title: Effect of cognitive remediation on gait in sedentary seniors.
abstract: BACKGROUND
  Attention and executive functions show strong associations with slow gait and falls in seniors and have been shown to be amenable to cognitive remediation. However, cognitive remediation as a strategy to improve mobility has not been investigated.
  
  
  METHODS
  Using a randomized single-blind control design, 24 sedentary older adults (exercise less than or equal to once weekly and gait velocity <1 m/s) were randomly assigned to an 8-week computerized cognitive remediation program or wait-list. Primary outcome was change in gait velocity during normal pace and "walking while talking" conditions. We also compared the proportion of improvers (velocity change ≥4 cm/s) in each group.
  
  
  RESULTS
  The 10 participants who completed cognitive remediation improved gait velocity from baseline during normal walking (68.2 ± 20.0 vs 76.5 ± 17.9 cm/s, p = .05) and walking while talking (36.7 ± 13.5 vs 56.7 ± 20.4 cm/s, p = .002). The 10 intervention participants improved gait velocity over the 8-week intervention both during normal walking (change: 8.2 ± 11.4-1.3 ± 6.8 cm/s, p = .10) and walking while talking (change: 19.9 ± 14.9-2.5 ± 20.1 cm/s, p = .05) compared with the 10 control participants. Six intervention participants were improvers on normal pace walking compared with three controls (odds ratio = 3.0, 95% confidence interval = 0.5-19.6). All 10 intervention participants improved on walking while talking compared with 3 controls (odds ratio = 3.5, 95% confidence interval = 1.5-8.0).
  
  
  CONCLUSIONS
  The findings of this pilot trial are promising and suggest that cognitive remediation may improve mobility in sedentary seniors. This approach should be validated in larger scale trials.
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY 10461, USA. joe.verghese@einstein.yu.edu
authors.forename: Joe
authors.initials: J
authors.lastname: Verghese
authors.forename: Jeannette
authors.initials: J
authors.lastname: Mahoney
authors.forename: Anne F
authors.initials: AF
authors.lastname: Ambrose
authors.forename: Cuiling
authors.initials: C
authors.lastname: Wang
authors.forename: Roee
authors.initials: R
authors.lastname: Holtzer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000503:physiopathology* / Q000534:rehabilitation*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D010865:Pilot Projects; D057185:Sedentary Behavior; D016037:Single-Blind Method; D016896:Treatment Outcome