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Older Fallers With Poor Working Memory Overestimate Their Postural Limits

  • Teresa Liu-Ambrose
    Correspondence
    Correspondence to Teresa Liu-Ambrose, PhD, PT, 357-2647 Willow St, Vancouver, BC, V5Z 3P1, Canada
    Affiliations
    Centre for Hip Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada

    Department of Psychology, University of British Columbia, Vancouver, BC, Canada

    Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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  • Yasmin Ahamed
    Affiliations
    Centre for Hip Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada

    Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
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  • Peter Graf
    Affiliations
    Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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  • Fabio Feldman
    Affiliations
    Centre for Hip Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada

    Injury Prevention and Mobility Laboratory, School of Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
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  • Stephen N. Robinovitch
    Affiliations
    Centre for Hip Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada

    Injury Prevention and Mobility Laboratory, School of Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
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      Abstract

      Liu-Ambrose T, Ahamed Y, Graf P, Feldman F, Robinovitch SN. Older fallers with poor working memory overestimate their postural limits.

      Objective

      To compare the accuracy of perceived postural limits between older fallers with good working memory and those with poor working memory.

      Design

      Cross-sectional study.

      Setting

      Research laboratory.

      Participants

      Thirty-three community-dwelling older adults with a history of falls.

      Interventions

      Not applicable.

      Main Outcome Measures

      We measured the accuracy of perceived postural limits by using the perceived reach test in 33 fallers. The difference between the verbal digits forward test score and the verbal digits backward test score was used to provide an index of the central executive component of working memory. Participants were then allocated into 2 groups: (1) good working memory or (2) poor working memory. Comparisons of group characteristics and scores were undertaken by using Student independent-sample t tests for differences in means between those with good working memory and those with poor memory. One hierarchical linear regression model was constructed to determine the independent association of the central executive component of working memory with the accuracy of older fallers' perceived reach capacity.

      Results

      There was a significant difference in the mean percentage error in perceived reach between older fallers with good working memory and those with poor working memory (P=.01). The verbal digit span difference score was independently associated with the percentage error in perceived reach. The verbal digit span difference score resulted in an R2 change of 18.2% and significantly improved the regression model (F1,26 change, 7.45; P=.01).

      Conclusions

      Our novel results suggest that impaired executive functioning may increase falls risk by impairing older adults' judgment in motor planning for daily activities. However, future studies with larger sample sizes are needed to confirm our current results.

      Key Words

      List of Abbreviations:

      ABC (Activities-specific Balance Confidence), BDI (Beck Depression Inventory), MMSE (Mini-Mental State Examination), TUG (Timed Up & Go)
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