Changes in executive functions and self-efficacy are independently associated with improved usual gait speed in older women
1 Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
2 Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
3 Department of Psychology, University of British Columbia, Vancouver, BC, Canada
4 Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
BMC Geriatrics 2010, 10:25 doi:10.1186/1471-2318-10-25Published: 19 May 2010
Improved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Thus, we examined the independent association of change in executive functions and change in falls-related self-efficacy with improved gait speed among community-dwelling senior women.
A secondary analysis of the 135 senior women aged 65 to 75 years old who completed a 12-month randomized controlled trial of resistance training. Usual gait speed was assessed using a 4-meter walk. Three executive processes were assessed by standard neuropsychological tests: 1) set shifting; 2) working memory; and 3) selective attention and response inhibition. A linear regression model was constructed to determine the independent association of change in executive functions and falls-related self-efficacy with change in gait speed.
Improved selective attention and conflict resolution, and falls-related self-efficacy, were independently associated with improved gait speed after accounting for age, global cognition, baseline gait speed, and change in quadriceps strength. The total variance explained was 24%.
Interventions that target executive functions and falls-related self-efficacy, in addition to physical functions, to improve gait speed may be more efficacious than those that do not.
ClinicalTrials.gov Identifier: NCT00426881