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Clin Interv Aging. 2013;8:175-84. doi: 10.2147/CIA.S37733. Epub 2013 Feb 15.

Older women with dementia can perform fast alternating forearm movements and performance is correlated with tests of lower extremity function.

Author information

  • 1Division of Geriatric Medicine, Department of Health Sciences, Lund University, Lund, Sweden. eva.bramell-risberg@med.lu.se

Abstract

BACKGROUND:

The purpose of this work was to study the performance and reliability of a test of fast alternating forearm movements and its relationship with measures of lower extremity function in older women with dementia.

METHODS:

Fast alternating movements was studied in 26 female patients (mean age 81.7 ± 5.9 years) with dementia and 34 controls (mean age 87.5 ± 4.7 years). Subgroup analyses for those aged 80-89 years were performed due to significant differences in the mean ages of the study groups. Test-retest reliability for alternating forearm movements was studied in 11 patients (mean age 80.3 ± 6.7 years) and 10 controls (mean age 87.4 ± 1.6 years). Pulses generated were transformed to an analog signal shown on a modified electrocardiogram. Numbers of cycles at 10 and 15 seconds were calculated for the right and left hand. Walking 2 × 15 m and the Get-Up-and Go (GUG) test were performed at self-selected and maximal speed. Associations between tests of upper and lower extremity function were sought in eight patients (mean age 85 ± 2.7 years) and 16 controls (mean age 85.1 ± 2.8 years) and also according to types of dementia in nine patients with probable Alzheimer's disease and 10 patients with other types of dementia.

RESULTS:

Patients with dementia could perform the test and had significantly fewer cycles (P = 0.02-0.006) at both 10 and 15 seconds compared with controls after age adjustment. A higher number of cycles was associated with higher self-selected walking speeds in patients (r = -0.79). Test-retest reliability for alternating forearm movements was high for both patients (intraclass correlation 0.88-0.94) and controls (intraclass correlation 0.74-0.94).

CONCLUSION:

Alternating forearm movements at fast speed can be used as a reliable test in both patients with dementia and healthy older subjects. The test can be used as a measure of bradykinesia and might be useful as a proxy for lower extremity function in older persons with dementia when testing of the lower extremities is not applicable due to walking disability.

KEYWORDS:

cognitive impairment; elderly; gait; upper extremity

PMID:
23439990
[PubMed - indexed for MEDLINE]
PMCID:
PMC3578443
Free PMC Article

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