Relationship between dual task walking, cognition, and depression in oldest old people.

BACKGROUND: The purpose of the study was to investigate the relationship between dual task walking, cognition, and depression in oldest old people living in the community. METHODS: We conducted an observational cross-sectional study at Federal University of São Carlos (Brazil). We assessed 67 community-dwelling older adults aged 80 years and over, who were able to walk alone and did not present with a risk of dementia (assessed by Mini-Mental State Examination, MMSE). The assessment consisted of anamnesis, dual task using the Timed Up and Go test associated with a motor task (TUGT-motor) and a cognitive task (TUGT-cognitive); cognitive measures using MMSE, Montreal Cognitive Assessment (MoCA), Clock Drawing test (CDT) and verbal fluency, and depressive measures by the Geriatric Depression Scale (GDS). RESULTS: There was a correlation with higher magnitude between cognitive tests and TUGT-cognitive, compared to TUGT-motor. For TUGT-motor, the highest correlations with cognitive tests were found between time and MMSE, MoCA (total score), and MoCA visuospatial/executive domain. For TUGT-cognitive, the highest correlations with cognitive tests were between number of steps and MMSE and between time and MMSE. GDS showed a significant weak correlation with number of steps taken in TUGT-motor, wrong words, and correct/time of TUGT-cognitive. CONCLUSIONS: Dual task performances are associated with cognition in oldest old. Furthermore, dual task tests have less influence of educational level, are functional, fast, and easily applicable in clinical practice. Future studies are needed to confirm if dual task test is useful for cognitive screening in oldest old.

Relationship between balance and dual task walking in the very elderly.

AIM: To investigate the relationship between balance and dual task performance in adults aged over 80 years, and to analyze possible differences between fallers and non-fallers in dual task performance. METHODS: An observational cross-sectional study was carried out at the Federal University of São Carlos (Brazil). We assessed 67 community-dwelling older adults aged over 80 years who were able to walk. The volunteers were divided into groups of fallers and non-fallers. The one-leg standing and tandem tests were used to assess balance. Dual task was assessed by the Timed Up and Go test, associated with a motor task (TUGT-motor) and a cognitive task (TUGT-cognitive). Statistical analyses were carried out, and the significance level was set at α = 5%. RESULTS: Significant correlations were found between balance and dual task variables. Fallers took significantly more time and steps on both the TUGT-motor and the TUGT-cognitive, with no significant differences on balance tests between groups. CONCLUSIONS: Recognizing the influence of dual task walking on balance and fall risk could help health professionals to prevent falls in older adults, as well as optimize assessment and intervention planning.

The effect of gender on foot anthropometrics in older people.

CONTEXT: Some questions remain regarding the anthropometric differences between the feet of young men and women, but the gap is much greater when dealing with older adults. No studies were found concerning these differences in an exclusively older adult population, which makes it difficult to manufacture shoes based on the specific anthropometric measurements of the older adult population and according to gender differences. OBJECTIVE: To identify differences between the anthropometric foot variables of older men and women. DESIGN: Cross-sectional. PARTICIPANTS: 154 older women (69.0 ± 6.8 y) and 131 older men (69.0 ± 6.5 y). MAIN OUTCOME MEASURES: The foot evaluations comprised the variables of width, perimeter, height, length, 1st and 5th metatarsophalangeal angles, the Arch Index (AI), and the Foot Posture Index (FPI). A data analysis was performed using t test and a post hoc power analysis. RESULTS: Women showed significantly higher values for the width and perimeter of the toes, width of the metatarsal heads, and width of the heel and presented significantly lower values for the height of the dorsal foot after normalization of the data to foot length. The 1st and 5th metatarsophalangeal angles were smaller in the men. There were no differences between men and women with respect to AI and FPI. CONCLUSIONS: Overall, the current study shows evidence of differences between some of the anthropometric foot variables of older men and women that must be taken into account for the manufacture of shoes for older adults.

The relationship between the body mass index (BMI) and foot posture in elderly people.

We wanted to evaluate the postural characteristics of the feet of older people and their relationship with the BMI. We evaluated 227 older women and 172 older men with respect to the BMI, the arch index (AI) and the foot posture index (FPI). The obese women presented mean values for the AI significantly greater than those of the normal and overweight women. The means for some of the criteria of the FPI were significantly higher in the obese men. There was a positive correlation between the BMI and the AI and some of the FPI criteria. The conclusion was that obese women presented flatter feet while obese men presented more pronated feet, indicating a relationship between high BMI values and postural characteristics of the feet of subjects studied.

The relationship between wearing incorrectly sized shoes and foot dimensions, foot pain, and diabetes.

CONTEXT: Wearing inappropriate shoes can cause biomechanical imbalance, foot problems, and pain and induce falls. OBJECTIVE: To verify the prevalence of wearing incorrectly sized shoes and the relationship between incorrectly sized shoes and foot dimensions, pain, and diabetes among older adults. DESIGN: A cross-sectional study. PARTICIPANTS: 399 older adults (227 women and 172 men) age 60 to 90 y. MAIN OUTCOME MEASURES: The participants were asked about the presence of diabetes, pain in the lower limbs and back, and pain when wearing shoes. Foot evaluations comprised the variables of width, perimeter, height, length, first metatarsophalangeal angle, the Arch Index, and the Foot Posture Index. The data analysis was performed using a 2-sample t test and chi-square test. RESULTS: The percentage of the participants wearing shoe sizes bigger than their foot length was 48.5% for the women and 69.2% for the men. Only 1 man was wearing a shoe size smaller than his foot length. The older adults wearing the incorrect shoe size presented larger values for foot width, perimeter, and height than those wearing the correct size, but there were no significant differences between the groups with respect to the Arch Index and the Foot Posture Index. Incorrectly sized shoes were associated with ankle pain in women but not with diabetes. Men were more likely to wear incorrectly fitting shoes. The use of correctly sized shoes was associated with back pain in women. CONCLUSIONS: The use of incorrectly sized shoes was highly prevalent in the population studied and was associated with larger values for foot width, perimeter, and height and with ankle pain.

Obesidade em idosos do Município de São Carlos, SP e sua associaçãocom diabetes melito e dor articular / Obesity among older people of the City of São Carlos, SP, Brazil, and its association with diabetes mellitus and joint pain

Este estudo tem por objetivo verificar a prevalência de obesidade e sua associação com diabetes melito (DM) e dores articulares na população idosa residente em São Carlos, SP. Foram avaliadas 227 idosas (média de idade 69,6±6,8 anos) e 172 idosos (69,4±6,7 anos) quanto ao índice de massa corporal (IMC) e questionados quanto à presença de diabetes e dor articular. Os dados foram tratados estatisticamente. Os resultados mostram que 73,6% das idosas e 66,9% dos idosos apresentavam sobrepeso ou eram obesos. As médias de IMC foram maiores nos indivíduos com idade inferior a 75 anos. Entre as mulheres da amostra foi encontrada associação entre a presença de DM, dores no pé, tornozelo e joelho e a condição“obesa”. No grupo masculino, a condição obeso só apresentou associação com a presença de DM. Foi pois constatada associação entre obesidade e presença de DM. Mulheres idosas apresentam maior prevalência de obesidade e associação entre dores articulares e excesso de peso corporal.

The aim of this study was to assess prevalence of obesity and its association with diabetes mellitus (DM) and joint pain among elderly dwellers in the city of São Carlos, SP, Brazil. A total of 399 aged people – 227 women (mean age 69.6±6.8) and 172 men (mean age 69.4±6.7) – were assessed as to body mass index (BMI) and were questioned whether they had diabetes and joint pain. Data were statistically analysed. Results showed that 73.6% of the women and 66.9% of the men were overweight or obese; BMI values were higher in subjects aged under 75. Among women, associations were found between the obese condition, presenceof diabetes, and foot, ankle and knee pain. In the male group, the obese condition presented association only with presence of diabetes. An association was hence found between obesity and DM. Prevalence of obesity was greater in elderly women, who also presented association between joint pain and high BMI values.

The influence of arthritis on the anthropometric parameters of the feet of older women.

Age-related and arthritis-related foot modifications have been described in literature, but there is a lack of references that allow shoes to be designed on the basis of specific anthropometric measurements of older women. The aim of this study was to identify the anthropometric characteristics of the feet of elderly women with and without arthritis. This is an observational transversal study. The right and left feet of 227 older women aged between 60 and 90 years (69.6 + or - 6.8 years) were evaluated, of whom 45 reported a diagnosis of arthritis (non-osteoarthritis). The anthropometric evaluation of the feet comprised the variables of width, perimeter, height, foot length, first and fifth metatarsophalangeal angles, the arch-index and the foot posture index (FPI). The data were analyzed using the analysis of probability to compare the groups (arthritic and non-arthritic women). The differences between the means were significant in the case of the FPI and some of its criteria, such as the calcaneal frontal plane position, the bulge in the region of the talo-navicular joint and the forefoot alignment. The width of the right foot was also significantly greater in the women with arthritis. These results are preliminary findings that may help direct larger studies of foot characteristics among older adults with arthritis.

The relationship between foot pain, anthropometric variables and footwear among older people.

OBJECTIVE: To verify the prevalence of pain among older people when wearing shoes, and the relationships between foot pain, high-heeled shoes and anthropometric variables. METHOD: Both feet of 227 older women and 172 older men were evaluated with respect to anthropometric variables, arch index and foot posture index. The participants were also asked about the presence of foot pain while wearing high-heeled shoes. The data were analyzed using the Chi-square test, Pearson's correlation, MANOVA, multiple regression analysis, t test, and analysis of probability. FINDINGS: The prevalence of foot pain when wearing shoes was high and was associated with the female gender, however wearing high-heeled shoes was not associated with pain. The women with foot pain presented larger values for the circumferences of the metatarsal heads and the instep (after normalization with the foot length) than those without pain. The men with pain did not present different measurements from those without pain.

Equilíbrio estático e dinãmico em indivíduos senescentes e o índice de massa corporal / Static and dynamic balanc in older people and the body mass index

O estudo objetivou analisar o equilíbrio estático e o dinãmico em indivíduos senescentes e verificar sua associação com a idade e com o Índice de Massa Corporal (IMC). Foram avaliados 303 mulheres (62,97+-7,59 anos) e 51 homens (65,69+-7,49 anos) por meio do teste de Apoio Unipodal, teste de Velocidade Máxima ao Andar e cálculo do IMC. As mulheres mais velhas, com maior IMC e com pior desempenho no teste de equilíbrio dinãmico tiveram pior desempenho no teste de equilíbrio estático. Houve fraca correlação entr o tempo gasto no Teste de Velocidade Máxima ao Andar, IMC e idade. Homens com mais idade e pior desempenho no equilíbrio dinãmico também tiveram pior desempenho no equilíbrio estático e houve moderada correlação entre idade e equilíbrio dinâmico.