The Impact of Dual-Tasks and Disease Severity on Posture, Gait, and Functional Mobility among People Living with Dementia in Residential Care Facilities: A Pilot Study.

Gait speed and timed-up-and-go (TUG) predict cognitive decline, falls, and mortality. Dual-tasks may be useful in cognitive screening among people living with dementia (PWD), but more evidence is needed. This cross-sectional study aimed to compare single- and dual-task performance and determine the influence of dementia severity on dual-task performance and interference. Thirty PWD in two residential care facilities (Age: 81.3 ± 7.1 years; Montreal Cognitive Assessment: 10.4 ± 6.0 points) completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backward), single- (walk 4 m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)), and dual-task functional mobility (TUG while completing a category task) with APDM inertial sensors. Dual-tasks resulted in greater sway frequency, jerk, and sway area; slower gait speed; greater double limb support; shorter stride length; reduced mid-swing elevation; longer TUG duration; reduced turn angle; and slower turn velocity than single-tasks (ps < 0.05). Dual-task performance was impacted (reduced double limb support, greater mid-swing elevation), and dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild PWD. Moderate-to-severe PWD had poorer dynamic stability and a reduced ability to appropriately select a cautious gait during dual-tasks than those with mild PWD, indicating the usefulness of dual-tasks for cognitive screening.

Analysis of Factors Influencing Financial Cost and Morbidity in Nonfatal Firearm Injuries.

Representing 68% of firearm-related injuries, nonfatal firearm injuries cause substantial morbidity and are associated with high costs to patients and the health care system. A retrospective analysis was performed to evaluate 359 adults in the Southeastern United States from 2019 to 2021. IBM SPSS was used for descriptive and parametric statistical analysis. The mean total cost of stay (TCOS) was $36,639.12, length of stay (LOS) was 8.61 days, number of times to the operating room was 1.88, and number of follow-ups was 3.21. Vascular and traumatic brain injuries were associated with higher TCOS and LOS. Vascular injuries were associated with more operating room visits. Bony injuries and non-TBI neurological injuries were associated with more follow-up appointments. In this brief report, we aim to understand the effect injury types have on these factors to help inform trauma protocol development with the goal of decreasing financial burdens.