Skip to main content
Log in

The impact of a home-based computerized cognitive training intervention on fall risk measure performance in community dwelling older adults, a pilot study

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance.

Design

This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group.

Participants

Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19).

Intervention

Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program.

Measurements

Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7.

Results

Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14m/s in the intervention group.

Conclusion

A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Administration on Aging, United States Department of Health and Human Services. Profile of Older Americans:2010. Available at http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2010/4.aspx. Accessed June 25, 2011.

    Google Scholar 

  2. Beinhoff U, Hilbert V, Bittner D, Gron G, Riepe MW. Screening for cognitive impairment: a triage for outpatient care. Dement Geriatr Cogn Disord. 2005;20:278–285.

    Article  PubMed  Google Scholar 

  3. Sands LP, Yaffe K, Lui L, Stewart A, Eng C, Covinsky K. The effects of acute illness on ADL decline over 1 year in frail older adults with and without cognitive impairment. J. Gerontol. A Biol. Sci. Med. Sci.. 2002;57:M449–M454.

    Article  PubMed  Google Scholar 

  4. Yaffe K, Fox P, Newcomer R, et al. Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA.2002;287:2090–2097.

    Article  PubMed  Google Scholar 

  5. Muir SW, Gopaul K, Montero Odasso MM. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age ageing. 2012;41:299–309.

    Article  PubMed  Google Scholar 

  6. Persad CC, Jones JL, Ashton-Miller JA, Alexander NB, Giordani B. Executive function and gait in older adults with cognitive impairment. J Gerontol A Biol Sci Med Sc. 2008;63A:1350–1356.

    Article  Google Scholar 

  7. Tabbarah M, Crimmins EM, Seeman TE. The relationship between cognitive and physical performance: MacArthur studies of successful aging. J Gerontol A Biol Sci Med Sc. 2002;57A:M228–M235.

    Article  Google Scholar 

  8. Montero-Odasso M, Casas A, Hansen KT, et al. Quantitative gait analysis under dual-task in older people with mild cognitive impairment: A reliability study. J Neuroeng Rehabil. 2009;6:35–35.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Liu-Ambrose TY, Ashe MC, Graf P, Beattie BL, Khan KM. Increased risk of falling in older community-dwelling women with mild cognitive impairment. Phys Ther. 2008;88:1482.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Cavanaugh, J.C. & Blanchard-Fields, F. (2011). Adult development and aging. Belmont, CA: Wadsworth.

    Google Scholar 

  11. Elliott R. Executive functions and their disorders. Br Med J.2003;65:49.

    Google Scholar 

  12. Lamoth CJ, van Deudekom FJ, van Campen JP, Appels BA, de Vries OJ, Pijnappels M. Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people. J Neuroeng Rehabil. 2011;8:2.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Martin K, Thomson R, vaz L, Wood A, Garry M, Srikanth V. Visual Spatial Ability and Memory Are Associated with Falls Risk in Older People. Dement Geriatr Cogn Disord. 2009;27:451

    Article  CAS  PubMed  Google Scholar 

  14. Montero-Odasso M, Bergman H, Phillips NA, Wong CH, Sourial N, Chertkow H. Dual-tasking and gait in people with mild cognitive impairment. The effect of working memory. BMC Geriatrics. 2009;9:41–41.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Hughes TF. Promotion of cognitive health through cognitive activity in the aging population. Aging Health. 2010;6:111–121.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Acevedo A, Loewenstein DA. Nonpharmacological cognitive interventions in aging and dementia. J Geriatr Psychiatry Neurol. 2007:239–249.

    Google Scholar 

  17. Clare L. Cognitive training and cognitive rehabilitation for people with early-stage dementia. Rev Clin Gerontol. 2003;13:75–83.

    Article  Google Scholar 

  18. Talassi E, Guerreschi M, Feriani M, Fedi V, Bianchetti A, Trabucchi M. Effectiveness of a cognitive rehabilitation program in mild dementia (MD) and mild cognitive impairment (MCI): a case control study. Arch Gerontol Geriatr. 2007;44 Suppl 1:391–399.

    Article  PubMed  Google Scholar 

  19. Belleville S. Cognitive training for persons with mild cognitive impairment. Int Psychogeriatr. 2008;20:57–66.

    PubMed  Google Scholar 

  20. Marsiske M, Ball K, Wright E, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA.2006;296:2805.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Rebok GW, Ball K, Guey LT, et al. Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. J Am Geriatr Soc. 2014;62:16–24.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Verghese J, Mahoney J, Ambrose A, Wang C, Holtzer R. Effect of cognitive remediation on gait in sedentary seniors. J Gerontol A Biol Sci Med Sc. 2010;12:1338–1343.

    Article  Google Scholar 

  23. Smith-Ray RL, Makowski-Woidan B, Hughes SL. A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact Black older adults. Health Educ Behav. 2014;41:62S–69S.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Smith-Ray RL, Hughes SL, Prohaska TR, Little DM, Jurivich DA, Hedecker D. Impact of cognitive training on balance and gait in older adults. J Gerontol B Psychol Sci Soc Sci.(2013)doi: 10.1093/geronb/gbt097 First published online: November 5, 2013

    Google Scholar 

  25. Brookmeyer R, Evans DA, Hebert L, et al. National estimates of the prevalence of Alzheimer’s disease in the United States. Alzheimers Dement. 2011;7:61–73.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Montero-Odasso M, Verghese J, Beauchet O, Hausdorff JM. Gait and cognition: a complementary approach to understanding brain function and the risk of falling. JAGS. 2012;60:2127–2136.

    Article  Google Scholar 

  27. Lampit A, Hallock H, Moss R, Kwok S, Rosser M, Lukjanenko M, et al. The timecourse of global cognitive gains from supervised computer-assisted cognitive training: A randomized, active-controlled trial in elderly with multiple dementia risk factors. JPAD. 2014;1(1): 33–39.

    Google Scholar 

  28. Mackenzie L, Byles J, D’Este C. Validation of self-reported fall events in intervention studies. Clinical rehabilitation. 2006;20:331–339.

    Article  PubMed  Google Scholar 

  29. Vazzana R, Bandinelli S, Lauretani F, et al. Trail making test predicts physical impairment and mortality in older persons. JAGS. 2010;58:719–724.

    Article  Google Scholar 

  30. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for Mild Cognitive Impairment. JAGS. 2005;53:695–699.

    Article  Google Scholar 

  31. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82:128–137.

    PubMed  Google Scholar 

  32. Buatois S. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. JAGS. 2008;56:1575–1577.

    Article  Google Scholar 

  33. Donini LM, Gillette-Guyonnet S, Visser M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an international academy on nutrition and aging (IANA) task force. J Nutr Health Aging. 2009;13:881–889.

    Article  PubMed  Google Scholar 

  34. Crowe SF. The differential contribution of mental tracking, cognitive flexibility, visual search, and motor speed to performance on parts A and B of the Trail Making Test. J Clin Psychol. 1998;54:585–591.

    Article  CAS  PubMed  Google Scholar 

  35. Bowie CR. Administration and interpretation of the Trail Making Test. Nature Protocols. 2006;1:2277–2281.

    Article  CAS  PubMed  Google Scholar 

  36. Jefferson AL, O’Connor MK, Green RC, Ashendorf L, Chaisson C, Stern RA. Trail making test errors in normal aging, mild cognitive impairment, and dementia. Arch Clin Neuropsychol. 2007;23:129–137.

    Google Scholar 

  37. Montero-Odasso M, Schapira M, Soriano ER, Varela M, et al. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sc. 2005;60A:1304–1309.

    Article  Google Scholar 

  38. Deshpande N, Ferrucci L, Guralnik J, Metter EJ, Bandinelli S. Gait speed under varied challenges and cognitive decline in older persons: A prospective study. Age Ageing. 2009;38:509–514.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Annweiler C, Schott A, Abellan van Kan G, et al. The Five-Times-Sit-to-Stand test, a marker of global cognitive functioning among community-dwelling older women. J Nutr Health Aging. 2011;15:271–276.

    Article  CAS  PubMed  Google Scholar 

  40. Herman T, Giladi N, Hausdorff JM. Properties of the ‘timed up and go’ test: more than meets the eye. Gero. 2011;57:203–210.

    Google Scholar 

  41. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896.

    CAS  PubMed  Google Scholar 

  42. Thabane L, Ma J, Chu R, et al. A tutorial on pilot studies: the what, why and how. BMC medical research methodology. 2010; 2009;10:1–1.

    Article  Google Scholar 

  43. Ball K, Tennstedt SL, Unverzagt FW, et al. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002;288:2271–2281.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Cipriani G, Bianchetti A, Trabucchi M. Outcomes of a computer-based cognitive rehabilitation program on Alzheimer’s disease patients compared with those on patients affected by mild cognitive impairment. Arch Gerontol Geriatr. 2006;43:327–335.

    Article  PubMed  Google Scholar 

  45. Finn M, McDonald S. Computerised cognitive training for older persons with mild cognitive impairment: A pilot study using a randomised controlled trial design. Brain Impairment. 2011;12:187–199.

    Article  Google Scholar 

  46. Li KZH, Roudaia E, Lussier M, Bherer L, Leroux A, McKinley PA. Benefits of cognitive dual-task training on balance performance in healthy older adults. J Gerontol A Biol Sci Med Sc. 2010;65A:1344–1352.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Blackwood.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blackwood, J., Shubert, T., Fogarty, K. et al. The impact of a home-based computerized cognitive training intervention on fall risk measure performance in community dwelling older adults, a pilot study. J Nutr Health Aging 20, 138–145 (2016). https://doi.org/10.1007/s12603-015-0598-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-015-0598-5

Key words

Navigation