Functional Mobility and postural balance in older adults with Alzheimer's disease: comparative study between mild and moderate stages

Authors

DOI:

https://doi.org/10.33448/rsd-v11i16.37968

Keywords:

Posture control; Neurodegenerative disorders; Physical Functional Performance; Cognitive impairment.

Abstract

Objective: This study aimed to compare the functional mobility and postural balance of older adults among smild and moderate stages of Alzheimer's disease using the Timed Up and Go test (TUGT) and the Clinical Test of Sensory Interaction and Balance (CTSIB). Methodology: Forty elderly people were divided into two groups according to the mild (CDR1; n = 26) and moderate (CDR2; n = 14) stages of the disease. The Clinical Dementia Rating Scale (CDR) was used for staging the disease, which allows classifying the different degrees of dementia, assessing cognition and behavior. The scale allows classification into CDR 0 (normal or no alteration); 0.5 (questionable or mild cognitive impairment); 1 (mild dementia); 2 (moderate dementia) and 3 (severe dementia). In this study, only subjects classified as CDR 1 or CDR 2 were included. For the assessment of functional mobility, the Timed Up and Go Test (TUGT) was used in the conditions of single task, dual cognitive task and dual motor task, and the Clinical Test of Sensory (CTSIB) to assess postural balance. Data were compared between groups. Results: Performance on the TUGT single task, cognitive dual task, and motor dual task was significantly worse in the CDR2 group compared to the CDR1 group (p < 0.05). The CTSIB was not significantly different between the groups in the four conditions. Conclusion: Functional mobility during tasks involving cognition differs between older adults with mild and moderate dementia, and this commitment is more accentuated in dual-task situations. Postural balance did not differ between the stages of the disease.

References

Alexandre, T. S., Meira, D. M., Rico, N. C., & Mizuta, S. K. (2012). Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly. Brazilian Journal of Physical Therapy, 16(5), 381-388. 10.1590/S1413-35552012005000041.

Allali, G., Launay, C. P., Blumen, H. M., Callisaya, M. L., De Cock, A .M., Kressig, R. W., Srikanth, V., Steinmetz, J. P., Verghese, J., & Beauchet, O., (2017) Biomathics Consortium (2017). Falls, Cognitive Impairment, and Gait Performance: Results from the GOOD Initiative. Journal of the American Medical Directors Association, 18(4), 335-340. 10.1016/j.jamda.2016.10.008.

Allali, G., Verghese, J. (2020). Falls in Older Adults with MCI and Alzheimer’s Disease. In Montero-Odasso, M., Camicioli, R. (Eds.), Falls and Cognition in Older Persons (pp. 211-228). 10.1007/978-3-030-24233-6_12.

Almeida, O. P. (1998). Mini mental state examination and the diagnosis of dementia in Brazil. Arquivos de Neuro-Psiquiatria, 56(3B), 605-612. 10.1590/S0004-282X1998000400014.

Ansai, J. H., Andrade, L. P., Masse, F. A .A., Gonçalves, J., Takahashi, A. C. M., Vale, F. A. C., & Rebelatto, J. R. (2017). Risk Factors for Falls in Older Adults with Mild Cognitive Impairment and Mild Alzheimer Disease. Journal of Geriatric Physical Therapy, 42(3), 116-121. 10.1519/JPT.0000000000000135.

Ansai, J. H., Andrade, L. P., Rossi, P. G., Takahashi, A. C .M., Vale, F. A. C., & Rebelatto, J. R. (2017). Gait, dual-task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer’s disease. Brazilian Journal of Physical Therapy, 21(2), 144-151. 10.1016/j.bjpt.2017.03.010.

Ansai, J. H., Vassimon-Barroso, V., Farche, A. C. S., Buto, M. S. S., Andrade, L. P., & Rebelatto, J. R. (2019). Accuracy of mobility tests for screening the risk of falls in patients with mild cognitive impairment and Alzheimer's disease. Revista Fisioterapia e Pesquisa, 26(3), 258-264. 10.1590/1809-2950/18006726032019.

Barreto, M. S., Carreira, L., & Marcon, S.S. (2015). Envelhecimento populacional e doenças crônicas: Reflexões sobre os desafios para o Sistema de Saúde Pública. Revista Kairós Gerontologia, 18(1), 325-339. 10.23925/2176-901X.2015v18i1p325-339.

Borel, L., & Alescio-Lautier, B. (2014). Posture and cognition in the elderly: Interaction and contribution to the rehabilitation strategies. Neurophysiologie Clinique/Clinical Neurophysiology, 44(1), 95–107. doi:10.1016/j.neucli.2013.10.129

Borges, A. P. O., Carneiro, J.A.O., Zaia, J. E., Carneiro, A. A. O., & Takayanagui, O. M. (2016). Evaluation of postural balance in mild cognitive impairment through a three-dimensional electromagnetic system. Brazilian Journal of Otorhinolaryngology, 82(4), 433-441. 10.1016/j.bjorl.2015.08.023.

Borges, S., Radanovic, M., & Forlenza, O. V. (2015). Functional mobility in a divided attention task in older adults with cognitive impairment. Journal of Motor Behavior, 47(5), 378–385. 10.1080/00222895.2014.998331.

Bortoli, C.G., Piovezan, M. R., Piovesan, E. J., & Zonta, M. B. (2015). Equilíbrio, quedas e funcionalidade em idosos com alteração da função cognitiva. Revista brasileira de geriatria e gerontologia, 18(3), 587-597. 10.1590/1809-9823.2015.14057.

Cezar, N., Aprahamian, I., Ansai, J. H., de Oliveira, M., da Silva, D., Gomes, W. L., Barreiros, B. A., Langelli, T., & de Andrade, L. P. (2021). Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX). Experimental gerontology, 150, 111390. 10.1016/j.exger.2021.111390

Cristofori, I., Cohen-Zimerman, S., & Grafman, J. (2019). Executive functions. Handbook of Clinical Neurology, 163, 197-219. 10.1016/B978-0-12-804281-6.00011-2.

Cruz, D.T ., Cruz, F. M., Ribeiros, A .L., Veiga, C. L., & Leite, I. C. G. (2015). Associação entre capacidade cognitiva e ocorrência de quedas em idosos. Cadernos Saúde Coletiva, 23(4), 386-393. 10.1590/1414-462X201500040139.

De Melo, L. M., Ansai, J. H., Rossi, P. ., Vale, F. A. C., Takahashi, A. C. M., & Andrade, L. P. (2019). Performance of an Adapted Version of the Timed Up-and-Go Test in People with Cognitive Impairments. Journal of Motor Behavior, 51(6), 647-654. 10.1080/00222895.2018.1552917.

Demain, A., et al. (2013). High-level gait and balance disorders in the elderly: a midbrain disease? Journal of Neurology, 261(1), 196–206. 10.1007/s00415-013-7174-x

Dyer, A. H., Lawlor, B., & Kennelly, S .P. (2020). Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD. BMC Geriatrics, 20(1), 117. 10.1186/s12877-020-01531-w.

Fatori, C. O., Leite, C. F., Souza, L. A. P. S., & Patrizzi, L. J. (2015). Dupla Tarefa e Mobilidade Funcional de idosos ativos. Revista brasileira de geriatria e gerontologia, 18(01), 29-37. 10.1590/1809-9823.2015.13180.

Folstein, M. F., Folstein, S. E., & Mchugh, P. R. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-98. 10.1016/0022-3956 (75)90026-6.

Frota, N. A .F., Nitrini, R., Damasceno, B. P., Forlenza, O. V., Dias-Tosta, E., Silva, A. B., Herrera Junior, E., & Magaldi, R. M., (2011). Group Recommendations in Alzheimer’s Disease; Vascular Dementia of the Brazilian Academy of Neurology (2011). Criteria for the diagnosis of Alzheimer’s disease Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dementia & Neuropsychologia, 5(3), 146-152. 10.1590/S1980-57642011DN05030002.

Fujisawa, C., Umegaki, H., Okamoto, K., Nakashima, H., Kuzuya, M., Toba, K., & Sakurai, T. (2017). Physical function differences between the stages from normal cognition to moderate Alzheimer disease. Journal of the American Medical Directors Association, 18(4), 368.e9-368.e15. 10.1016/j.jamda.2016.12.079.

Gonçalves, J., Ansai, J. H., Masse, F. A. A., Vale, F .A. C., Takahashi, A. C. M., & Andrade, L. P. (2018). Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer’s disease: a prospective cohort study.Brazilian Journal of Physical Therapy, 22(5), 417-423. 10.1016/j.bjpt.2018.03.011.

Haskel, M. V. L., Bonini, J. S., Santos, S. C., Silva, W. C. F. N., Bueno, C. F. O., Bortolanza, M. C. Z., Zornita, M. C., & Riedi, D. C. (2017). Functionality on mild, moderate and severe Alzheimer’s disease: a cross-sectional study. Acta Fisiátrica, 24(2), 82-85. 10.5935/0104-7795.20170016.

Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A., & Martin, R. L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140(6), 566-572. 10.1192/bjp.140.6.566.

Kato-Narita, E. M., Nitrini, R., & Radanovic, M. (2011). Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity. Arquivos de Neuro-Psiquiatria, 69(2A), 202-207. 10.1590/s0004-282x2011000200012

.

Kato-Narita, E. M., & Radanovic, M. (2009). Characteristics of falls in mild and moderate Alzheimer’s disease. Dementia & Neuropsychologia, 3(4), 337–343. 10.1590/S1980-57642009DN30400013.

Maki, B. E., & McIlroy, W. E. (2007). Cognitive demands and cortical control of human balance-recovery reactions. Journal of Neural Transmission, 114(10), 1279–1296. doi:10.1007/s00702-007-0764-y

Montaño, M. B., & Ramos, L. R. (2005). Validity of Portuguese version of Clinical Dementia Rating. Revista de Saúde Pública, 39(6), 912-917. 10.1590/s0034-89102005000600007.

Montero-Odasso, M., Muir, S. W., & Speechley, M. (2012). Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual-tasking, and risk of falls. Archives of physical medicine and rehabilitation, 93(2), 293-299. 10.1016/j.apmr.2011.08.026.

Morris, J. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43(11), 2412-2414. 10.1212/WNL.43.11.2412-a.

Muir-Hunter, S. W., & Wittwer, J. E. (2016). Dual-task testing to predict falls in community-dwelling older adults: a systematic review. Physiotherapy, 102(1), 29–40. 10.1016/j.physio.2015.04.011.

Nietzsche, B. O., Moraes, H. P., & Tavares Júnior, A. R. (2015). Doença de Alzheimer: novas diretrizes para o diagnóstico. Revista Médica de Minas Gerais, 25(2), 237-243. 10.5935/2238-3182.20150043.

Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. 10.1111/j.1532-5415.1991.tb01616.x.

Shumway-Cook, A., & Horak, F. B. (1986). Assessing the influence of sensory interaction on balance. Suggestion from the field. Physical Therapy, 66(10), 1548-1550. 10.1093/ptj/66.10.1548.

Silva, L. B., & Souza, M. F. S. (2018). Neuropsychological and cognitive disorders of Alzheimer's disease: Psychotherapy and Neuropsychological Rehabilitation as alternative treatments. Revista da Graduação em Psicologia da PUC Minas, 3(5), 466-484.

Siqueira, J. F., Antunes, M. D., Nascimento Júnior, J. R. A., & Oliveira, D. V. (2019). Effects of dual-task exercises in elderly with Alzheimer’s Disease: A systemic review. Saúde e Pesquisa, 12(1), 197-202. 10.17765/2176-9206.2019v12n1p197-202.

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Published

11/12/2022

How to Cite

MELO, M. C. S. de; ANDRADE, S. K. D. do R. e S. .; PEIXOTO, V. G. N. de M. P. .; CAVALCANTI, F. A. da C.; GAZZOLA, J. M. . Functional Mobility and postural balance in older adults with Alzheimer’s disease: comparative study between mild and moderate stages. Research, Society and Development, [S. l.], v. 11, n. 16, p. e346111637968, 2022. DOI: 10.33448/rsd-v11i16.37968. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/37968. Acesso em: 18 apr. 2024.

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Health Sciences