G.K. Sudario1, D. Lipardo2
1Doña Remedios Trinidad Romualdez Medical Foundation, Department of Physical Therapy, College of Biomedical Sciences, Tacloban City, Philippines, 2University of Santo Tomas, Department of Physical Therapy, College of Rehabilitation Sciences, Sampaloc, Manila, Philippines
Background: Older adults in nursing homes are at a higher risk of developing problems in functional mobility and cognition compared to community-dwelling older adults. The link between functional mobility and cognition of older adults living in nursing homes is not fully recognised and appreciated by health care professionals, regular staffs, and volunteers.
Purpose:
1) To determine the prevalence of probable cognitive impairment; 2) to identify the common functional problems in terms of dynamic balance and gait speed; and 3) to determine the association between functional mobility and cognition among older adults living in nursing homes.
Methods: This descriptive observational study with correlational design recruited institution-based older adults from three nursing homes in Leyte, Philippines. The Montreal Cognitive Assessment (MoCA) was used to examine cognitive function; the Timed-up and Go Test (TUG) was used for dynamic balance and functional mobility ; and the 10-Meter Walk Test (10MWT) was used for gait speed. Pearson Product Moment Coefficient Correlation was used to determine the association between functional mobility and cognitive function. Simple linear regression analysis was employed to determine the intensity and direction of association and level of significance of functional mobility and cognitive function. Multivariate linear regression analysis was used to examine the relationship of adjusted covariates that influence functional mobility and cognitive function. Statistical significance was set at (p<0.05).
Results: Thirty older adults, with a mean age of 73.0 ± 9.07 years (60% female) participated in this study. The prevalence of probable cognitive impairment (score of < 26 in MoCA) was 90%, which was predominant in > 70 years old and male (91.6 %). The common functional problems were impairment in dynamic balance and mobility at 70% with the mean of TUG score of 20.5 ± 16.1 s, and gait speed at 73.3% with the mean velocity of 0.9 ± 0.6 m/s in preferred speed and 1.2 ± 0.7 m/s in fastest speed of 10MWT. There was significant correlation between cognitive function (MoCA) and TUG manual (r=-.731, p< .001), cognitive function and preferred speed (r=-.629, p<.001) of 10MWT, and cognitive function and fastest speed (r=-.573, p = .001) of 10MWT.
Conclusion(s): Cognitive impairment is highly prevalent in nursing homes. Institution-based older adults showed impaired dynamic balance and slow speed. Significant correlation between functional mobility problems and cognitive decline in institution-based older adults was established. The development and implementation of Physical Therapy interventions that can maintain and enhance physical and cognitive functions should be an integral part of older adult’s daily activities.
Implications: Health care professionals, regular staffs, and volunteers in nursing homes, not only from Leyte, Philippines but also in other countries, should be aware of the problems in functional mobility and cognition of institution-based older adults by conducting regular screening such that appropriate physical therapy intervention programs are implemented to mitigate the effects of functional decline and cognitive impairment in this geriatric population.
Funding, acknowledgements: This paper was funded by K to 12 Transition Program of the Commission on Higher Education, Manila, Philippines.
Keywords: Institution-based older adults, Functional decline, Cognitive impairment
Topic: Older people
Did this work require ethics approval? Yes
Institution: University of Santo Tomas
Committee: University of Santo Tomas Graduate School Ethics Review Committee
Ethics number: GS-2017-PN 108
All authors, affiliations and abstracts have been published as submitted.
