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P2.019 Subtle neurological abnormalities as risk factors for geriatric syndromes: a longitudinal population-based study
S48
Poster Session II
Results: The DTD-A (mean decrements <1%) and DTD-V (mean changes <1%) were small, but significant (p < 0.009) for all DT’s. For each DT’s, cognitive function measures were not different in subjects with low vs. high DTD-A, but subjects with a low DTD-V had higher (better) EF (p < 0.009). Subjects with a low DTD-V had higher DGI scores, compared to those with a high DTD-V (p < 0.01), but these scores were not related to the DTD-A. Conclusions: Among relatively healthy older adults, the mediators of the DT effect on swing time and swing time variability are different. To meet the everyday challenges of DT, a consistent step-to-step gait pattern apparently depends on intact gait, balance and EF.
P2.017 Age-related changes in postural responses to platform translation F. Hlavacka° , D. Abrahamova Bratislava, Slovakia Postural responses to support surface motion represent some indications related to possible balance impairment. The aim of the study was to investigate age-related changes in the postural responses to platform translation with 3 different velocities and accelerations. Ten healthy young (20−28 years) and 11 healthy senior (65−76 years) subjects were studied. Subjects stood on force platform with their eyes closed. The 8-second trials 20 cm backward platform translations with velocities 10, 15, 20 cm/s repeated 4 times each. The changes in trunk and head orientation in sagittal plane were recorded by accelerometric inclinometers. The EMG activity of gastrocnemius (GAS), tibialis anterior (TA) and centre of foot pressure (CoP) were recorded. The results showed that maximal values of CoP responses to platform translation were increased in seniors, but their return to initial CoP position were faster. The seniors showed a 100 ms delay of scaling in the CoP responses to the velocity of platform translation. The maximal values of trunk and head inclinations to different velocities of platform translation were also increased in seniors with faster return period to initial position. The EMG activity of GAS muscle to backward platform translation was about similar shape for seniors and juniors, but GAS integrated EMG activity was increased in seniors. Significant difference was found as to coactivation of TA and GAS muscles in seniors. It is likely that seniors increased stiffening ankle joints in order to help with balance control. Supported by European FP6 project SENSACTION-AAL and Slovak grant agency VEGA 2/4070/27.
span (r = −0.18; p = 0.003) and verbal fluency (r = −0.21; p = 0.001), while the BBT and DGI were not (p > 0.18). Conclusions: The TUG appears to be an especially appropriate tool for clinical assessment of functional mobility. In healthy older adults, it does not suffer from ceiling effects, is normally distributed, and is related to executive function, while the BBT and DGI do not. The transferring and turning components of the TUG may help convert this relatively simple motor task into a more complex measure of mobility that also depends on cognitive resources.
P2.019 Subtle neurological abnormalities as risk factors for geriatric syndromes: a longitudinal population-based study M. Inzitari1° , C. Pozzi1 , L. Ferrucci2 , D. Chiarantini1 , L.A. Rinaldi1 , M. Baccini13 , R. Pini1 , G. Masotti1 , N. Marchionni1 , M. Di Bari1 1 Florence, Italy; 2 Baltimore, MD, USA Background and Aims: In elders without overt neurological diseases, subtle, but clinically detectable, neurological abnormalities (SNA) proved to be associated with impaired physical performance. In this prospective cohort study, we examined whether SNA predicted cognitive and functional status, death and cerebrovascular events (CVE) in unselected older persons. Methods: In participants without history of stroke, parkinsonism and dementia or cognitive impairment, a score (NSNA) was obtained by summing SNA detected on clinical exam. Cognitive status and disability were re-assessed 4 years later, and deaths and CVE were documented over 8 years. Results: Of 506 participants free of neurological diseases (age 71.9±0.3, mean±SEM; 42% men), 59% had a NSNA of 1 or more (mean±SEM: 1.1±0.06, range 0−8). At baseline, NSNA increased with age and with declining cognitive and physical performance, depressive symptoms and disability, also after adjusting for several covariates. Prospectively, NSNA predicted worsening cognitive status and disability, adjusting for demographics and for baseline comorbidity, cognitive and physical performance. Mortality rate was 22.6, 23.3, 23.9, 58.6, and 91.9 per 1,000 person-years in participants with an NSNA of 0, 1, 2, 3 and 4+, respectively. Compared with an NSNA of <3, having an NSNA of 3+ was associated with an increased adjusted risk of death (HR 1.77, 95% CI 1.25−2.74) and of CVE (HR 1.94, 95% CI 1.07−3.54) over 8 years. Conclusions: In this sample of older community-dwellers without overt neurological diseases, SNA were associated with cognitive and functional decline and independently predicted mortality and CVE.
P2.018 The Timed Up and Go test: more than meets the eye N. Inbar-Borovsky1° , T. Herman1 , M. Brozgol1 , L. Mariasin1 , N. Giladi1 , J.M. Hausdorff1,2 1 Tel-Aviv, Israel; 2 Boston, MA, USA Background: Several clinical tools have been developed to assess gait, balance and fall risk including the Berg Balance Test (BBT), the Dynamic Gait Index (DGI) and the Timed Up and Go (TUG). While these all measure mobility, each has a unique focus. We speculated that their psychometric properties may be different and tested whether cognitive function may explain disparities. Methods: BBT, DGI and TUG were assessed in 266 older adults (76.4±4.3 yrs; 58.3% women) who were free from neurodegenerative disease, dementia, and pathologies likely to affect gait or cognitive function. The Mini-Mental State Exam (MMSE), backwards digit span, and verbal fluency measured cognitive function. The One-Sample KolmogorovSmirnov Test evaluated deviations from a normal distribution and Pearson’s correlation coefficients quantified associations. Results: The BBT, the DGI, and the TUG scores all indicated good mobility (54.0±2.4; 22.8±1.5; 9.5±1.7 s, respectively). The BBT and DGI were not normally disturbed (p < 0.001), but the TUG was (p = 0.713). TUG times were negatively correlated with MMSE (r = −0.18; p = 0.003), digit
P2.020 Benefit of a music exercise program incorporating elocution with abdominal respiration in the elderly living in the community K. Kawahara° , E. Saito, S. Matsushita, J. Shimizu, C. Ishida, R. Takahara, K. Hayano, C. Chuhyang, K. Murata, M. Kinoshita Tokyo, Japan Background and Aims: The elderly living on their own can not relate tripping while walking, distorted posture, and frequent choking while swallowing to swallowing dysfunction and the risk for aspiration. Coordination with respiration is important in swallowing, and respiration is closely related to posture. We established a music exercise program incorporating elocution with abdominal respiration. In this study, the benefit was evaluated three weeks later. Methods: The elderly people followed the program incorporating elocution with abdominal respiration and the data before and after the program were compared. And we used an evaluation system to evaluate voices with an osseous conduction microphone that we developed. Results: The subjects comprised 15 elderly people, 5 in their 60s, 7 in their 70s, 2 in their 80s, and 1 in their 90s. As past history, 1 had asthma, 5 had hypertension, and 3 had lumbago. The swallowing function
Poster Session II
Results: The DTD-A (mean decrements <1%) and DTD-V (mean changes <1%) were small, but significant (p < 0.009) for all DT’s. For each DT’s, cognitive function measures were not different in subjects with low vs. high DTD-A, but subjects with a low DTD-V had higher (better) EF (p < 0.009). Subjects with a low DTD-V had higher DGI scores, compared to those with a high DTD-V (p < 0.01), but these scores were not related to the DTD-A. Conclusions: Among relatively healthy older adults, the mediators of the DT effect on swing time and swing time variability are different. To meet the everyday challenges of DT, a consistent step-to-step gait pattern apparently depends on intact gait, balance and EF.
P2.017 Age-related changes in postural responses to platform translation F. Hlavacka° , D. Abrahamova Bratislava, Slovakia Postural responses to support surface motion represent some indications related to possible balance impairment. The aim of the study was to investigate age-related changes in the postural responses to platform translation with 3 different velocities and accelerations. Ten healthy young (20−28 years) and 11 healthy senior (65−76 years) subjects were studied. Subjects stood on force platform with their eyes closed. The 8-second trials 20 cm backward platform translations with velocities 10, 15, 20 cm/s repeated 4 times each. The changes in trunk and head orientation in sagittal plane were recorded by accelerometric inclinometers. The EMG activity of gastrocnemius (GAS), tibialis anterior (TA) and centre of foot pressure (CoP) were recorded. The results showed that maximal values of CoP responses to platform translation were increased in seniors, but their return to initial CoP position were faster. The seniors showed a 100 ms delay of scaling in the CoP responses to the velocity of platform translation. The maximal values of trunk and head inclinations to different velocities of platform translation were also increased in seniors with faster return period to initial position. The EMG activity of GAS muscle to backward platform translation was about similar shape for seniors and juniors, but GAS integrated EMG activity was increased in seniors. Significant difference was found as to coactivation of TA and GAS muscles in seniors. It is likely that seniors increased stiffening ankle joints in order to help with balance control. Supported by European FP6 project SENSACTION-AAL and Slovak grant agency VEGA 2/4070/27.
span (r = −0.18; p = 0.003) and verbal fluency (r = −0.21; p = 0.001), while the BBT and DGI were not (p > 0.18). Conclusions: The TUG appears to be an especially appropriate tool for clinical assessment of functional mobility. In healthy older adults, it does not suffer from ceiling effects, is normally distributed, and is related to executive function, while the BBT and DGI do not. The transferring and turning components of the TUG may help convert this relatively simple motor task into a more complex measure of mobility that also depends on cognitive resources.
P2.019 Subtle neurological abnormalities as risk factors for geriatric syndromes: a longitudinal population-based study M. Inzitari1° , C. Pozzi1 , L. Ferrucci2 , D. Chiarantini1 , L.A. Rinaldi1 , M. Baccini13 , R. Pini1 , G. Masotti1 , N. Marchionni1 , M. Di Bari1 1 Florence, Italy; 2 Baltimore, MD, USA Background and Aims: In elders without overt neurological diseases, subtle, but clinically detectable, neurological abnormalities (SNA) proved to be associated with impaired physical performance. In this prospective cohort study, we examined whether SNA predicted cognitive and functional status, death and cerebrovascular events (CVE) in unselected older persons. Methods: In participants without history of stroke, parkinsonism and dementia or cognitive impairment, a score (NSNA) was obtained by summing SNA detected on clinical exam. Cognitive status and disability were re-assessed 4 years later, and deaths and CVE were documented over 8 years. Results: Of 506 participants free of neurological diseases (age 71.9±0.3, mean±SEM; 42% men), 59% had a NSNA of 1 or more (mean±SEM: 1.1±0.06, range 0−8). At baseline, NSNA increased with age and with declining cognitive and physical performance, depressive symptoms and disability, also after adjusting for several covariates. Prospectively, NSNA predicted worsening cognitive status and disability, adjusting for demographics and for baseline comorbidity, cognitive and physical performance. Mortality rate was 22.6, 23.3, 23.9, 58.6, and 91.9 per 1,000 person-years in participants with an NSNA of 0, 1, 2, 3 and 4+, respectively. Compared with an NSNA of <3, having an NSNA of 3+ was associated with an increased adjusted risk of death (HR 1.77, 95% CI 1.25−2.74) and of CVE (HR 1.94, 95% CI 1.07−3.54) over 8 years. Conclusions: In this sample of older community-dwellers without overt neurological diseases, SNA were associated with cognitive and functional decline and independently predicted mortality and CVE.
P2.018 The Timed Up and Go test: more than meets the eye N. Inbar-Borovsky1° , T. Herman1 , M. Brozgol1 , L. Mariasin1 , N. Giladi1 , J.M. Hausdorff1,2 1 Tel-Aviv, Israel; 2 Boston, MA, USA Background: Several clinical tools have been developed to assess gait, balance and fall risk including the Berg Balance Test (BBT), the Dynamic Gait Index (DGI) and the Timed Up and Go (TUG). While these all measure mobility, each has a unique focus. We speculated that their psychometric properties may be different and tested whether cognitive function may explain disparities. Methods: BBT, DGI and TUG were assessed in 266 older adults (76.4±4.3 yrs; 58.3% women) who were free from neurodegenerative disease, dementia, and pathologies likely to affect gait or cognitive function. The Mini-Mental State Exam (MMSE), backwards digit span, and verbal fluency measured cognitive function. The One-Sample KolmogorovSmirnov Test evaluated deviations from a normal distribution and Pearson’s correlation coefficients quantified associations. Results: The BBT, the DGI, and the TUG scores all indicated good mobility (54.0±2.4; 22.8±1.5; 9.5±1.7 s, respectively). The BBT and DGI were not normally disturbed (p < 0.001), but the TUG was (p = 0.713). TUG times were negatively correlated with MMSE (r = −0.18; p = 0.003), digit
P2.020 Benefit of a music exercise program incorporating elocution with abdominal respiration in the elderly living in the community K. Kawahara° , E. Saito, S. Matsushita, J. Shimizu, C. Ishida, R. Takahara, K. Hayano, C. Chuhyang, K. Murata, M. Kinoshita Tokyo, Japan Background and Aims: The elderly living on their own can not relate tripping while walking, distorted posture, and frequent choking while swallowing to swallowing dysfunction and the risk for aspiration. Coordination with respiration is important in swallowing, and respiration is closely related to posture. We established a music exercise program incorporating elocution with abdominal respiration. In this study, the benefit was evaluated three weeks later. Methods: The elderly people followed the program incorporating elocution with abdominal respiration and the data before and after the program were compared. And we used an evaluation system to evaluate voices with an osseous conduction microphone that we developed. Results: The subjects comprised 15 elderly people, 5 in their 60s, 7 in their 70s, 2 in their 80s, and 1 in their 90s. As past history, 1 had asthma, 5 had hypertension, and 3 had lumbago. The swallowing function