Smith-Ray Renae L, Hughes Susan L, Prohaska Thomas R, Little Deborah M, Jurivich Donald A, Hedeker Donald
Center for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago.
Center for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago. Community Health Sciences, School of Public Health, University of Illinois at Chicago.
J Gerontol B Psychol Sci Soc Sci. 2015 May;70(3):357-66. doi: 10.1093/geronb/gbt097. Epub 2013 Nov 5.
Cognitive processing plays an important role in balance and gait and is a contributing factor to falls in older adults. This relationship may be explained by the fact that higher order cognitive functions such as executive functions are called upon while walking. The purpose of this study was to examine whether a cognitive training intervention leads to significant improvements on measures of balance and gait.
This randomized trial tested whether cognitive training over 10 weeks improves balance and gait in older adults. Participants were randomly assigned to a computer-based cognitive training intervention or measurement-only control. Outcomes included Timed Up and Go (TUG), gait speed, and gait speed with a cognitive distraction. Data were analyzed using analysis of covariance models with change scores.
Participants' (N = 51) average age was 82.7 for those randomized to intervention and 81.1 for those randomized to control. After 10 weeks, intervention group participants performed significantly better than controls on the TUG. When the cohort was limited to those categorized as slow walkers (baseline 10-m walk ≥ 9 s), intervention participants performed significantly better than controls on TUG and distracted walking.
Cognitive training slows degradation of balance and improves gait while distracted, rendering it a promising approach to falls prevention.
认知加工在平衡和步态中起着重要作用，是导致老年人跌倒的一个因素。这种关系可能是由于在行走时需要调用诸如执行功能等高级认知功能。本研究的目的是检验认知训练干预是否能显著改善平衡和步态指标。
这项随机试验测试了为期10周的认知训练是否能改善老年人的平衡和步态。参与者被随机分配到基于计算机的认知训练干预组或仅进行测量的对照组。结果包括定时起立行走测试（TUG）、步态速度以及存在认知干扰时的步态速度。使用具有变化分数的协方差分析模型对数据进行分析。
随机分配到干预组的参与者（N = 51）平均年龄为82.7岁，随机分配到对照组的参与者平均年龄为81.1岁。10周后，干预组参与者在TUG测试中的表现明显优于对照组。当队列仅限于那些被归类为慢行者（基线10米步行时间≥9秒）时，干预组参与者在TUG测试和有干扰的行走测试中的表现明显优于对照组。
认知训练可减缓平衡能力的下降，并在有干扰的情况下改善步态，使其成为预防跌倒的一种有前景的方法。
