OBJECTIVE: To investigate whether simultaneous cognitive tasks influence maximal motor performance in frail geriatric patients with a history of injurious falls and different levels of cognitive function. DESIGN: Experimental 3-group design. SETTING: Geriatric rehabilitation hospital. PARTICIPANTS: Twenty-two healthy, young adults (mean age +/- standard deviation, 27.7 +/- 9y) and 23 geriatric patients (mean age, 80.9 +/- 5.4y) with a history of injurious falls with (Mini-Mental State Examination [MMSE] score, 20.5 +/- 1.6) and without (MMSE score, 28.1 +/- 1.2) cognitive impairment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Motor performance: peak and integral of maximal isometric strength of leg extensors. Cognition: semiautomated calculation steps (serial 2 forward) and nonautomated calculation steps derived from the MMSE (serial 7 retro). Motor and cognitive performances were examined as single and dual tasks. RESULTS: In frail geriatric patients, especially in patients with cognitive impairment, maximal motor performance decreased significantly during all dual tasks. Cognitive performance was reduced, depending on the task and group. CONCLUSION: In frail or cognitively impaired geriatric patients, additional tasks can substantially decrease maximal motor performance. Insufficient resources on dual tasking may thus be a link in connecting the high incidence of falls with frailty and cognitive impairment in geriatric patients with a history of injurious falls. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
OBJECTIVE: To investigate whether simultaneous cognitive tasks influence maximal motor performance in frail geriatric patients with a history of injurious falls and different levels of cognitive function. DESIGN: Experimental 3-group design. SETTING: Geriatric rehabilitation hospital. PARTICIPANTS: Twenty-two healthy, young adults (mean age +/- standard deviation, 27.7 +/- 9y) and 23 geriatric patients (mean age, 80.9 +/- 5.4y) with a history of injurious falls with (Mini-Mental State Examination [MMSE] score, 20.5 +/- 1.6) and without (MMSE score, 28.1 +/- 1.2) cognitive impairment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Motor performance: peak and integral of maximal isometric strength of leg extensors. Cognition: semiautomated calculation steps (serial 2 forward) and nonautomated calculation steps derived from the MMSE (serial 7 retro). Motor and cognitive performances were examined as single and dual tasks. RESULTS: In frail geriatric patients, especially in patients with cognitive impairment, maximal motor performance decreased significantly during all dual tasks. Cognitive performance was reduced, depending on the task and group. CONCLUSION: In frail or cognitively impaired geriatric patients, additional tasks can substantially decrease maximal motor performance. Insufficient resources on dual tasking may thus be a link in connecting the high incidence of falls with frailty and cognitive impairment in geriatric patients with a history of injurious falls. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation