Associations Between Cognitive Function, Balance, and Gait Speed in Community-Dwelling Older Adults with COPD.

BACKGROUND AND PURPOSE: Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults. However, it is unknown whether a relationship exists between cognitive function and falls in patients with COPD. The aim of this study was to examine the relationships between cognitive function, balance, and gait speed in older adults with COPD. PATIENTS AND METHODS: A secondary analysis was performed using data from the 2010 wave of the Health and Retirement Study (HRS). Cognitive (immediate and delayed recall, executive function) and physical (gait speed, tandem balance time) measure data were extracted for older adults with COPD (n = 382) and an age-matched control group without COPD (n = 382) who met inclusion/exclusion criteria. Multivariate linear regression modeling was performed to examine associations between cognitive function and mobility or balance while controlling for age, gender, body mass index, grip strength, and education. RESULTS: In older adults with COPD, delayed recall was significantly associated with tandem balance performance (ß= 1.42, P < .05). Other cognitive measures were not associated with gait speed or balance. CONCLUSION: In older adults with COPD, one of four cognitive functions was associated with a static standing balance task. Screening of cognitive function, specifically delayed recall, should be a part of the management of falls in this population.

Use of activPAL to Measure Physical Activity in Community-Dwelling Older Adults: A Systematic Review.

Objective: To perform a systematic review of the literature to describe how the activPAL accelerometer has been used to measure physical activity (PA) in community-dwelling older adults to standardize collection of PA data in this population using this thigh-worn accelerometer. Data Sources: A comprehensive search of the following databases was completed: Cumulative Index to Nursing and Allied Health Complete, Embase, OVID Medicine, PubMed/Web of Science, and Scopus. Study Selection: Studies were included if published before August 1, 2020, were written in English, and used activPAL to measure PA in community-dwelling, noninstitutionalized adults 65 years or older. Titles and abstracts were independently reviewed, and the decision to include or exclude was made by 100% consensus. Data Extraction: Three research team members independently extracted the data from included studies. Extracted data were compared and discussed with relevant information included. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Data Synthesis: A total of 7 articles met the inclusion criteria. Three of the 7 studies used activPAL to report steps/d, ranging from 864-15847 steps/d. Time spent stepping or walking was reported by 4 studies using various units. Sit-to-stand transitions were reported by 4 studies, averaging 10-63 transitions/d. Sedentary time was assessed in 6 studies, whereas moderate to vigorous physical activity was not measured using activPAL in any study. Conclusions: The activPAL is most often used to collect data on step count and walking, sit-to-stand transitions, and sedentary time in community-dwelling older adults.