Acurácia de testes de mobilidade para o rastreio do risco de quedas no comprometimento cognitivo leve e doença de Alzheimer

Autores

DOI:

https://doi.org/10.1590/1809-2950/18006726032019

Palavras-chave:

Quedas, Cognição, Idosos

Resumo

A identificação de distúrbios da marcha e do equilíbrio em estágios iniciais da doença de Alzheimer (DA) e do comprometimento cognitivo leve (CCL) pode reduzir ou prevenir quedas na população idosa. Transversal, este estudo tem como objetivo determinar quais testes de mobilidade melhor discriminam o risco de quedas em idosos com CCL e DA leve. A mobilidade funcional foi avaliada pelo timed up and go test (TUG) e o teste de velocidade de marcha de 10 metros (10MWT). Foi produzido um calendário de quedas, com acompanhamento via contato telefônico durante 6 meses. Para o grupo CCL (n=38), o tempo gasto no 10MWT foi a melhor variável para discriminar caidores, com nota de corte de 10,69 segundos associada a maior precisão (76,3%). No grupo DA (n=37), a cadência do 10MWT foi a melhor variável para discriminar os caidores, com nota de corte de 101,39 passos por minuto associada a uma precisão de 81,1%. Como conclusão, o tempo e a cadência do 10MWT foram as variáveis mais precisas para rastrear o risco de quedas em idosos com CCL e DA leve, respectivamente. O 10MWT é um teste funcional, simples e fácil e pode ser amplamente utilizado na prática clínica.

Downloads

Os dados de download ainda não estão disponíveis.

Referências

Montero-Odasso M, Muir SW, Speechley M. Dual-task complexity

affects gait in people with mild cognitive impairment: the interplay

between gait variability, dual tasking, and risk of falls. Arch Phys

Med Rehabil. 2012;93(2):293-9. doi: 10.1016/j.apmr.2011.08.026

Chen S-F, Huang S-F, Lu L-T, Wang M-C, Liao J-Y, Guo J-L.

Patterns of perspectives on fall-prevention beliefs by

community-dwelling older adults: a Q method investigation.

BMC Geriatr. 2016;16:132. doi: 10.1186/s12877-016-0307-1

Borges SM, Radanovic M, Forlenza OV. Fear of falling and falls

in older adults with mild cognitive impairment and Alzheimer’s

disease. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn.

;22(3):312-321. doi: 10.1080/13825585.2014.933770

Castrillo A, Olmos LMG, Rodríguez F, Duarte J. Gait disorder

in a cohort of patients with mild and moderate alzheimer’s

disease. Am J Alzheimers Dis Other Demen. 2016;31(3):257-62.

doi: 10.1177/1533317515603113

Taylor ME, Delbaere K, Mikolaizak AS, Lord SR, Close JC. Gait

parameter risk factors for falls under simple and dual task

conditions in cognitively impaired older people. Gait Posture.

;37(1):126-30. doi: 10.1016/j.gaitpost.2012.06.024

American Geriatrics Society and British Geriatrics Society.

Summary of the updated American geriatrics society/british

geriatrics society clinical practice guideline for prevention of

falls in older persons. J Am Geriatr Soc. 2011;59(1):148-57. doi:

1111/j.1532-5415.2010.03234.x

Garcia-Pinillos F, Cozar-Barba M, Munoz-Jimenez M,

Soto-Hermoso V, Latorre-Roman P. Gait speed in older

people: an easy test for detecting cognitive impairment,

functional independence, and health state. Psychogeriatrics.

;16(3):165-171. doi: 10.1111/psyg.12133

Tiedemann A, Shimada H, Sherrington C, Murray S, Lord S.

The comparative ability of eight functional mobility tests for

predicting falls in community-dwelling older people. Age

Ageing. 2008;37(4):430-5. doi: 10.1093/ageing/afn100

Alexandre TS, Meira DM, Rico NC, Mizuta SK. Accuracy of timed

up and go test for screening risk of falls among communitydwelling elderly. Rev Bras Fisioter. 16(5):381-8. doi: 10.1590/

S1413-35552012005000041

Allan LM, Ballard CG, Rowan EN, Kenny RA. Incidence and

prediction of falls in dementia: a prospective study in older people.

PLoS ONE. 2009;4(5):e5521. doi: 10.1371/journal.pone.0005521

Coelho FG, Stella F, Andrade LP, Barbieri FA, Santos-Galduróz

RF, Gobbi S, et al. Gait and risk of falls associated with frontal

cognitive functions at different stages of Alzheimer’s disease.

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn.

;19(5):644-56. doi: 10.1080/13825585.2012.661398

Ansai JH, Andrade LP, Rossi PG, Takahashi ACM, Vale FAC,

Rebelatto JR. Gait, dual task and history of falls in elderly

with preserved cognition, mild cognitive impairment, and mild

Alzheimer’s disease. Braz J Phys Ther. 2017;21(2):144-51. doi:

1016/j.bjpt.2017.03.010

Lustosa LP, Silva JP, Coelho FM, Pereira DS, Parentoni AN,

Pereira LSM. Efeito de um programa de resistência muscular

na capacidade funcional e na força muscular dos extensores

do joelho em idosas pré-frágeis da comunidade: ensaio clínico

aleatorizado do tipo crossover. Rev. Bras Fisioter. 2011;15(4):318-24.

doi: 10.1590/S1413-35552011000400010

Novaes RD, Miranda AS, Dourado VZ. Usual gait speed

assessment in middle-aged and elderly Brazilian subjects.

Rev Bras Fisioter. 2011;15(2):117-122. doi: 10.1590/S1413-

Shumway-Cook A, Brauer S, Woollacott M. Predicting the

probability for falls in community-dwelling older adults using

the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.

Gibson MJS, Andres RO, Kennedy TE, Coppard LC. The

prevention of falls in later life. A report of the Kellogg

International Work Group on the Prevention of Falls by the

Elderly. Dan Med Bull. 1987;34 (Suppl. 4):1-24.

Sackett DL. A primer on the precision and accuracy of the

clinical examination. JAMA Netw Open. 1992;267(19):2638-44.

doi: 10.1001/jama.1992.03480190080037

Taylor ME, Ketels MM, Delbaere K, Lord SR, Mikolaizak AS,

Close JCT. Gait impairment and falls in cognitively impaired

older adults: an explanatory model of sensorimotor and

neuropsychological mediators. Age Ageing. 2012;41(5):665-9.

doi: 10.1093/ageing/afs057

Starr JM, Leaper SA, Murray AD, Lemmon HA, Staff RT, Deary

IJ, et al. Brain white matter lesions detected by magnetic

resonance [correction of resosnance] imaging are associated

with balance and gait speed. J Neurol Neurosurg Psychiatry.

;74(1):94-8. doi: 10.1136/jnnp.74.1.94

Cavanaugh JC, Blanchard-Fields F. Adult development and

aging. 7th ed. Belmont: Wadsworth; 2011.

Allali G, Annweiler C, Blumen HM, Callisaya ML, De Cock

Am, Kressig RW, et al. Gait phenotype from mild cognitive

impairment to moderate dementia: results from the GOOD

initiative. Eur J Neurol. 2016;23(3):527-41. doi: 10.1111/ene.12882

Blackwood J, Shubert T, Forgarty K, Chase C. Relationships

between performance on assessments of executive function

and fall risk screening measures in community-dwelling older

adults. J Geriatr Phys Ther. 2016;39(2):89-96. doi: 10.1519/

JPT.0000000000000056

Pedersen MM, Holt NE, Grande L, et al. Mild cognitive impairment

status and mobility performance: an analysis from the Boston

RISE study. J Gerontol A Biol Sci Med Sci. 2014;69(12):1511-8.

doi: 10.1093/gerona/glu063

Horikawa E, Matsui T, Arai H, Seki T, Iwasaki K, Sasaki H. Risk

of falls in Alzheimer’s disease: a prospective study. Intern Med.

;44(7):717-21. doi: 10.2169/internalmedicine.44.717

Herman T, Giladi N, Hausdorff JM. Properties of the ‘timed

up and go’ test: more than meets the eye. Gerontology.

;57(3):203-10. doi: 10.1159/000314963

Camicioli R, Bouchard T, Licis L. Dual-tasks and walking fast:

relationship to extra-pyramidal signs in advanced Alzheimer

disease. J Neurol Sci. 2006;248(1-2):205-9. doi: 10.1016/

j.jns.2006.05.013

Morris R, Lord S, Bunce J, Burn D, Rochester L. Gait and

cognition: mapping the global and discrete relationships in

ageing and neurodegenerative disease. Neurosci Biobehav

Rev. 2016;64:326-45. doi: 10.1016/j.neubiorev.2016.02.012

Holtzer R, Wang C, Verghese J. The relationship between

attention and gait in aging: facts and fallacies. Motor Control.

;16(1):64-80.

Yogev-Seligmann G, Hausdorff JM, Giladi N. The role of executive

function and attention in gait. Mov Disord. 2008;23(3):329-42.

doi: 10.1002/mds.21720

Downloads

Publicado

2019-03-04

Edição

Seção

Pesquisa Original

Como Citar

Acurácia de testes de mobilidade para o rastreio do risco de quedas no comprometimento cognitivo leve e doença de Alzheimer. (2019). Fisioterapia E Pesquisa, 26(3), 258-264. https://doi.org/10.1590/1809-2950/18006726032019