Research Endeavors

Attention Status in Fall Risk in Older Adults
Principal Investigator: Lisa Riolo, PhD, PT
Funding Source: Veterans Affairs Rehabilitation Research & Development E2121

This three-year project will address the following research questions. 1) Do older people with a history of falling navigate an obstacle course more slowly and with more errors (trips, stops, coming in contact with objects) than age-matched controls? 2) What effect does performing a working memory task have on negotiating an obstacle course? 3) What is the relationship between visual attention and time to navigate an obstacle course? 4) How much variation of fall risk can be explained by a set of risk factors as predictor variables? 5) What factors exist that provide a parsimonious description of the relationships among fall risk predictors?

Many falls occur in older adults without identifiable causes. Inattention to a cluttered environment may be a previously unstudied cause for falls. If multi-task conditions are difficult for the aging population, then falls are going to be common unless elderly people receive training to increase attention or to reduce clutter in their environments. If a relationship between visual attention and/or working memory and difficulty negotiating an obstacle course is identified, we will develop and test interventions directed at these deficits in order to reduce fall risk. Thus, this line of research has potential to reduce the disability and injury related to falls in the aging population. Future studies will: 1) develop and test the effects of rehabilitative interventions directed at attention and working memory on fall risk and 2) validate the model of fall risk using a prospective study of fall occurrence.

The Impact of Environment on the Assessment of Dementia
Principal Investigator: Steve Hoppes, PhD, OTR

The purpose of this pilot study was to use a standardized assessment of independent living skills to explore the effects of environment on functional performance of individuals with dementia. Twelve participants (6 males, 6 females), diagnosed with dementia, were given the Structured Assessment of Independent Living Skills (SAILS). Participants were assessed in their homes, in an adult day-services facility they regularly attended, and in an occupational therapy clinic.

Data were analyzed using repeated measures analysis of variance (ANOVA). There was no evidence of a learning effect from repeated assessments. Participants' performances did not differ (p > .05) on any of the four subscales of the SAILS (motor, cognitive, instrumental activities, and social interaction) between the clinic and the adult day-service facility. Neither did participants' performances differ (p > .15) on three subscales (cognitive, instrumental activities, and social interaction) in the home, clinic, and adult day-services facility. However, participants' performance on the SAILS motor score was significantly higher in the home than in the clinic (p = 0.014).

Participants' motor performance was significantly better at home than in an unfamiliar environment. Effects of environment on motor performance, and absence of effects on cognitive, instrumental, and social performances, can be explained through ecological theory. These results suggest that the ability to adapt movement to an unfamiliar environment may decline with the onset and progression of dementia.