The effects of balance training with or without cognitive training in older adults with MCI and impaired mobility

Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function and dementia. The rate of progression of MCI to dementia in older adults has been found to be between 10-12% per year, whereas those without cognitive impairment acquire dementia at a rate of only 1-2% per year. MCI has been linked to poor dual-tasking, impaired balance and functional mobility, and is a significant risk factor for falls. Individuals with MCI need preventive therapies that target both the cognitive and mobility-related outcomes. Dr. Jehu has identified pairing targeted dual-tasking training with balance and mobility training as a promising  preventative therapy.

In recent research, balance and mobility training (BMT), and balance and mobility plus cognitive training (BMT+C) programs have been shown to improve dual-tasking and functional mobility in the healthy older adult population; however no previous interventions have targeted dual-task training in individuals with MCI. Dr. Jehu will extend this work to individuals with MCI in order to improve cognitive and mobility outcomes. The BMT and BMT+C interventions will determine whether individuals with MCI can reverse cognitive and functional declines and improve to healthy older adult norms.

The timed up & go (TUG) is a commonly used clinical functional mobility assessment tool. TUG has been shown to be an independent predictor of cognitive decline following an ischemic stroke, and has accurately differentiated between healthy older adults and older adults with MCI. Dr. Jehu aims to use TUG to improve the diagnostic interpretation of important clinical measures used to evaluate individuals with MCI.

Dr. Jehu’s research may serve to improve the interpretation of clinical diagnostic tools, which could revolutionize the prescription of exercise in older adults with MCI and improve the overall interpretation of commonly used clinical assessment tools.

End of Award Update: April 2022

Most exciting outputs

In our study Sex differences in subsequent falls and falls-risk: A prospective cohort study in older adults (Gerontology, 2021), we found that modifiable risk factors related to cognition, physical function, psychological wellbeing, and health status predicted subsequent falls. In males, better mobility was not as protective of falls compared with females. This may be due to males’ poorer executive function, contributing to decreased judgement or slowed decision-making during mobility. These results may inform efficacious sex-specific falls prevention strategies.

Impacts so far

I would not have obtained a position as an assistant professor without my Health Research BC / Vancouver Coastal Health Research Institute Research fellowship. I am confident that the experience I had working with Dr. Teresa Liu-Ambrose provided me with the skills I needed to secure a job.

Potential future influence

During my fellowship, I learned the skills needed to become an independent researcher. Some skills include randomized controlled trial design, implementation science methods, how to conduct systematic reviews, skills in cognitive testing, grant writing, and working with patient populations such as older adults who fall and those with cognitive impairment

Next steps 

I am now an assistant professor at Augusta University in Augusta Georgia. I was recently awarded an intramural grant to examine the effects of 6 months of exercise on cognition among people living with dementia. I am thrilled to be leading a team of interdisciplinary researchers and healthcare professionals.

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