Study Provides Evidence that Falls Screening Should Assess Executive, as well as Physical, Function

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Dr. Teresa Liu-Ambrose, PhD, PT, Associate Professor, is a Canada Research Chair and a Peter Wall Institute Scholar at the University of British Columbia,Department of Physical Therapy. She directs the Aging, Mobility and Cognitive Neuroscience Laboratory as well as the Vancouver General Hospital’s Falls Prevention Clinic. Her research program focuses broadly on defining the role of targeted exercise training to improve the health and quality of life of older adults. In particular, her research program aims to optimize function among those at particular risk for both physical and cognitive decline.

ElderBranch interviewed Dr. Liu-Ambrose to discuss her paper, “Overall reductions in functional brain activation are associated with falls in older adults: an fMRI study.” Dr. Liu-Ambrose wrote the paper along with Dr. Lindsay Nagamatsu, Dr. Lara Boyd, Dr. Chun Liang Hsu, and Dr. Todd Handy, all of the University of British Columbia.

Mobility and balance clearly can increase a senior’s risk of falling. How does cognitive function play into falls risk?

Cognitive processes such as attention, planning, and decision making are vital to ensuring safe mobility. For example, not paying attention to your physical environment can increase your risk of falling.

Please describe your study and how this builds upon your previous work.

In our study, we used a neuroimaging technique called functional magnetic resonance imaging, to see if there are differences in how the brain functions while performing a simple attention task between older fallers and non-fallers.

Please describe the key findings from your research.

We found that compared with non-fallers, older fallers demonstrated reduced activation of a brain region that supports planning, reasoning, and motor planning. Importantly, such cognitive functions are essential for safe mobility and supports our past research that showed older fallers have poor decision making and judgment when crossing a simulated virtual street.

What do you see as the main implications from your finding that executive cognitive functions play a critical role in falls risk in older adults?

The main implications are: falls screening should include the assessment of executive functions, in addition to the assessment of physical abilities (e.g., leg strength, balance) and medication interactions.

Can your results be used to help identify seniors with higher falls risk and take steps to reduce that risk?

Yes, I believe so. An older adult who has both impaired executive functions and impaired physical function would be at greater risk for falls than an older adult with only impaired physical function.

What do you see as the next steps to further your work in this area?

We are assessing whether strategies that improve executive functions would result in lower falls risk.

Source: ElderBranch

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