Which interventions incorporating physical and cognitive elements are most effective to improve gait in cognitively impaired older adults? A systematic review

Abstract

Background: The primary objective of this systematic review was to determine effective interventions to improve gait (speed, stride length, double limb support) in older adults with cognitive impairments.Methods: Eligibility criteria included randomized controlled trials in English, older adults aged 45 years and over with mild to severe cognitive impairments, outcomes of gait, and interventions including exercise/physical activity, cognitive elements, or both. Databases searched were PubMed, CINAHL, Scopus, ProQuest, and Cochrane. PEDro was utilized to assess risk of bias.Results: Ten randomized controlled trials were included. Statistically significant changes were found in different aspects of gait with dual task, exercise programs, multimodal exercises, and functional training.Conclusion: It was found that performing multiple modes of interventions to treat older adults with cognitive impairments demonstrated best results. Gait performance of older adults with cognitive impairments is shown to improve with a myriad of interventions that challenge the physical and cognitive performance of this population. The strengths of the review are performing a comprehensive search. All included articles were randomized controlled trials and a moderate agreement. The limitations of the review are small exclusion criteria, small sample sizes, and detail reporting issues.