Executive dysfunction and effectiveness of physical program in older adults: which association?

Abstract

Little is known about the association between executive function and the magnitude of improvement from personalised exercise interventions on gait performance among older-old adults. We examined whether the effectiveness of personalised intervention on gait performance is dependent on the patient's baseline dysexecutive syndrome, as assessed by the Frontal Assessment Battery. A total of 175 older community-dwellers (83.57 ± 5.2years; 70.2% female) were recruited from the day centre for after-care and rehabilitation in the Nantes Ambulatory Centre of the Clinical Gerontology (France), and were followed during a pre-post-intervention, single-arm retrospective design. The intervention consisted of an individual personalised rehabilitation program over a period of 7weeks, with twice-weekly sessions (45min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), Timed Up and Go test, and handgrip strength test were assessed. Using a pre-post analysis of covariance, a significant increase in dual-task gait speed while counting (+ 0.10m/s; + 15%) and in dual-fluency gait speed (+ 0.06m/s; + 10%), and in Timed Up and Go performance (- 2.9s; + 17.8%) was observed after the rehabilitation program, regardless the baseline executive status. An individual personalized intervention is effective to improve mobility performance and the dual-task gait speed in older-old adults. The magnitude of those effects is independent of the patient's baseline characteristics including the executive function status. Even the most deficient baseline characteristics of patients should not be viewed as clinical barrier for implementing a beneficial individual intervention in high-risk older adults.