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Amélioration de la détection et de la prévention de la chute chez la personne âgée au moyen de challenges cognitifs lors de la marche| old_uid | 9483 |
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| title | Amélioration de la détection et de la prévention de la chute chez la personne âgée au moyen de challenges cognitifs lors de la marche |
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| start_date | 2011/01/06 |
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| schedule | 10h30 |
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| online | no |
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| summary | The long-term objective of this proposal is to develop screening tools for early identification of future fall risk in the elderly and to evaluate new therapeutic interventions that would counteract the underlying pathological process. Falls are a major health concern and efforts are needed to address the causes of gait unsteadiness in elderly fallers. It is increasingly clear that walking is tightly linked to executive functioning, which refers to higher-level cognitive abilities that enable an individual to successfully engage in independent goal-directed behavior. Investigations using dual-tasking paradigms, where performance on attention-demanding tasks and walking is evaluated when they are performed separately and concurrently, suggest that executive changes play a role in the causal pathway of falls. Furthermore, alterations in the subtle but crucial fluctuations present from one stride to the next during walking seem to be sensitive markers of fall risk. It is possible that executive function decline is responsible for these changes in stride-to-stride variability, but this has not yet been investigated. Through the use of dual-task paradigms, this proposal will: Aim1/ disentangle the interrelationships between specific aspects of walking (e.g., step width variability vs. step length variability) and executive function components (e.g., planning, cognitive flexibility, response inhibition, and working memory). Because falls in the elderly is a multifactorial problem, outcomes will be adjusted for intrinsic risk factors (e.g., visual or hearing problems, muscular weakness, osteoarthritis or peripheral neuropathy) that contribute to falls; Aim 2/ identify cortical regions that overlap between the gait- and the cognition-related networks, and how these regions interact into distinct networks in relationship to the executive processes involved in dual-task paradigms proposed in Aim 1; Aim 3/ determine whether and how much nonlinear time series measures add to the predictive power and accuracy of the hospital falls risk screening tools ; and Aim 4/ investigate whether the addition of a dual-task challenge component, as part of a comprehensive multifactorial fall risk assessment and intervention, could result in a reduction of falls. |
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| responsibles | Hoffmann, Marin |
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