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Exercise, Processing Speed, and Subsequent Falls: A Secondary Analysis of a 12-Month Randomized Controlled Trial.

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Title: Exercise, Processing Speed, and Subsequent Falls: A Secondary Analysis of a 12-Month Randomized Controlled Trial.
Authors: Liu-Ambrose, Teresa, Davis, Jennifer C, Falck, Ryan S, Best, John R, Dao, Elizabeth, Vesely, Kristin, Ghag, Cheyenne, Rosano, Caterina, Hsu, C L, Dian, Larry, Cook, Wendy, Madden, Kenneth M, Khan, Karim M
Source: Journals of Gerontology Series A: Biological Sciences & Medical Sciences; Apr2021, Vol. 76 Issue 4, p675-682, 8p
Subject Terms: CLINICAL trial registries, SECONDARY analysis, COGNITIVE ability, OLDER people, SPEED, TRAUMATOLOGY diagnosis, EXERCISE & psychology, PREVENTION of injury, RESEARCH, COGNITIVE processing speed, POSTURAL balance, HOME care services, RESEARCH methodology, COGNITION, GERIATRIC assessment, EVALUATION research, NEUROPSYCHOLOGICAL tests, COMPARATIVE studies, ACCIDENTAL falls, TRAUMA severity indices, BLIND experiment, RESEARCH funding, REACTION time, WOUNDS & injuries, EXERCISE therapy
Abstract: Background: Strength and balance retraining exercises reduce the rate of subsequent falls in community-dwelling older adults who have previously fallen. Exercise can also improve cognitive function, including processing speed. Given processing speed predicts subsequent falls, we aimed to determine whether improved processing speed mediated the effects of the Otago Exercise Program on the rate of subsequent: (i) total falls, (ii) non-injurious falls, (iii) moderate injurious falls, and (iv) serious injurious falls.Method: A secondary complete case analysis of a 12-month, single-blind, randomized clinical trial among 256 of 344 adults aged at least 70 years who fell in the previous 12 months. Participants were randomized 1:1 to receive usual care plus the Otago Exercise Program (n = 123) or usual care (n = 133), consisting of fall prevention care provided by a geriatrician. The primary outcome was self-reported number of falls over 12 months (ie, rate of falls). Processing speed was assessed at baseline and at 12 months by the Digit Symbol Substitution Test (DSST). Causal mediation analyses were conducted using quasi-Bayesian estimates and 95% confidence intervals.Results: Exercise significantly reduced the rate of subsequent moderate injurious falls (IRR = 0.49; 95% CI: 0.31, 0.77; p = .002) and improved processing speed (estimated mean difference: 1.16 points; 95% CI: 0.11, 2.21). Improved DSST mediated the effect of exercise on the rate of subsequent moderate injurious falls (estimate: -0.06; 95% CI: -0.15, -0.001; p = .036).Conclusion: Improved processing speed may be a mechanism by which exercise reduces subsequent moderate injurious falls in older adults who fell previously.Clinical Trials Registration Number: ClinicalTrials.gov Protocol Registration System:NCT01029171: https://clinicaltrials.gov/ct2/show/NCT01029171NCT00323596: https://clinicaltrials.gov/ct2/show/NCT00323596. [ABSTRACT FROM AUTHOR]
Copyright of Journals of Gerontology Series A: Biological Sciences & Medical Sciences is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Exercise, Processing Speed, and Subsequent Falls: A Secondary Analysis of a 12-Month Randomized Controlled Trial.
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  Data: Journals of Gerontology Series A: Biological Sciences & Medical Sciences; Apr2021, Vol. 76 Issue 4, p675-682, 8p
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  Data: <searchLink fieldCode="DE" term="%22CLINICAL+trial+registries%22">CLINICAL trial registries</searchLink><br /><searchLink fieldCode="DE" term="%22SECONDARY+analysis%22">SECONDARY analysis</searchLink><br /><searchLink fieldCode="DE" term="%22COGNITIVE+ability%22">COGNITIVE ability</searchLink><br /><searchLink fieldCode="DE" term="%22OLDER+people%22">OLDER people</searchLink><br /><searchLink fieldCode="DE" term="%22SPEED%22">SPEED</searchLink><br /><searchLink fieldCode="DE" term="%22TRAUMATOLOGY+diagnosis%22">TRAUMATOLOGY diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22EXERCISE+%26+psychology%22">EXERCISE & psychology</searchLink><br /><searchLink fieldCode="DE" term="%22PREVENTION+of+injury%22">PREVENTION of injury</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br /><searchLink fieldCode="DE" term="%22COGNITIVE+processing+speed%22">COGNITIVE processing speed</searchLink><br /><searchLink fieldCode="DE" term="%22POSTURAL+balance%22">POSTURAL balance</searchLink><br /><searchLink fieldCode="DE" term="%22HOME+care+services%22">HOME care services</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH+methodology%22">RESEARCH methodology</searchLink><br /><searchLink fieldCode="DE" term="%22COGNITION%22">COGNITION</searchLink><br /><searchLink fieldCode="DE" term="%22GERIATRIC+assessment%22">GERIATRIC assessment</searchLink><br /><searchLink fieldCode="DE" term="%22EVALUATION+research%22">EVALUATION research</searchLink><br /><searchLink fieldCode="DE" term="%22NEUROPSYCHOLOGICAL+tests%22">NEUROPSYCHOLOGICAL tests</searchLink><br /><searchLink fieldCode="DE" term="%22COMPARATIVE+studies%22">COMPARATIVE studies</searchLink><br /><searchLink fieldCode="DE" term="%22ACCIDENTAL+falls%22">ACCIDENTAL falls</searchLink><br /><searchLink fieldCode="DE" term="%22TRAUMA+severity+indices%22">TRAUMA severity indices</searchLink><br /><searchLink fieldCode="DE" term="%22BLIND+experiment%22">BLIND experiment</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH+funding%22">RESEARCH funding</searchLink><br /><searchLink fieldCode="DE" term="%22REACTION+time%22">REACTION time</searchLink><br /><searchLink fieldCode="DE" term="%22WOUNDS+%26+injuries%22">WOUNDS & injuries</searchLink><br /><searchLink fieldCode="DE" term="%22EXERCISE+therapy%22">EXERCISE therapy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Strength and balance retraining exercises reduce the rate of subsequent falls in community-dwelling older adults who have previously fallen. Exercise can also improve cognitive function, including processing speed. Given processing speed predicts subsequent falls, we aimed to determine whether improved processing speed mediated the effects of the Otago Exercise Program on the rate of subsequent: (i) total falls, (ii) non-injurious falls, (iii) moderate injurious falls, and (iv) serious injurious falls.<bold>Method: </bold>A secondary complete case analysis of a 12-month, single-blind, randomized clinical trial among 256 of 344 adults aged at least 70 years who fell in the previous 12 months. Participants were randomized 1:1 to receive usual care plus the Otago Exercise Program (n = 123) or usual care (n = 133), consisting of fall prevention care provided by a geriatrician. The primary outcome was self-reported number of falls over 12 months (ie, rate of falls). Processing speed was assessed at baseline and at 12 months by the Digit Symbol Substitution Test (DSST). Causal mediation analyses were conducted using quasi-Bayesian estimates and 95% confidence intervals.<bold>Results: </bold>Exercise significantly reduced the rate of subsequent moderate injurious falls (IRR = 0.49; 95% CI: 0.31, 0.77; p = .002) and improved processing speed (estimated mean difference: 1.16 points; 95% CI: 0.11, 2.21). Improved DSST mediated the effect of exercise on the rate of subsequent moderate injurious falls (estimate: -0.06; 95% CI: -0.15, -0.001; p = .036).<bold>Conclusion: </bold>Improved processing speed may be a mechanism by which exercise reduces subsequent moderate injurious falls in older adults who fell previously.<bold>Clinical Trials Registration Number: </bold>ClinicalTrials.gov Protocol Registration System:NCT01029171: https://clinicaltrials.gov/ct2/show/NCT01029171NCT00323596: https://clinicaltrials.gov/ct2/show/NCT00323596. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Journals of Gerontology Series A: Biological Sciences & Medical Sciences is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1093/gerona/glaa239
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        Text: English
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      – SubjectFull: CLINICAL trial registries
        Type: general
      – SubjectFull: SECONDARY analysis
        Type: general
      – SubjectFull: COGNITIVE ability
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      – SubjectFull: OLDER people
        Type: general
      – SubjectFull: SPEED
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      – SubjectFull: TRAUMATOLOGY diagnosis
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      – SubjectFull: EXERCISE & psychology
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      – SubjectFull: PREVENTION of injury
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      – SubjectFull: COGNITIVE processing speed
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      – SubjectFull: POSTURAL balance
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      – SubjectFull: ACCIDENTAL falls
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      – SubjectFull: TRAUMA severity indices
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      – SubjectFull: BLIND experiment
        Type: general
      – SubjectFull: RESEARCH funding
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      – SubjectFull: REACTION time
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      – SubjectFull: WOUNDS & injuries
        Type: general
      – SubjectFull: EXERCISE therapy
        Type: general
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      – TitleFull: Exercise, Processing Speed, and Subsequent Falls: A Secondary Analysis of a 12-Month Randomized Controlled Trial.
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              Text: Apr2021
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              Y: 2021
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