed in Community-Dwelling Older Adults with COPD.}, journal = {Journal of Geriatric Physical Therapy}, volume = {46}, year = {2023}, pages = {46-52}, abstract = {

BACKGROUND AND PURPOSE: Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults. However, it is unknown whether a relationship exists between cognitive function and falls in patients with COPD. The aim of this study was to examine the relationships between cognitive function, balance, and gait speed in older adults with COPD.

PATIENTS AND METHODS: A secondary analysis was performed using data from the 2010 wave of the Health and Retirement Study (HRS). Cognitive (immediate and delayed recall, executive function) and physical (gait speed, tandem balance time) measure data were extracted for older adults with COPD (n = 382) and an age-matched control group without COPD (n = 382) who met inclusion/exclusion criteria. Multivariate linear regression modeling was performed to examine associations between cognitive function and mobility or balance while controlling for age, gender, body mass index, grip strength, and education.

RESULTS: In COPD, delayed recall was significantly associated with tandem balance performance (β = 1.42, P < .05). Other cognitive measures were not associated with gait speed or balance.

CONCLUSION: In older adults with COPD, cognitive function was associated with balance and mobility. Screening of cognitive function, specifically delayed recall, should be a part of the management of falls in this population.

}, keywords = {balance, Cognition, Community-dwelling, COPD, Gait speed}, issn = {2152-0895}, doi = {10.1519/JPT.0000000000000323}, author = {Gore, Shweta and Blackwood, Jennifer and Ziccardi, Tyler} } @article {12009, title = {Screening recall in older cancer survivors detects differences in balance and mobility.}, journal = {Supportive Care In Cancer}, volume = {30}, year = {2022}, pages = {2605-2612}, abstract = {

PURPOSE: Cognitive impairments have been reported by up to two-thirds of cancer survivors whose primary cancer did not occur in the central nervous system. Physical impairments as sequelae of cancer-related cognitive impairment (CRCI) have not been well described in previous studies. Furthermore, there is scarcity of literature describing differences among physical performance in those with and without CRCI. The purpose of this study is to examine the differences in physical function of older cancer survivors based on cognitive ability to determine if physical performance differs when different cognitive screening measures are employed.

METHODS: Adults age 65 + with a history of cancer from the 2010 Health and Retirement Study (n = 1,953) were assigned to groups according to their cognitive ability. Between-group demographic, mobility, and cognitive differences were analyzed using chi-squared and t tests. Recall and orientation were used as cognitive variables, and physical performance outcomes included gait speed, balance, and grip strength.

RESULTS: Respondents with Low Recall had more impaired balance (semi-tandem, tandem) (p < .05) and slower gait speeds (p < .05). Respondents that were Not-Oriented had slower gait speed (p < .05). Between-group differences in demographics were found by recall and orientation groups.

CONCLUSIONS: Impairments in balance and gait speed are able to be detected when recall is screened in a population of older cancer survivors. When assessing how physical mobility is related to fall risk, a screen of cognition should go beyond just orientation.

}, keywords = {Cognition, Memory, Neoplasms, Orientation, Postural Balance, Short-term, walking speed}, issn = {1433-7339}, doi = {10.1007/s00520-021-06705-9}, author = {Blackwood, Jennifer and Sweeney, Robert and Rybicki, Kateri} } @article {9817, title = {Cognitive Function and Falls in Older Adults With Type 2 Diabetes Mellitus.}, journal = {Journal of Geriatric Physical Therapy}, year = {2019}, abstract = {

BACKGROUND AND PURPOSE: Cognitive impairments have been reported in older adults with type 2 diabetes (T2DM), which subsequently increases the risk of falling. However, the relationship between specific cognitive processes and falls has not been reported. Therefore, the purpose of this study was to describe the contribution of cognitive function on falls in older adults with T2DM and to describe any differences by age group.

METHODS: A cross-sectional analysis was conducted of 1171 older adult respondents with T2DM from the 2010 wave of the Health and Retirement Study. Group assignment was based on age: younger group 65 to 74 years (N = 662) or older group (N = 509). Groupwise comparisons on demographic, cognitive, and mobility variables were completed, followed by logistic regression analyses to examine the contribution of specific cognitive processes on falls for the sample and then by group after controlling for demographic and mobility-related variables.

RESULTS: Significant differences existed between groups in demographic, cognitive, and mobility variables and falls. Executive function was consistently identified as a predictor of falls in the whole sample (odds ratio [OR] = 1.06; 95\% CI, 1.02-1.09) and within groups: younger group (OR = 1.06; 95\% CI, 1.01-1.11) and older group (OR = 1.07; 95\% CI, 1.01-1.13), while delayed recall was a much stronger predictor of falls in the older group (OR = 1.28; 95\% CI, 1.03-1.59). Orientation and immediate recall were not predictors of falls.

CONCLUSIONS: Executive function and delayed recall, 2 cognitive domains reported to influence glycemic control and disease management in those with T2DM, are associated with an increased fall risk and should be included in the assessment of fall risk in this population.

}, keywords = {Cognitive Ability, Diabetes, Falls}, issn = {2152-0895}, doi = {10.1519/JPT.0000000000000209}, author = {Blackwood, Jennifer} } @article {11685, title = {The Influence of Cognitive Function on Balance, Mobility, and Falls in Older Cancer Survivors}, journal = {Rehabilitation Oncology}, volume = {37}, year = {2019}, pages = {77{\textendash}82}, abstract = {Introduction: Older cancer survivors fall more often, as disease-associated sequelae such as impaired cognitive function contribute to a higher falls risk. Cognitive dysfunction may contribute to falls and mobility; however, this relationship is not well described. The purpose of this study was to examine associations between cognitive function, gait speed, balance, and falls in older cancer survivors. Methods: A cross-sectional analysis of 573 older cancer survivors was conducted from the 2010 Health and Retirement Study wave. Groups were assigned on the basis of falls history: Falls (N = 222) or No Falls (N = 351). Groupwise comparisons on demographic, cognitive, and physical mobility variables were completed. Linear regression analyses were performed to examine associations between cognitive function (recall, orientation, executive function), gait speed, tandem balance, and falls in the sample and by group. Results: Significant between-group differences existed in demographic, cognitive function, falls, and mobility variables. Falls were inversely associated with executive function (β = -0.18, P < .05). Delayed recall was linearly associated with tandem stance in the whole sample (β = 0.11, P < .05). Falls history was able to detect differing relationships between gait speed and each of the cognitive processes (β = 0.11-0.17 for fallers; β = 0.11-0.22 for nonfallers), indicating the underlying influence of cognition on mobility in cancer survivors. Discussion: Different cognitive processes influence falls, balance, and mobility in the older cancer survivor, especially those with a history of falling. Assessments of balance and falls should include screening more than orientation to detect cognitive impairments that impact mobility and falls.}, keywords = {balance, Cancer Survivors, Cognition, Falls, mobility}, doi = {10.1097/01.REO.0000000000000128}, author = {Blackwood, Jennifer} }