title: A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact Black older adults.
abstract: BACKGROUND
  Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest declines in executive function experience more falls. The purpose of this study was twofold: to demonstrate the feasibility of a community-based cognitive training program for cognitively intact Black older adults and to analyze its impact on gait and balance in this population.
  
  
  METHODS
  This pilot study used a pretest/posttest randomized trial design with assignment to an intervention or control group. Participants assigned to the intervention completed a computer-based cognitive training class that met 2 days a week for 60 min over 10 weeks. Classes were held at senior/community centers. Primary outcomes included balance as measured by the Berg Balance Scale (BBS), 10-meter gait speed, and 10-meter gait speed under visuospatial dual-task condition. All measures were assessed at baseline and immediately post-intervention.
  
  
  RESULTS
  Participants were community-dwelling Black adults with a mean age of 72.5 and history of falls (N = 45). Compared to controls, intervention participants experienced statistically significant improvements in BBS and gait speed. Mean performance on distracted gait speed also improved more for intervention participants compared to controls.
  
  
  CONCLUSIONS
  Findings from this pilot randomized trial demonstrate the feasibility of a community-based cognitive training intervention. They provide initial evidence that cognitive training may be an efficacious approach toward improving balance and gait in older adults known to have a history of falls.
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA rsmith27@uic.edu.
authors.forename: Renae L
authors.initials: RL
authors.lastname: Smith-Ray
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Makowski-Woidan
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hughes
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D003153:Community Health Services; D005684:Gait; D006293:Health Promotion; D006299:Health Services for the Aged; D006801:Humans; D004856:Postural Balance; D014481:United States
keywords: aging and health; community health; computer-mediated health promotion; health behavior new media and social media interventions