Relationship between cognition and gait performance in older adults receiving physical therapy interventions in the home.
Persons undergoing physical therapy home services often have difficulty with mobility and gait. The purpose of this study was to determine whether there was a relationship between gait and a rating of cognitive functioning in persons undergoing home-care physical therapy services. Patients over the age of 65 (n = 11,601) seen by a home-care agency between 2007 and 2008 were included in the retrospective analysis, and 10,953 (mean +/- standard deviation age 83.2 +/- 7.1; 31%) met the criteria of being able to ambulate independently or with an assistive device. All patients attempted to perform the modified Clinical Test of Sensory Integration and Balance plus either the Performance Oriented Measurement Assessment (POMA) or the Dynamic Gait Index (DGI). Mental function was scored as part of the Outcome and Assessment Information Set. A multivariate model with adjustment for age and sex identified gait performance as measured by the DGI to be independently associated with the likelihood that a patient required cognitive prompting (p = 0.03). Both the DGI and POMA scores were independently associated with requiring assistance/dependence with cognitive tasks. There was a strong relationship between cognition and gait performance in persons undergoing physical therapy interventions in the home. Changes in gait may be related to cognitive decline.
Professor in Physical Therapy, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260. whitney@pitt.edu.
Susan L
SL
Whitney
Gregory F
GF
Marchetti
Jennifer
J
Ellis
Laurie
L
Otis
Faisal
F
Asiri
Ahmad
A
Alghadir
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D057187:Independent Living; D008297:Male; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D012189:Retrospective Studies; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology*
Outcome and Assessment Information 
Set (OASIS); balance; cognition; falls; gait; home care; measurement; older adults; physical therapy; residence