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- All Subjects: Falls
- Creators: Der Ananian, Cheryl
- Creators: Dhālīwāla, Simarana
Description
Falls are a public health concern for older adults with or without cognitive impairment, including clinical Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) dementia. Executive function (EF) is linked to falls and is notably impaired in individuals with MCI and AD dementia. However, it is unclear which EF assessments are associated with falls in older adults with intact cognition, MCI, and AD dementia. Apolipoprotein E4 (ApoE4) increases the risk of MCI and AD dementia, with limited information suggesting decreased EF and gait impairment in ApoE4 carriers. The purpose of this study was to 1) investigate the relationships between EF assessments and falls (fall history and future fall) by cognitive status (intact cognition, MCI, AD dementia) and 2) determine if ApoE4 moderates the relationship between EF and falls across cognitive status. EF assessments included Digit Span (DS), Trail Making Test (ΔTMT), Stroop Interference Test, Controlled Oral Word Association assessments of phonemic and semantic fluency (COWAC), and Clock Drawing Test. Binary logistic regression was used with secondary data to analyze the EF and falls relationship. Results showed a significant association of the ΔTMT with fall history but may not be appropriate for use with people with AD dementia due to a floor effect. Significant interaction effects were shown between AD dementia and DS, ΔTMT, and EF as a latent variable, where individuals with a fall history had better EF performance. The interaction effects are influenced by the lower percentage of reported falls in people with severe AD dementia. In the second aim, a confounding effect exposed a potential four-way interaction where higher EF in ApoE4 non-carriers with AD dementia experienced a future fall without a fall history. Overall, more research is needed to determine which EF assessments are best suited for fall risk assessment and whether ApoE4 plays a role in the relationship between EF and falls. Since the low percentage of reported falls in people with severe AD dementia exposed a differing trend between EF and falls, more research is needed to develop valid and reliable tools for collecting fall data in individuals with severe AD dementia.
ContributorsDelgado, Ferdinand (Author) / Der Ananian, Cheryl (Thesis advisor) / Yu, Fang (Thesis advisor) / Mackinnon, David P (Committee member) / Peterson, Daniel S (Committee member) / Ofori, Edward (Committee member) / Arizona State University (Publisher)
Created2023
Description
Purpose: This study explored the potential correlates of exercise self-efficacy among older adults with a self-reported diagnosis of arthritis. Methods: This study was a secondary data analysis and used a cross-sectional design. Data was collected from a convenience sample of Non-Hispanic White and Non-Hispanic Black individuals between 2006-2008 (N=208). Descriptive statistics were run to assess means and frequencies within the sample. Bivariate statistics (Pearson and Spearman correlations, T-tests and one-way analysis of variance) were run to examine relationships between the independent and dependent variables. Multiple linear regression analyses were conducted to examine independent predictors of self-efficacy for exercise (SEE) and barriers self-efficacy for exercise (BSE). Results: Participants were predominantly female (85.6%), white (62.9%), retired (58.1%) and had a mean age of 66.6 [10.7] years. For education level, 23.4% reported a Master’s degree or higher and 18.6% reported they had at most a high school degree or GED. Nearly 47% of the sample were classified as obese based on self-reported body mass index (BMI) and 68.3% of the sample were not meeting the American College of Sports Medicine physical activity (PA) recommendations. Participants reported a relatively high BSE (22.6) and an average SEE (22.7). Significant positive associations were seen with outcome expectation for exercise (EOE), social support, and total minutes of PA and negative associations with BMI, physical function, pain, and negative affect with SEE and BSE. Meeting the PA guidelines (t134.5=4.60, 95%CI= 4.7(6.71-2.68), p<0.001) and being white (t164=2.82, 95%CI=2.82(0.57-5.08), p=0.014) were associated with SEE and BSE (t165=3.42, 95%CI= 4.37(6.89-1.85), p=0.001) and (t164=2.34, 95%CI= 2.95(0.46-5.43), p=0.021), respectively. In regression analyses, significant predictors of SEE were education (p=.006), physical function (p=.006) and EOE (p<.001). Significant predictors of BSE were physical function (p=.020), social support (p=.031), EOE (p=<.001), education level (p=.037), and total minutes of PA (p=.022). The variables in the SEE model accounted for 50.5% (R=.737, R2=.505) of the total variance and the variables in BSE model accounted for 41.1% (R=.672, R2=.411) of the total variance of the model. Discussion: EOE appears to be an important predictor of SEE and BSE. Examining the temporal relationship between EOE and SEE is warranted.
ContributorsDhālīwāla, Simarana (Author) / Der Ananian, Cheryl (Thesis advisor) / Sebren, Ann (Committee member) / Hrncir, Shawn (Committee member) / Arizona State University (Publisher)
Created2016
Description
The ability to walk while completing a secondary task, dual-task walking (DTW), poses notable challenges for individuals affected by neurological disorders, such as multiple sclerosis (MS), who experience both cognitive and motor problems secondary to their disease. However, DTW is an everyday activity that has putative importance for optimal function. Although some research in the past decade has begun to examine changes in DTW in MS, there is still limited work to understand the predictors of DTW, the factors that might moderate relationships between baseline cognitive and motor function and DTW ability, and its consequences (e.g., for quality of life [QoL] or fall risk). To contribute to the understanding of these phenomena and their intersections, three secondary data analyses of two relatively large data sets in the area were conducted to address five major aims. The first step was to identify of the most relevant of these inherently involved domains (cognitive [aim 1] and motor [aim 2] abilities). Lasso regression for inference was performed to address this question for both cognitive (South Shore Neurologic Associates, PC data) and motor (University of Kansas Medical Center [KUMC] data) domains. Next, evaluations to explore the moderating role of the psychological impacts that are common in MS (e.g., depression and falls self-efficacy) were undertaken to determine whether the relationships between cognitive and motor function and DTW ability are different for individuals with different levels of these factors using regression with factor scores performed with each data set (aim 3). As a final step, relationships between DTW and distal outcomes like QoL (cross-sectionally using both data sets and factor score regression; aim 4) and falls (cross-sectionally and longitudinally using KUMC data and negative binomial regression; aim 5). These studies contribute to the corpus of knowledge about DTW in MS in needed ways.
ContributorsVan Liew, Charles (Author) / Peterson, Daniel S (Thesis advisor) / Ofori, Edward (Committee member) / Der Ananian, Cheryl (Committee member) / McNeish, Daniel (Committee member) / Dibble, Leland (Committee member) / Arizona State University (Publisher)
Created2021