Cognição e subtarefas do Timed Up and Go em idosos preservados cognitivamente, com comprometimento cognitivo leve e doença de Alzheimer: um estudo longitudinal
Fecha
2022-04-29Autor
Ferreira, Ana Carolina Gonçalves Vilarinho
Metadatos
Mostrar el registro completo del ítemResumen
Background: Studies suggest that motor alterations are associated with a higher risk of
developing cognitive impairment in the elderly. However, no studies were found in the
literature that evaluated over time the relationship between specific cognitive domains and
functional mobility, nor how functional mobility can predict changes in the cognitive diagnosis
in cognitively preserved elderly people with mild cognitive impairment (MCI) and Alzheimer's
disease. Alzheimer's (AD). The Timed Up and Go (TUG) and its subtasks - getting up, walking
forward, returning, walking back, and turning to sit - is a test widely used in clinical practice to
assess functional mobility in the elderly and allows for the analysis of greater cognitive
resources. additional organization and planning during the walk, being challenging when
compared to straight-line walking tests. Aims: In this thesis two studies were developed: 1) The
first aimed to assess whether the measures of functional mobility of the TUG subtasks in elderly
people with different conitive profiles (cognitively preserved, MCI and AD) are related to
declines in cognitive domains (attention/orientation, memory, fluency, language, visuospatial
skills, and global cognitive performance) after 32 months. 2) The second study aimed to analyze
whether functional mobility, assessed by the TUG and its subtasks, predicts changes in the
cognitive diagnosis and compared the progression of the cognitive diagnosis of MCI, AD and
cognitively preserved after 32 months. Furthermore, it analyzed whether the initial performance
of the TUG and its subtasks showed similar characteristics among elderly people who worsened
or not in the cognitive diagnosis. Method: The volunteers were evaluated in relation to the
cognitive medical diagnosis by a specialized team. Cognitive functions were assessed by the
Addebrooke Cognitive Examination – Revised (ACE-R) and Clinical Assessment of Dementia
(CDR). Functional mobility was evaluated by TUG, associated with the motion capture system
using the Qualisys Track Manager software at two moments: M1 (initial moment evaluated
between January and September 2015 and diagnosed as cognitively preserved, MCI or AD) and
M2 (after 32 months evaluated between September 2017 and May 2018).Results: These studies
showed that the return subtask had a positive relationship with decline in most cognitive
domains, except verbal fluency, and total scores of global cognitive functions, as assessed by
ACER after 32 months.
It was also observed that the initial performance in time and cadence of the TUG, the average
speed in the forward gait subtask and the number of steps in the return gait were able to predict
changes in the cognitive diagnosis after a period of 32 months. In addition, in this same period,
most of the elderly maintained or improved the cognitive diagnosis and this same elderly had a
shorter TUG time when compared to the group that had a worsening of the cognitive diagnosis.
Conclusions: The cognitive impairment caused by MCI and AD can promote a decline in
functional mobility not only in more advanced stages of the disease, but also in pre-dementia
stages, such as MCI or mild AD stage. Therefore, a clinical assessment of functional mobility
using the TUG and its subtasks can contribute to the understanding of the progress of cognitive
changes in elderly people with MCI, AD and cognitively preserved. Thus, health professionals,
especially physical therapists, can have a better understanding of the evolution of AD and MCI
by developing care strategies to delay the progression of functional mobility and the consequent
impact on the lives of these elderly people.
Colecciones
El ítem tiene asociados los siguientes ficheros de licencia: