Effect of cognitive remediation on gait in sedentary seniors.
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.
Verghese
Joe
J
Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY 10461, USA. joe.verghese@einstein.yu.edu
Mahoney
Jeannette
J
Ambrose
Anne F
AF
Wang
Cuiling
C
Holtzer
Roee
R
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