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Performance-based assessment of falls risk in older veterans with executive dysfunction

Performance-based assessment of falls risk in older veterans with executive dysfunction. Barbara L. Fischer, PsyD; William T. Hoyt, PhD; Lawrence Maucieri, PhD; Amy J. Kind, MD, PhD; Gail Gunter-Hunt, MSW; Teresa Chervenka Swader, MSW; Ronald E. Gangnon, PhD; Carey E. Gleason, PhD. Aim

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Performance-based assessment of falls risk in older veterans with executive dysfunction

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  1. Performance-based assessment of falls risk in older veterans with executive dysfunction Barbara L. Fischer, PsyD; William T. Hoyt, PhD; Lawrence Maucieri, PhD; Amy J. Kind, MD, PhD; Gail Gunter-Hunt, MSW; Teresa Chervenka Swader, MSW; Ronald E. Gangnon, PhD; Carey E. Gleason, PhD

  2. Aim • Examine whether Timed Up and Go (TUG) test detects potential fallers whose risk is associated with cognitive deficits. • Relevance • Falling is serious hazard for older veterans. • American Geriatrics Society (AGS) guidelines for screening for falls risk may be less successful with specific subgroups of patients.

  3. Method • Participants included 120 mostly male patients referred to Memory Assessment Clinic because of cognitive impairment. • Determined whether: • TUG tasks and AGS criteria were differentially associated with executive dysfunction. • TUG tasks identified potential fallers outside of those recognized by AGS criteria. • These tasks distinguished groups of fallers.

  4. Results • TUG-Cognition scores: • Were strongly associated with executive dysfunction. • Differed systematically between fallers grouped by number of falls.

  5. Results • TUG-Cognition scores were strongly associated with executive function • TUG-Cognition score discriminated between never/single and multiple fallers (avg. 3.72 sec.) • Patients uniquely identified by TUG-Cognition were older and less medically frail.

  6. Conclusion • Findings suggest that TUG-Cognition shows promise in identifying fallers whose risk is related to or compounded by cognitive impairment. • Future research should study predictive validity of these measures by following patients prospectively.

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