John R Best1,2,3, Jennifer C Davis1,4, Teresa Liu-Ambrose1,2,3. 1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada. 2. Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada. 3. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. 4. Centre for Clinical Epidemiology and Evaluation, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVES: To examine whether good executive function (EF; the cognitive processes important for goal-oriented and controlled behavior) at baseline and maintenance of EF over time predict maintenance of physical performance, functional status, physical activity, and mood over a 1-year period, and conversely, to examine whether baseline functioning in these noncognitive domains predicts maintenance of EF over the same period of time. DESIGN: 12-month prospective cohort study. SETTING: Vancouver Falls Prevention Clinic. PARTICIPANTS: Community-dwelling older adults (N = 199; mean age 81.6 ± 6.5; 63% female) referred to the clinic after a fall. MEASURMENTS: At each time point, structural equation modeling created a latent EF variable from performance on five EF tasks. Physical performance (physiological falls risk and gait speed), instrumental activities of daily living (IADLs), physical activity, and depressive symptoms were also assessed at each time point. RESULTS: Higher baseline EF predicted decreases in depressive symptoms (P = .005) and maintenance of IADLs (P = .006) from baseline to follow-up. Improvements in EF correlated with increases in gait speed (P = .005) and physical activity (P = .03) and with the maintenance of IADLs (P = .002) over follow-up. All effects were independent of demographic characteristics and global cognitive function. Baseline performance in the noncognitive domains did not predict changes in EF. CONCLUSION: In older fallers, EF is a marker of resiliency in several noncognitive domains and should therefore be assessed. Furthermore, interventions to improve EF should be tested in older fallers with EF deficits.
OBJECTIVES: To examine whether good executive function (EF; the cognitive processes important for goal-oriented and controlled behavior) at baseline and maintenance of EF over time predict maintenance of physical performance, functional status, physical activity, and mood over a 1-year period, and conversely, to examine whether baseline functioning in these noncognitive domains predicts maintenance of EF over the same period of time. DESIGN: 12-month prospective cohort study. SETTING: Vancouver Falls Prevention Clinic. PARTICIPANTS: Community-dwelling older adults (N = 199; mean age 81.6 ± 6.5; 63% female) referred to the clinic after a fall. MEASURMENTS: At each time point, structural equation modeling created a latent EF variable from performance on five EF tasks. Physical performance (physiological falls risk and gait speed), instrumental activities of daily living (IADLs), physical activity, and depressive symptoms were also assessed at each time point. RESULTS: Higher baseline EF predicted decreases in depressive symptoms (P = .005) and maintenance of IADLs (P = .006) from baseline to follow-up. Improvements in EF correlated with increases in gait speed (P = .005) and physical activity (P = .03) and with the maintenance of IADLs (P = .002) over follow-up. All effects were independent of demographic characteristics and global cognitive function. Baseline performance in the noncognitive domains did not predict changes in EF. CONCLUSION: In older fallers, EF is a marker of resiliency in several noncognitive domains and should therefore be assessed. Furthermore, interventions to improve EF should be tested in older fallers with EF deficits.
Authors: Hal H Atkinson; Stephen R Rapp; Jeff D Williamson; James Lovato; John R Absher; Margery Gass; Victor W Henderson; Karen C Johnson; John B Kostis; Kaycee M Sink; Charles P Mouton; Judith K Ockene; Marcia L Stefanick; Dorothy S Lane; Mark A Espeland Journal: J Gerontol A Biol Sci Med Sci Date: 2009-09-29 Impact factor: 6.053
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Authors: John R Best; Teresa Liu-Ambrose; Robert M Boudreau; Hilsa N Ayonayon; Suzanne Satterfield; Eleanor M Simonsick; Stephanie Studenski; Kristine Yaffe; Anne B Newman; Caterina Rosano Journal: J Gerontol A Biol Sci Med Sci Date: 2016-04-10 Impact factor: 6.053