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Published on: December 9, 2014
Minimum toe clearance variability in older adults with mild cognitive impairment: Differences to healthy controls and
Berit K Labott1, Fabian Herold2, Corinna Langhans3
1Department of Sport Science, Faculty of Humanities, Otto-von-Guericke University, Magdeburg, Germany; Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany; Department of Neurology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany; University of Münster, Department of Neuromotor Behaviour and Exercise, Münster, Germany.
Background:
Falls in older adults with mild cognitive impairment (MCI) are a major health issue. For healthy individuals, higher variability in minimum toe clearance (MTC) during gait is associated with the risk of tripping-related falls and dance intervention reduces MTC variability. Such empirical evidence is lacking for individuals with MCI.
Research Question:
We aimed to assess differences in MTC variability between healthy older adults and older adults with MCI. Furthermore, we analysed the effects of a six-month dance intervention on MTC variability in older adults with MCI.
Methods:
We recruited community-dwelling cognitively healthy control participants (n = 34) and participants with MCI (n = 55). All participants underwent gait assessment using inertial sensors. In a cohort study, MTC variability of healthy vs. MCI participants was compared using Welch's t-test. There were no significant differences in the participant's characteristics except for cognitive performance. In a randomised controlled trial, participants with MCI were randomly allocated to either an intervention (IG, n = 27) or a passive control group (CG, n = 28). IG was required to attend a twice-weekly 90-minute dance program for six months. After six months, the gait assessment was repeated in both groups of MCI participants, and the effect of the dance intervention on MTC variability was assessed using 2-level random intercept models. Additionally, the mean MTC was analysed in a secondary analysis.
Results:
Adults with MCI exhibited a significantly higher MTC variability compared to healthy adults (p = .016, d = 0.53), but no difference was found in the mean MTC (p = .980, d < 0.01). The dance intervention did not improve either MTC variability (p = .182) or mean MTC (p = .742).
Significance:
The higher MTC variability in older adults with MCI compared to healthy controls may contribute to their higher fall risk. Future studies should investigate the effects of an individually tailored dance intervention, and other intervention approaches on MTC variability and fall risk.
