Date of Award

6-2013

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Kieran Fogarty

Second Advisor

Dr. Carla Chase

Third Advisor

Dr. Tiffany Shubert

Keywords

executive function, cognitive training, mild cognitive impairment, fall risk, community dwelling older adults

Abstract

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of EF, MCI, and fall risk. The purpose of the first paper was to investigate the relationship between EF as measured with the Trail Making Test Part B and the four measures of fall risk.

The results of this cross-sectional study suggested that EF was significantly associated with usual gait speed in community dwelling older adults which remained after adjusting for age and education. EF was associated with the TUG and usual gait speed in those with MCI.

The objective of the second paper was to describe how performance differed on the four measures of fall risk in those with MCI. No significant differences in mean scores were found on measures of fall risk in those with MCI; however the cognitive resources required during fall risk assessments should be considered in the selection of measures. In those with MCI, balance confidence was not associated with usual gait speed or with performance on the FTSTS.

The third paper examined how a progressively challenging six week computerized cognitive training program focused on the cognitive domains of attention, set shifting, and visual spatial ability impacted fall risk measure performance. Results indicated that there was no significant difference on measures of fall risk, EF, or MCI following the cognitive training program.

Access Setting

Dissertation-Open Access

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