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P2.023 Postural stability in the elderly: a comparison between fallers and non fallers
Ageing index was 11.1 on average. And one had a history of falling down, who had experienced falling down twice in the last three months. There was a significant difference between before and after training in vital capacity and MEP and MIP (p < 0.05). In the osseous conduction-based voice evaluation system, it was confirmed that acquisition of abdominal respiration remarkably changed frequencies and pressure levels of multiple sounds. Conclusion: Since the elderly themselves can visually confirm the effect of training, it is possible to continue the training in daily life. Health care service providers can apply it as an effective program to prevent aspiration in the elderly.
P2.021 Spatial working memory in normal aging and mild cognitive impairment (MCI) Kessels° ,
O. Meulenbroek, G. Fernandez, M.G.M. Olde Rikkert R.P.C. Nijmegen, The Netherlands Background and Aims: Spatial working memory is crucial in maintaining goal-oriented gait in older age. Working memory capacity decreases substantially with age, but may be relatively intact in MCI and early Alzheimer’s disease (AD). However, short-term maintenance of spatial information has been shown to depend on hippocampal function, which is clearly impaired in MCI. We examined spatial working memory in healthy young (N = 25) and older adults (N = 25) and amnestic MCI patients (N = 12). Methods: The Box Task was used, in which participants had to search for hidden every-day objects in a set of 4, 6, 8 and 10 boxes presented on a touch-sensitive screen. Within-search errors occurred if the participant returned to a previously opened empty box within one search. Betweensearch errors occurred if the participant returned to a box that already contained a previously found object. Results: As expected, error rate increased with an increasing memory load in all groups (p < 0.0005), with more between-search errors being made than within-search errors. The younger adults outperformed the older and MCI groups, showing a significant Memory Load x Group interaction (p < 0.0005). Interestingly, the performance of the MCI patients and the older adults on both error measures did not significantly differ. Conclusions: Although spatial working memory capacity decreases with advancing age, it is not additionally impaired in MCI patients. Probably, MCI patients are able to compensate for mild hippocampal dysfunction. Effects of early AD and MCI on gait probably are not explained by decline in spatial working memory.
P2.022 Residual attentional capacity amongst young and elderly during dual and triple task walking U. Laessoe1,2° , H.C. Hoeck1 , O. Simonsen2 , M. Voigt1 Jutland, Denmark
1 Aalborg, 2 North
Background: Walking is considered an automatic function which demands little attention. Minor deficits in postural control during walking can minimize the residual attentional capacity. This may, however, not be revealed in a simple examination of the gait performance. The aim of this study was therefore to investigate the use of more challenging dual task combinations in order to detect age-related changes in gait performance. Methods: Eleven community-dwelling elderly and 13 young subjects participated in the study. The participants walked along a figure-of-eight track at a self-selected speed. The effect of introducing a concurrent cognitive task during walking with and without a concurrent functional motor task was evaluated. Stride-to-stride variability was measured by heel contacts and trunk-accelerometry. Results: In response to the cognitive task the elderly increased their temporal stride-to-stride variability by 39% in the walking task and by 57% in the combined motor task. These increases were significantly larger
S49
than observed for the young. Equivalent decreases in trunk acceleration autocorrelation coefficients and gait speed were found.
Temporal stride-to-stride variance coefficient. Conclusions: A combination of sufficiently challenging motor tasks and concurrent cognitive tasks can reveal signs of limited residual attentional capacity during walking amongst the elderly.
P2.023 Postural stability in the elderly: a comparison between fallers and non fallers M. Lazaro del Nogal, A. Gonzalez Ramirez° , G. La Torre Gonzalez, C. Fernandez Perez, J.M. Ribera Casado Madrid, Spain Background and Aims: A poor postural stability in older people is associated with an increased risk of falling. Detecting disturbances that affect both posture and gait is a main concern in common assessment of fallers. Our study investigated the utility of instrumental evaluation by use of Neurocom Balance Master in the global assessment of elderly people with gait problems and risk of falling. Methods: Case–control study concerning 226 subjects older than 65 years (2 groups of 113 subjects each according the existence [A] or no [B] to falling incidents during the last 6 months). Balance Master Tests: Modified Clinical Test for the Sensory Interaction on Balance (mCTSIB), Rhythmic Weight Shift (RWS). Statistical analysis SPSS 12.0. Results: mCTSIB mean results [degrees/s]: Firm surface, eyes open: A: 0.4(0.3−0.5); B: 0.4(0.3−0.5) [p = 0.065]; Firm surface, eyes closed: A: 0.5(0.4−0.7); B: 0.4(0.3−0.6) [p = 0.032]; Foam surface, eyes open: A: 1.4(1.0−2.6); B: 0.9(0.7−1.3) [p < 0.001]; Foam surface, eyes closed: A: 3.7(2.0−6.0) B: 2.0(1.3−3.4); [p = 0.001]. RWS: Center of Gravity Velocity (degrees/s): no statistical differences. Directional Control forward– backward slow velocity: A 46(30−60); B 56(46−71) [p = 0.54]; moderate velocity: A: 48(32−62); B: 57(43−74) [p = 0.06]; fast velocity: A: 55(35−69); B: 59(44−68) [p = 0.004] (right–left velocity: no statistical differences). Conclusions: Posturographic evaluation by the mCTSIB (foam surface condition) and RWS (directional control on fast forward-backward movements), appears to be a sensitive tool to identify elderly people at high risk of falls.
P2.024 Mild cognitive impairment increases physiological and cognitive falls risk T. Liu-Ambrose° , M. Ashe, L. Nagamatsu, P. Graf, B.L. Beattie5 , K.M. Khan Vancouver, BC, Canada Background: Falls are a major health care problem for older people and are associated with cognitive dysfunction. Mild cognitive impairment (MCI) is an increasingly recognized clinical problem. No single study has comprehensively compared normal volunteers with those with MCI for well-recognized falls risk factors in both the physiological and cognitive
P2.021 Spatial working memory in normal aging and mild cognitive impairment (MCI) Kessels° ,
O. Meulenbroek, G. Fernandez, M.G.M. Olde Rikkert R.P.C. Nijmegen, The Netherlands Background and Aims: Spatial working memory is crucial in maintaining goal-oriented gait in older age. Working memory capacity decreases substantially with age, but may be relatively intact in MCI and early Alzheimer’s disease (AD). However, short-term maintenance of spatial information has been shown to depend on hippocampal function, which is clearly impaired in MCI. We examined spatial working memory in healthy young (N = 25) and older adults (N = 25) and amnestic MCI patients (N = 12). Methods: The Box Task was used, in which participants had to search for hidden every-day objects in a set of 4, 6, 8 and 10 boxes presented on a touch-sensitive screen. Within-search errors occurred if the participant returned to a previously opened empty box within one search. Betweensearch errors occurred if the participant returned to a box that already contained a previously found object. Results: As expected, error rate increased with an increasing memory load in all groups (p < 0.0005), with more between-search errors being made than within-search errors. The younger adults outperformed the older and MCI groups, showing a significant Memory Load x Group interaction (p < 0.0005). Interestingly, the performance of the MCI patients and the older adults on both error measures did not significantly differ. Conclusions: Although spatial working memory capacity decreases with advancing age, it is not additionally impaired in MCI patients. Probably, MCI patients are able to compensate for mild hippocampal dysfunction. Effects of early AD and MCI on gait probably are not explained by decline in spatial working memory.
P2.022 Residual attentional capacity amongst young and elderly during dual and triple task walking U. Laessoe1,2° , H.C. Hoeck1 , O. Simonsen2 , M. Voigt1 Jutland, Denmark
1 Aalborg, 2 North
Background: Walking is considered an automatic function which demands little attention. Minor deficits in postural control during walking can minimize the residual attentional capacity. This may, however, not be revealed in a simple examination of the gait performance. The aim of this study was therefore to investigate the use of more challenging dual task combinations in order to detect age-related changes in gait performance. Methods: Eleven community-dwelling elderly and 13 young subjects participated in the study. The participants walked along a figure-of-eight track at a self-selected speed. The effect of introducing a concurrent cognitive task during walking with and without a concurrent functional motor task was evaluated. Stride-to-stride variability was measured by heel contacts and trunk-accelerometry. Results: In response to the cognitive task the elderly increased their temporal stride-to-stride variability by 39% in the walking task and by 57% in the combined motor task. These increases were significantly larger
S49
than observed for the young. Equivalent decreases in trunk acceleration autocorrelation coefficients and gait speed were found.
Temporal stride-to-stride variance coefficient. Conclusions: A combination of sufficiently challenging motor tasks and concurrent cognitive tasks can reveal signs of limited residual attentional capacity during walking amongst the elderly.
P2.023 Postural stability in the elderly: a comparison between fallers and non fallers M. Lazaro del Nogal, A. Gonzalez Ramirez° , G. La Torre Gonzalez, C. Fernandez Perez, J.M. Ribera Casado Madrid, Spain Background and Aims: A poor postural stability in older people is associated with an increased risk of falling. Detecting disturbances that affect both posture and gait is a main concern in common assessment of fallers. Our study investigated the utility of instrumental evaluation by use of Neurocom Balance Master in the global assessment of elderly people with gait problems and risk of falling. Methods: Case–control study concerning 226 subjects older than 65 years (2 groups of 113 subjects each according the existence [A] or no [B] to falling incidents during the last 6 months). Balance Master Tests: Modified Clinical Test for the Sensory Interaction on Balance (mCTSIB), Rhythmic Weight Shift (RWS). Statistical analysis SPSS 12.0. Results: mCTSIB mean results [degrees/s]: Firm surface, eyes open: A: 0.4(0.3−0.5); B: 0.4(0.3−0.5) [p = 0.065]; Firm surface, eyes closed: A: 0.5(0.4−0.7); B: 0.4(0.3−0.6) [p = 0.032]; Foam surface, eyes open: A: 1.4(1.0−2.6); B: 0.9(0.7−1.3) [p < 0.001]; Foam surface, eyes closed: A: 3.7(2.0−6.0) B: 2.0(1.3−3.4); [p = 0.001]. RWS: Center of Gravity Velocity (degrees/s): no statistical differences. Directional Control forward– backward slow velocity: A 46(30−60); B 56(46−71) [p = 0.54]; moderate velocity: A: 48(32−62); B: 57(43−74) [p = 0.06]; fast velocity: A: 55(35−69); B: 59(44−68) [p = 0.004] (right–left velocity: no statistical differences). Conclusions: Posturographic evaluation by the mCTSIB (foam surface condition) and RWS (directional control on fast forward-backward movements), appears to be a sensitive tool to identify elderly people at high risk of falls.
P2.024 Mild cognitive impairment increases physiological and cognitive falls risk T. Liu-Ambrose° , M. Ashe, L. Nagamatsu, P. Graf, B.L. Beattie5 , K.M. Khan Vancouver, BC, Canada Background: Falls are a major health care problem for older people and are associated with cognitive dysfunction. Mild cognitive impairment (MCI) is an increasingly recognized clinical problem. No single study has comprehensively compared normal volunteers with those with MCI for well-recognized falls risk factors in both the physiological and cognitive