Changes in executive functions and self-efficacy are independently associated with improved usual gait speed in older women.
BACKGROUND
Improved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Thus, we examined the independent association of change in executive functions and change in falls-related self-efficacy with improved gait speed among community-dwelling senior women.


METHODS
A secondary analysis of the 135 senior women aged 65 to 75 years old who completed a 12-month randomized controlled trial of resistance training. Usual gait speed was assessed using a 4-meter walk. Three executive processes were assessed by standard neuropsychological tests: 1) set shifting; 2) working memory; and 3) selective attention and response inhibition. A linear regression model was constructed to determine the independent association of change in executive functions and falls-related self-efficacy with change in gait speed.


RESULTS
Improved selective attention and conflict resolution, and falls-related self-efficacy, were independently associated with improved gait speed after accounting for age, global cognition, baseline gait speed, and change in quadriceps strength. The total variance explained was 24%.


CONCLUSIONS
Interventions that target executive functions and falls-related self-efficacy, in addition to physical functions, to improve gait speed may be more efficacious than those that do not.


BACKGROUND
ClinicalTrials.gov Identifier: NCT00426881.
Liu-Ambrose
Teresa
T
Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada. tlambrose@exchange.ubc.ca
Davis
Jennifer C
JC
Nagamatsu
Lindsay S
LS
Hsu
Chun Liang
CL
Katarynych
Lindsay A
LA
Khan
Karim M
KM
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology; D056344:Executive Function / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D055070:Resistance Training / Q000639:trends; D020377:Self Efficacy; D016138:Walking / Q000502:physiology* / Q000523:psychology