Juliana Hotta Ansai

Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial.

To compare the effect of multicomponent and resistance training and detraining on cognition and depressive symptoms in oldest‐old community‐dwelling people.

Effects of two physical exercise protocols on physical performance related to falls in the oldest old: a randomized controlled trial

To compare the effects of 16‐week multicomponent and resistance training, and 6‐week detraining on physical variables related to a higher risk of falls in very old people.

Relationship between balance and dual task walking in the very elderly

To investigate the relationship between balance and dual task performance in adults aged over 80 years, and to analyze possible differences between fallers and non‐fallers in dual task performance.

Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease

Highlights • Dual tasks can be applicable to assess elderly with mild Alzheimers disease.• Patients with preserved cognition and mild cognitive impairment presented with similar mobility.• Specific local and consequences of falls were identified for each cognitive group.

Relationship between dual task walking, cognition, and depression in oldest old people.

BACKGROUND The purpose of the study was to investigate the relationship between dual task walking, cognition, and depression in oldest old people living in the community. METHODS We conducted an observational cross-sectional study at Federal University of São Carlos (Brazil). We assessed 67 community-dwelling older adults aged 80 years and over, who were able to walk alone and did not present with a risk of dementia (assessed by Mini-Mental State Examination, MMSE). The assessment consisted of anamnesis, dual task using the Timed Up and Go test associated with a motor task (TUGT-motor) and a cognitive task (TUGT-cognitive); cognitive measures using MMSE, Montreal Cognitive Assessment (MoCA), Clock Drawing test (CDT) and verbal fluency, and depressive measures by the Geriatric Depression Scale (GDS). RESULTS There was a correlation with higher magnitude between cognitive tests and TUGT-cognitive, compared to TUGT-motor. For TUGT-motor, the highest correlations with cognitive tests were found between time and MMSE, MoCA (total score), and MoCA visuospatial/executive domain. For TUGT-cognitive, the highest correlations with cognitive tests were between number of steps and MMSE and between time and MMSE. GDS showed a significant weak correlation with number of steps taken in TUGT-motor, wrong words, and correct/time of TUGT-cognitive. CONCLUSIONS Dual task performances are associated with cognition in oldest old. Furthermore, dual task tests have less influence of educational level, are functional, fast, and easily applicable in clinical practice. Future studies are needed to confirm if dual task test is useful for cognitive screening in oldest old.

The relationship between dual-task and cognitive performance among elderly participants who exercise regularly.

BACKGROUND: The dual-task performance is associated with the functionality of the elderly and it becomes more complex with age. OBJECTIVE: To investigate the relationship between the Timed Up and Go dual task (TUG-DT) and cognitive tests among elderly participants who exercise regularly. METHOD: This study examined 98 non-institutionalized people over 60 years old who exercised regularly. Participants were assessed using the TUG-DT (i.e. doing the TUG while listing the days of the week in reverse order), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Mini Mental State Examination (MMSE). The motor (i.e. time and number of steps) and cognitive (i.e. number of correct words) data were collected from TUG-DT . We used a significance level of α=0.05 and SPSS 17.0 for all data analyses. RESULTS: This current elderly sample featured a predominance of women (69.4%) who were highly educated (median=10 years of education) compared to Brazilian population and mostly non-fallers (86.7%). The volunteers showed a good performance on the TUG-DT and the other cognitive tests, except the MoCA, with scores below the cutoff of 26 points. Significant and weak correlations were observed between the TUG-DT (time) and the visuo-spatial/executive domain of the MoCA and the MMSE. The cognitive component of the TUG-DT showed strong correlations between the total MoCA performance score and its visuo-spatial/executive domain. CONCLUSIONS: The use of the TUG-DT to assess cognition is promising; however, the use of more challenging cognitive tasks should be considered when the study population has a high level of education.

Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos

Introduction: Fall is a common problem in the elderly and it can reduce their mobility and independence. The use of simple tools to detect risk of falls is essential to prevent and treat such events. However, there is no consensus about the most appropriate tools for each situation. Objective: To review studies about efficacy, sensitivity and specificity of Timed Up and Go Test (TUGT) and Berg Balance Scale (BBS) in order to ascertain which is the most appropriate to predict falls in the elderly. Methods: We performed a literature review from MEDLINE, PubMed, ISI, LILACS and Portal de Periodicos CAPES databases, between 2001 and 2011. Results: We selected 17 different articles about BBS and 20 articles about TUGT. The review showed the two tools can be good predictors of falls. However, the articles differed in definition of fall and faller, type of study, quantity and characteristics of sample and assessment of falls, leading to different results as cutoff scores, sensitivity, specificity and prediction of fall. There is controversy about the ability of tools to predict falls in specific samples, such as active elderly. Conclusion: TUGT and BBS are effective to predict falls, provided they are adapted to each sample. Further studies should be performed using articles with homogeneous methods in order to support comparison of results about the effectiveness of tools.

Association Between Gait and Dual Task With Cognitive Domains in Older People With Cognitive Impairment

ABSTRACT The authors investigated whether impaired gait and dual-task performances are associated with specific cognitive domains among older people with preserved cognition (PC), mild cognitive impairment (MCI), and mild Alzheimers disease (AD). The sample comprised 40 older adults with PC, 40 with MCI, and 38 with mild AD. The assessment consisted of gait (measured by 10-m walk test and Timed Up and Go Test [TUGT]), dual task (measured by TUGT associated with a cognitive-motor task of calling a phone number), and cognition (domains of the Addenbrooke Cognitive Examination–Revised and Frontal Assessment Battery [FAB]). For data analysis, the Pearson product-moment correlation and the backward stepwise linear regression were conducted. Language, fluency, and visuospatial domains predicted the 10-m walk test measure specifically in PC, MCI, and AD groups. Only the visuospatial domain was independently associated with the TUGT measure in the MCI and AD groups. FAB score, language domain, and FAB score and fluency domain were the strongest predictors for the isolated cognitive-motor task measure in the PC, MCI, and AD groups, respectively. The visuospatial domain was independently associated with the dual-task test measure in all 3 groups. The study findings demonstrate the influence of specific cognitive domains in daily mobility tasks in people with different cognitive profiles.

Effects of the Addition of a Dual Task to a Supervised Physical Exercise Program on Older Adults' Cognitive Performance

The purpose of this study was to investigate the effects of the addition of a dual task to multicomponent training on cognition of active older adults. Eighty physically active older adults were divided into an intervention group (IG) and a control group (CG). Both groups performed multicomponent training over 12 weeks. The IG simultaneously performed exercises and cognitive tasks. The Mini-Mental State Examination, the Montreal Cognitive Assessment, and the Clock Drawing Test were used for cognitive assessments. The Timed Up and Go Test associated with a cognitive task was used for dual-task assessment. Significant interactions were not observed between groups in terms of the cognitive variables or the dual-task performance. An interaction was observed only for Timed Up and Go Test performance, which was better in the CG than in the IG. Active older adults showed no improvement in cognition following the addition of the dual task to the multicomponent training.

RELATIONSHIP BETWEEN COGNITIVE DISORDER AND METABOLIC SYNDROME IN ELDERS IN A BRAZILIAN COMMUNITY

Renata Bezerra Ara ujo, Daniela Dalpubel, Estela B. Ribeiro, Mariana Luciano Almeida, Francisco Assis Carvalho Vale, Juliana H. Ansai, Federal University of S~ao Carlos, S~ao Carlos, SP, Brazil; Federal University of S~ao Carlos, S~ao Carlos, Brazil; University of S~ao Paulo, Ribeir~ao Preto, Brazil; Federal University of S~ao Carlos (UFSCar) Universidade Federal de S~ao Carlos, S~ao Carlos, Brazil. Contact e-mail: renata_bza@hotmail.com