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Auteur Kim Delbaere
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The Impact of Peripheral Neuropathy and Cognitive Decrements on Gait in Older Adults With Type 2 Diabetes Mellitus / Tine Roman de Mettelinge in Archives of Physical Medicine and Rehabilitation, 2013/6 (2013)
Titre : The Impact of Peripheral Neuropathy and Cognitive Decrements on Gait in Older Adults With Type 2 Diabetes Mellitus Type de document : Article Auteurs : Tine Roman de Mettelinge ; Kim Delbaere ; Patrick Calders ; [et al.] Article en page(s) : pp. 1074-1079 Langues : Anglais (eng) Descripteurs : HE Vinci
Cognition ; Gériatrie ; Rééducation et réadaptation
Mots-clés : Gait Démarche Geriatrics Sensation Résumé : Objective
To investigate the effect of peripheral neuropathy and cognition on gait performance in older adults with type 2 diabetes mellitus.
Community and residential aged care setting.
Older adults (N=101; 56 patients with diabetes, 28 with peripheral neuropathy and 28 without peripheral neuropathy; and 45 matched controls).
Main Outcome Measures
Spatiotemporal gait parameters were recorded under 3 conditions: simple, counting backward by 3 from 40, and reciting animal names. The Mini-Mental State Examination and the clock drawing test were used to estimate cognitive impairment levels.
Compared with controls, older adults with diabetes walked slower, took shorter strides during all walking conditions, and showed more gait variability especially during dual-task conditions. Gait patterns did not differ between participants suffering from diabetes mellitus with and without neuropathy. Compared with normal walking, dual-task conditions affected all gait parameters similarly in all groups. Backward counting affected gait more than animal naming in participants with diabetes but not in healthy controls. Additional analyses in older adults with diabetes showed that participants with impaired cognitive function walked slower, took shorter strides, had shorter double support time, and increased gait variability compared with participants with intact cognitive function.
This study showed that gait parameters are affected in older adults with type 2 diabetes. Gait was further affected by reduced cognitive function, irrespective of the presence of neuropathy.
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in Archives of Physical Medicine and Rehabilitation > 2013/6 (2013) . - pp. 1074-1079[article]Sensorimotor, Cognitive, and Affective Functions Contribute to the Prediction of Falls in Old Age and Neurologic Disorders: An Observational Study / Kimberley S. van Schooten in Archives of Physical Medicine and Rehabilitation, Vol. 102, n° 5 (2021)
Titre : Sensorimotor, Cognitive, and Affective Functions Contribute to the Prediction of Falls in Old Age and Neurologic Disorders: An Observational Study Type de document : Article Auteurs : Kimberley S. van Schooten ; Morag E. Taylor ; Jacqueline C.T. Close ; Jennifer C. Davis ; Serena S. Paul ; Colleen Canning ; Mark D. Latt ; Phu Hoang ; Nicole A. Kochan ; Perminder S. Sachdev ; Henry Brodaty ; Catherine M. Dean ; Femke Hulzinga ; Stephen R. Lord ; Kim Delbaere Année de publication : 2021 Article en page(s) : p. 874-880 Note générale : https://doi.org/10.1016/j.apmr.2020.10.134 Langues : Anglais (eng) Descripteurs : HE Vinci
Chutes accidentelles ; Cognition ; Cortex sensorimoteur ; Dépression ; Réadaptation
Résumé : Objective
To determine whether impairments across cognitive and affective domains provide additional information to sensorimotor deficits for fall prediction among various populations.
We pooled data from 5 studies for this observational analysis of prospective falls.
Community or low-level care facility.
Older people (N=1090; 74.0±9.4y; 579 female); 500 neurologically intact (NI) older people and 3 groups with neurologic disorders (cognitive impairment, n=174; multiple sclerosis (MS), n=111; Parkinson disease, n=305).
Main Outcome Measures
Sensorimotor function was assessed with the Physiological Profile Assessment, cognitive function with tests of executive function, affect with questionnaires of depression, and concern about falling with falls efficacy questionnaires.
These variables were associated with fall incidence rates, obtained prospectively over 6-12 months.
Poorer sensorimotor function was associated with falls (incidence rate ratio [95% CI], 1.46 [1.28-1.66]). Impaired executive function was the strongest predictor of falls overall (2.91 [2.27-3.73]), followed by depressive symptoms (2.07 [1.56-2.75]) and concern about falling (2.02 [1.61-2.55]). Associations were similar among groups, except for a weaker relationship with executive impairment in NI persons and a stronger relationship with concern about falling in persons with MS. Multivariable analyses showed that executive impairment, poorer sensorimotor performance, depressive symptoms, and concern about falling were independently associated with falls.
Deficits in cognition (executive function) and affect (depressive symptoms) and concern about falling are as important as sensorimotor function for fall prediction. These domains should be included in fall risk assessments for older people and clinical groups.
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in Archives of Physical Medicine and Rehabilitation > Vol. 102, n° 5 (2021) . - p. 874-880[article]