Cognitive performances better identify fallers than mobility assessment among older adults with fear of falling.

BACKGROUND: Half of the people with fear of falling (FoF) are non-fallers, and the reason why some people considered non-fallers are afraid of falling is unknown, but reduced mobility or cognition, or both concurrently must be considered as potential risk factors. AIM: The study aimed to determine if mobility and/or cognitive abilities could identify people with a history of falls in older adults with FoF. METHODS: Twenty-six older adults with FoF participated in this study. Full cognitive and mobility assessments were performed assessing global cognitive impairments (MoCA score < 26), executive functions, memory, processing speed, visuospatial skills, mobility impairment (TUG time > 13.5 s), gait, balance and physical capacity. Information about falls occurring during the year prior to the inclusion was collected. Logistic regression analyses were performed to explore the association between falls and cognitive and mobility abilities. RESULTS: No significant differences in age, sex, level of education or body mass index were detected between fallers and non-fallers. Cognitive impairments (MoCA score < 26) distinguished between fallers and non-fallers (p = 0.038; R2 = 0.247). Among specific cognitive functions, visuospatial skills distinguished between fallers and non-fallers (p = 0.027; R2 = 0.258). Mobility impairments (TUG time > 13.5 s), gait, balance and physical capacity were not related to past falls. DISCUSSION/CONCLUSION: In older adults with FoF, global cognitive deficits detected by the MoCA are important factors related to falls and more particularly visuospatial skills seem to be among the most implicated functions. These functions could be targeted in multifactorial interventions.

Review: verbal agitation in dementia: the role of discomfort.

Verbal agitation (VA) is a disturbing and commonly observed behavioral symptom in people with dementia. Although several different variables contribute to VA, it seems that discomfort plays an important role. The overall objective of this article is to review the relationship between VA and discomfort among people with dementia. Specifically, this article discusses the place of discomfort within the conceptualizations of VA, empirical support for the association between discomfort and VA, and practical implications of this relationship in the assessment and treatment of VA. This article contributes to a better understanding of VA and provides recommendations for prevention and effective intervention.

RGC sensitivity to mild systemic hypoxia.

PURPOSE: Systemic hyperoxia, hypercapnia, and hypoxia are known to alter retinal perfusion. The effects such experimentally induced systemic blood gas perturbations have on inner neuroretinal function in humans were examined. METHODS: Twenty healthy adults participated in each of three test sessions. The effects of breathing pure oxygen (O2), carbogen, or a hypoxic gas on the pattern electroretinogram (pERG) were investigated. The stimulus consisted of high-contrast, black-and-white, 48-min arc checks reversing at 1 Hz. pERGs were recorded with a Dawson-Trick-Litzkow electrode at the end of 5 minutes of breathing room air, 5 minutes of breathing the test gas, immediately after the flow of gas was stopped, and 10 minutes after the flow of gas was stopped. RESULTS: Amplitudes and implicit times of the major positive (P50) and negative (N95) components of the pERG were not altered during the pure O2 and carbogen breathing sessions. Although the amplitude and implicit time of P50 were not modified significantly with systemic hypoxia, they were depressed and delayed, respectively, for N95. CONCLUSIONS: Inner neuroretinal function remained unchanged during increased blood O2 and carbon dioxide levels known to alter retinal blood flow, but it was altered during decreased blood O2 levels. Overall, these results indicate that the generators of P50 are resistant to systemic hyperoxia, hypercapnia/hyperoxia, and hypoxia. They further indicate that the generators of N95, namely the retinal ganglion cells, are particularly sensitive to transient, mild systemic hypoxia.