Abstract
BackgroundImproved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Thus, we examined the independent association of change in executive functions and change in falls-related self-efficacy with improved gait speed among community-dwelling senior women.MethodsA secondary analysis of the 135 senior women aged 65 to 75 years old who completed a 12-month randomized controlled trial of resistance training. Usual gait speed was assessed using a 4-meter walk. Three executive processes were assessed by standard neuropsychological tests: 1) set shifting; 2) working memory; and 3) selective attention and response inhibition. A linear regression model was constructed to determine the independent association of change in executive functions and falls-related self-efficacy with change in gait speed.ResultsImproved selective attention and conflict resolution, and falls-related self-efficacy, were independently associated with improved gait speed after accounting for age, global cognition, baseline gait speed, and change in quadriceps strength. The total variance explained was 24%.ConclusionsInterventions that target executive functions and falls-related self-efficacy, in addition to physical functions, to improve gait speed may be more efficacious than those that do not.Trial RegistrationClinicalTrials.gov Identifier: NCT00426881
Highlights
Improved usual gait speed predicts substantial reduction in mortality
There has been a call for research to determine whether interventions to improve gait speed affect survival [6], a better understanding of the modifiable factors that are independently associated with improved gait
The Health, Aging and Body Composition Study [7] highlighted that baseline lower executive functions predict subsequent decline in gait speed
Summary
Improved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Reduced speed is associated with risk of major health-related outcomes [1], including falls [2] and fracture [3], in older adults. It is associated with sub-clinical structural brain abnormalities [4] and cognitive function [5]. The Health, Aging and Body Composition Study [7] highlighted that baseline lower executive functions predict subsequent decline in gait speed. Evidence supports the hypothesis that cognitive and physical functions are inter-related
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