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Dementia, fall risk and routine clinical care: An opportunity to enhance care by incorporation of examiner independent computerized cognitive testing
Author(s) -
Kaczmarek Olivia,
Rosenfeld Yulia,
Chee Jordan,
Bumstead Barbara,
Zarif Myassar,
Anand Bhupinder,
Ofori Edward,
Gudesblatt Mark
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.054291
Subject(s) - cognition , dementia , falling (accident) , medicine , cognitive decline , cognitive test , visual memory , audiology , physical medicine and rehabilitation , psychology , gerontology , psychiatry , disease
Background Dementia is an encompassing term referring to multiple clinical conditions characterized by progressive cognitive impairment (CI) that interferes with an individual’s ability to function independently. Clinically, CI varies in degree and combination of cognitive deficits from memory loss, verbal impairment, apraxia to impaired executive function. Clinician recognition of such varied types/degrees of CI is likely problematic. Falls are common and their consequence costly in individuals with such cognitive impairment. Effective analysis of multiple aspects of cognitive function can be provided in routine care with a validated, examiner independent, sensitive and reliable computerized cognitive assessment battery, (CAB, Neurotrax) which specifically evaluates multiple cognitive domains (CD): Memory (MEM), Executive Function (EXE), Visual Spatial (VIS), Verbal Function (VER), Attention (ATT), Information Processing (INF), and Motor Skills (MOT) and a Global Cognitive Summary Score (GCS). Method Cross sectional analysis of PwDaD who underwent standardized CAB cognitive testing and were also screened for risk of falls based on number of falls in the past and persons fear of falling. Result 120 PwDaD, 57.5% female, average age 74 +/‐ 10 years. T‐tests were performed between CAB CD scores grouped by risk of falling (high/low). The following CD scores were associated with increased fall risk: GCS (p=<.05) and VIS (p=<.05). A significant increased fall risk was also associated with an accumulative CDI (# of individual cognitive domains impaired) (p=<.05). Conclusion As CAB measured cognition decreases PwDaD risk of falling increases. PwDaD at increased risk for falls had increased accumulative CI with an average of 3 CDI. PwDaD also at increased risk for falls have significantly lower GCS and Visual Spatial scores. Earlier identification of increased fall risk might allow clinicians an opportunity to effectively and pre‐emptively intervene to reduce such increased disability consequence and costs associated with this disease related impact.