- Email: [email protected]
Wireless fNIRS for neuroimaging during dual task walking and obstacle negotiation in the elderly: Feasible, reliable and valid?
S54
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
P070
Wireless fNIRS for neuroimaging during dual task walking and obstacle negotiation in the elderly: Feasible, reliable and valid? F. Nieuwhof a,∗ , M. Reelick a , M. Olde Rikkert b , A. Mirelman c , J. Hausdorff c , J. Claassen b a Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands b Geriatric Medicine/Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands c Laboratory For Gait Analysis And Neurodynamics, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel Text.– Many older adults experience difficulties walking, negotiating obstacles, and combining walking with a second task. These difficulties increase fall risk. In walking and especially in dual task situations, executive cognitive functions are important. Since these functions mostly rely on frontal lobe regions, attention should be paid to these regions in gait analysis and training. Functional Near Infrared Spectroscopy (fNIRS) is a method to quantify frontal lobe blood oxygenation levels, and thereby frontal activation. This pilot study aims to investigate the feasibility and validity of a wireless fNIRS device to detect frontal lobe activation during performance of gait tasks that include obstacle negotiation and dual tasking. Frontal lobe oxygenation will be measured bilaterally in twenty healthy older adults during several task conditions: rest; rest + performing a cognitive task; overground walking; treadmill walking; overground/treadmill walking + performing a cognitive task; overground walking + obstacle-negotiation. Task lengths will be one minute, repeated five times, with two minutes of rest between tasks. Task sequence will be randomized across subjects. The main outcome measures are change in levels of oxygenated, deoxygenated and total hemoglobin (Hb) during task performance. For each task, the maximum level of oxygenated Hb per trial and the time-locked fNIRS signal will be averaged over the five trials to determine both the degree of activation and the temporal pattern of activation. Additionally, blood pressure will continuously be monitored and user satisfaction will be assessed. Data will be collected from May to July 2012. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.071 P071
Orthostatic hypotension in geriatric inpatients: Prevalence, symptoms and indicators O. Vanden Bossche a , A. Verweylen a , B. Boland b,∗ , P. Cordier a Physical Medicine, Saint-Luc university Hospital, Bruxelles, Belgium b Geriatric Medicine, Saint-Luc university Hospital, Bruxelles, Belgium
falls as reason for admission (48 vs. 30%), use of antihypertensive drug (70 vs. 82%), cognitive impairment (55 vs. 57%), diabetes mellitus (27 vs. 22%), malnutrition (27 vs. 21%) or dehydration (27 vs. 18%). Conclusions. Both the prevalence of OH in patients admitted to the geriatric unit and the limited accuracy of symptoms (sensitivity 62%, specificity 75%) make its screening important in this setting. A physiotherapist may perform it during the first days of hospital stay. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.072 P072
Prevalence of falls in a memory clinic unit and related factors
L. Vargas ∗ , N. Tantinyà Unitat De Diagnòstic De Trastorns Cognitius I De La Conducta, Fundacio ACE, Barcelona, Spain
Introduction.– The relationship between the risk of falls and patients with cognitive impairment is well-known, especially in the residential and outpatient environment. Despite this, is always the problem of underreporting in the case of patients in the community. The objective of this study is to determine the prevalence of falls in a Dementia Day Care Center and its specific characteristics. Text.– The prevalence of falls in the Center between 2006 to 2011 is 204 falls within 729 users. The subjects falling were 124, but only 83 had assessable clinical data. Of them, 58 had a single fall and 25 within two to 11 falls, whereas regular fallers. The diagnosis of these patients are Dementia Alzheimer type (AD): 44 (53%), mixed or vascular dementia (MD): 17 (20.5%), other dementias: 15 (18.1%), and mild cognitive impairment: seven (8.4%). Conducting a study more detailed compared to the falls, is that patients with a single fall, 60.34% had AD and of the usual fallers 58.8% among patients with MD. A non-parametric test was carried out to confirmed statistical significance. We performed a bivariate analysis not found significant differences between the values of the MMSE, Global Deterioration Scale (GDS) and the Clinical Dementia Rating (CDR) and the number of falls. It was concluded that the prevalence of falls in the unit is 27.98%, with regard to the related diagnoses, it is important to note the relationship between the recurrences to fall with mixed or vascular dementias, which could have correlation with other factors besides the loss of memory. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.073
a
Introduction.– Orthostatic hypotension (OH) is an important cause of fall in older people. This study aimed at describing prevalence, symptoms and indicators of HO in frail older persons. Methods.– Screening of OH (defined as a decrease of at least 20/10 mmHg in systolic/diastolic blood pressure after 1 and 3 minutes in supine position) was prospectively performed by a physiotherapist during the first two days of hospital stay in older patients (≥ 75 years) admitted in our geriatric unit (08.2011–02.2012). Presence of symptoms (leg weakness, fatigue, lipothymia, dizziness, chest discomfort) was collected during this screening. Results.– Among 89 patients (85 ± 5 years, 60% female), 29 presented HO (prevalence 33%). In patients with OH, presence of symptom(s) was more frequent than in those without OH (62 vs. 25%, P = 0.002; ORatio 4.9 [95%CI: 1.9–12.7]). A history of fall during the last year was more frequent in patients with OH than in those without OH (86 vs. 60%, P = 0.02; OR 4.2 [1.3–13.5]). No other statistically significant difference was observed in terms of age, gender,
P073
Virtual reality interventions to improve balance in adults with impaired balance: A systematic review V. Booth a,∗ , T. Masud b , F. Bath-Hextall c Physiotherapy Department, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom b Healthcare Of Older People, Nottingham University Hospitals, Nottingham, United Kingdom c School Of Nursing, Midwifery And Physiotherapy, University of Nottingham, Nottingham, United Kingdom
a
Introduction.– In older people poor balance is a major risk factor for falls. Virtual reality is a developing intervention in the treatment of balance disorders. This systematic review evaluated the current available evidence on whether virtual reality interventions, including interactive gaming systems, can improve balance outcomes in adults with impaired balance. Methods.– Electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, PyschINFO, PyschBITE, OTseeker, Ei Compendex, Inspec, controlled trials register) were searched until November
8th Congress of the EUGMS / European Geriatric Medicine 3S (2012) S33–S143
P070
Wireless fNIRS for neuroimaging during dual task walking and obstacle negotiation in the elderly: Feasible, reliable and valid? F. Nieuwhof a,∗ , M. Reelick a , M. Olde Rikkert b , A. Mirelman c , J. Hausdorff c , J. Claassen b a Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands b Geriatric Medicine/Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands c Laboratory For Gait Analysis And Neurodynamics, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel Text.– Many older adults experience difficulties walking, negotiating obstacles, and combining walking with a second task. These difficulties increase fall risk. In walking and especially in dual task situations, executive cognitive functions are important. Since these functions mostly rely on frontal lobe regions, attention should be paid to these regions in gait analysis and training. Functional Near Infrared Spectroscopy (fNIRS) is a method to quantify frontal lobe blood oxygenation levels, and thereby frontal activation. This pilot study aims to investigate the feasibility and validity of a wireless fNIRS device to detect frontal lobe activation during performance of gait tasks that include obstacle negotiation and dual tasking. Frontal lobe oxygenation will be measured bilaterally in twenty healthy older adults during several task conditions: rest; rest + performing a cognitive task; overground walking; treadmill walking; overground/treadmill walking + performing a cognitive task; overground walking + obstacle-negotiation. Task lengths will be one minute, repeated five times, with two minutes of rest between tasks. Task sequence will be randomized across subjects. The main outcome measures are change in levels of oxygenated, deoxygenated and total hemoglobin (Hb) during task performance. For each task, the maximum level of oxygenated Hb per trial and the time-locked fNIRS signal will be averaged over the five trials to determine both the degree of activation and the temporal pattern of activation. Additionally, blood pressure will continuously be monitored and user satisfaction will be assessed. Data will be collected from May to July 2012. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.071 P071
Orthostatic hypotension in geriatric inpatients: Prevalence, symptoms and indicators O. Vanden Bossche a , A. Verweylen a , B. Boland b,∗ , P. Cordier a Physical Medicine, Saint-Luc university Hospital, Bruxelles, Belgium b Geriatric Medicine, Saint-Luc university Hospital, Bruxelles, Belgium
falls as reason for admission (48 vs. 30%), use of antihypertensive drug (70 vs. 82%), cognitive impairment (55 vs. 57%), diabetes mellitus (27 vs. 22%), malnutrition (27 vs. 21%) or dehydration (27 vs. 18%). Conclusions. Both the prevalence of OH in patients admitted to the geriatric unit and the limited accuracy of symptoms (sensitivity 62%, specificity 75%) make its screening important in this setting. A physiotherapist may perform it during the first days of hospital stay. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.072 P072
Prevalence of falls in a memory clinic unit and related factors
L. Vargas ∗ , N. Tantinyà Unitat De Diagnòstic De Trastorns Cognitius I De La Conducta, Fundacio ACE, Barcelona, Spain
Introduction.– The relationship between the risk of falls and patients with cognitive impairment is well-known, especially in the residential and outpatient environment. Despite this, is always the problem of underreporting in the case of patients in the community. The objective of this study is to determine the prevalence of falls in a Dementia Day Care Center and its specific characteristics. Text.– The prevalence of falls in the Center between 2006 to 2011 is 204 falls within 729 users. The subjects falling were 124, but only 83 had assessable clinical data. Of them, 58 had a single fall and 25 within two to 11 falls, whereas regular fallers. The diagnosis of these patients are Dementia Alzheimer type (AD): 44 (53%), mixed or vascular dementia (MD): 17 (20.5%), other dementias: 15 (18.1%), and mild cognitive impairment: seven (8.4%). Conducting a study more detailed compared to the falls, is that patients with a single fall, 60.34% had AD and of the usual fallers 58.8% among patients with MD. A non-parametric test was carried out to confirmed statistical significance. We performed a bivariate analysis not found significant differences between the values of the MMSE, Global Deterioration Scale (GDS) and the Clinical Dementia Rating (CDR) and the number of falls. It was concluded that the prevalence of falls in the unit is 27.98%, with regard to the related diagnoses, it is important to note the relationship between the recurrences to fall with mixed or vascular dementias, which could have correlation with other factors besides the loss of memory. Disclosure.– No significant relationships. http://dx.doi.org/10.1016/j.eurger.2012.07.073
a
Introduction.– Orthostatic hypotension (OH) is an important cause of fall in older people. This study aimed at describing prevalence, symptoms and indicators of HO in frail older persons. Methods.– Screening of OH (defined as a decrease of at least 20/10 mmHg in systolic/diastolic blood pressure after 1 and 3 minutes in supine position) was prospectively performed by a physiotherapist during the first two days of hospital stay in older patients (≥ 75 years) admitted in our geriatric unit (08.2011–02.2012). Presence of symptoms (leg weakness, fatigue, lipothymia, dizziness, chest discomfort) was collected during this screening. Results.– Among 89 patients (85 ± 5 years, 60% female), 29 presented HO (prevalence 33%). In patients with OH, presence of symptom(s) was more frequent than in those without OH (62 vs. 25%, P = 0.002; ORatio 4.9 [95%CI: 1.9–12.7]). A history of fall during the last year was more frequent in patients with OH than in those without OH (86 vs. 60%, P = 0.02; OR 4.2 [1.3–13.5]). No other statistically significant difference was observed in terms of age, gender,
P073
Virtual reality interventions to improve balance in adults with impaired balance: A systematic review V. Booth a,∗ , T. Masud b , F. Bath-Hextall c Physiotherapy Department, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom b Healthcare Of Older People, Nottingham University Hospitals, Nottingham, United Kingdom c School Of Nursing, Midwifery And Physiotherapy, University of Nottingham, Nottingham, United Kingdom
a
Introduction.– In older people poor balance is a major risk factor for falls. Virtual reality is a developing intervention in the treatment of balance disorders. This systematic review evaluated the current available evidence on whether virtual reality interventions, including interactive gaming systems, can improve balance outcomes in adults with impaired balance. Methods.– Electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, PyschINFO, PyschBITE, OTseeker, Ei Compendex, Inspec, controlled trials register) were searched until November