Executive Functions Are Associated with Fall Risk but not Balance in Chronic Cerebrovascular Disease.

Cosimo Tuena,Alice Chirico,Marco Stramba-Badiale,Pietro Cipresso,Elisa Pedroli,Karine Marie Goulene,Valentina Mancuso,Giuseppe Riva,Ilaria M A Benzi

doi:10.3390/jcm9113405

Abstract

Background: Older people’s deficits in executive functions (EF) have been shown to lead to higher fall risk, postural sway, and reduced speed. Crucially, EF impairments are even more pronounced in individuals with chronic cerebrovascular disease (CVD), namely vascular cognitive impairment. Methods: In this retrospective cross-sectional study, we used a complete neuropsychological battery, including the Trail Making Test (TMT) and physical measures, such as the Morse fall and EQUI scales, to assess 66 individuals with chronic CVD. Linear regressions, Bayesian analyses, and model selection were performed to see the impact of EF, global cognition, and vascular parkinsonism/hemiplegia on physical measures (fall risk and balance). Results: The TMT part B and BA correlated (r = 0.44 and r = 0.45) with Morse fall scale. Only EF significantly explained fall risk, whereas global cognition and vascular parkinsonism/hemiplegia did not. These findings were confirmed by Bayesian evidence and parsimony model selection. Balance was not significantly correlated with any of the neuropsychological tests. Conclusions: This is the first study investigating the relationship between cognitive and physical measures in a sample of older people with chronic CVD. The results are consistent with previous findings that link EF with fall risk in CVD.

Highlights

IntroductionCognition is an umbrella term that encompasses several domains (e.g., memory, attention, visuospatial ability, and executive functions [EF]) that contribute to processing information during functional tasks to maintain balance and prevent falls in older people [1]
Cognition is an umbrella term that encompasses several domains that contribute to processing information during functional tasks to maintain balance and prevent falls in older people [1]
We looked at correlations between neuropsychological functions and balance (EQUI scale)/fall risk (Morse fall scale) measures

Summary

Introduction

Cognition is an umbrella term that encompasses several domains (e.g., memory, attention, visuospatial ability, and executive functions [EF]) that contribute to processing information during functional tasks to maintain balance and prevent falls in older people [1]. EF is vital to accomplishing complex tasks that require the coordination of various cognitive sub-components (e.g., attention, set-shifting, and working memory) [5] These abilities are crucially related to balance and locomotion [2,4,6,7,8]. Hobert and colleagues [12] showed that healthy older people (50–78 years) with lower working memory and cognitive flexibility, assessed using the Trail Making Test (TMT) [13], presented higher dual-task costs in the walking task, compared to those with higher cognitive functions. Bayesian analyses, and model selection were performed to see the impact of EF, global cognition, and vascular parkinsonism/hemiplegia on physical measures (fall risk and balance). The results are consistent with previous findings that link EF with fall risk in CVD

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