Morag E Taylor1, Danielle A Lasschuit2, Stephen R Lord3, Kim Delbaere4, Susan E Kurrle5, A Stefanie Mikolaizak6, Tasha Kvelde7, Jacqueline C T Close8. 1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; Cognitive Decline Partnership Centre, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia. Electronic address: m.taylor@neura.edu.au. 2. Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia; Department of Geriatric Medicine, Prince of Wales Hospital, South East Sydney Local Health District, Sydney, NSW, Australia. Electronic address: dannielle.lasschuit@heatlh.nsw.gov.au. 3. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia. Electronic address: s.lord@neura.edu.au. 4. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia. Electronic address: k.delbaere@neura.edu.au. 5. Cognitive Decline Partnership Centre, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. Electronic address: susan.kurrle@sydney.edu.au. 6. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia. Electronic address: Stefanie.Mikolaizak@rbk.de. 7. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia. Electronic address: tasha.kvelde@health.nsw.gov.au. 8. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia. Electronic address: j.close@neura.edu.au.
Abstract
OBJECTIVES: This study aimed to document change in neuropsychological, physical and functional performance over one year and to investigate the relationship between baseline gait speed and cognitive decline in this period in older people with dementia. METHODS: One hundred and seventy-seven older people with dementia (Mini-Mental State Examination 11-23; Addenbrooke's Cognitive Examination-Revised <83) residing in the community or low level care facility completed baseline neuropsychological, physical and functional assessments. Of these, 134 participants agreed to reassessment of the above measures one year later. RESULTS: Overall, many neuropsychological, physical and functional performance measures declined significantly over the one year study period. Baseline gait speed was significantly associated with decline in verbal fluency (B(109)=2.893, p=0.046), specifically phonemic/letter fluency (B(109)=2.812, p=0.004) while controlling for age, education, dementia drug use and baseline cognitive performance. There was also a trend for an association between baseline gait speed and decline in clock drawing performance (B(107)=0.601, p=0.071). CONCLUSIONS: Older people with mild to moderate dementia demonstrate significant decline in neuropsychological, physical and functional performance over one year. Baseline gait speed is associated with decline in executive function over one year, suggesting shared pathways/pathology between gait and cognition.
OBJECTIVES: This study aimed to document change in neuropsychological, physical and functional performance over one year and to investigate the relationship between baseline gait speed and cognitive decline in this period in older people with dementia. METHODS: One hundred and seventy-seven older people with dementia (Mini-Mental State Examination 11-23; Addenbrooke's Cognitive Examination-Revised <83) residing in the community or low level care facility completed baseline neuropsychological, physical and functional assessments. Of these, 134 participants agreed to reassessment of the above measures one year later. RESULTS: Overall, many neuropsychological, physical and functional performance measures declined significantly over the one year study period. Baseline gait speed was significantly associated with decline in verbal fluency (B(109)=2.893, p=0.046), specifically phonemic/letter fluency (B(109)=2.812, p=0.004) while controlling for age, education, dementia drug use and baseline cognitive performance. There was also a trend for an association between baseline gait speed and decline in clock drawing performance (B(107)=0.601, p=0.071). CONCLUSIONS: Older people with mild to moderate dementia demonstrate significant decline in neuropsychological, physical and functional performance over one year. Baseline gait speed is associated with decline in executive function over one year, suggesting shared pathways/pathology between gait and cognition.
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