PHYSICAL PERFORMANCE AND ADVERSE HEALTH EVENTS IN OLDER ADULTS WITH DEMENTIA

Community-dwelling older adults with dementia are at increased risk for adverse health events, including falls. Physical performance measures, including gait speed, short physical performance battery (SPPB) and performance-oriented mobility assessment (POMA), may help clinicians better understand the occurrence of falls and health events in older adults with dementia. An in-home physical performance assessment was conducted in 82 older adults with dementia (mean Mini Mental Status Exam (MMSE) = 16.41) at baseline. Adverse health events were collected (via caregiver report) one month later, defined as a fall or health occurrence requiring medical attention. All participants were in the non-intervention stage of an exercise intervention study (Reducing Disabilities in Alzheimer’s Disease). At baseline, physical performance measures included gait speed (m/sec), SPPB, and POMA. Participants demonstrated impaired lower extremity function and high fall-risk (mean gait speed = 0.73 m/s, SPPB = 6.89, POMA = 22.84). At one-month follow-up, 18 (22%) participants had an adverse health event. Interestingly, participants with adverse health events had higher baseline scores on the SPPB (mean =8.28) compared to those without an adverse health event (mean = 6.61) (p = 0.048), and were slightly younger (mean=77.01 vs. 80.93; p = 0.05). There were no statistically significant differences in MMSE or gender (male =50% vs. 61%) between the two groups. This group of participants with higher health events may represent older adults with cognitive impairment who remain active despite elevated fall risk. This finding is important for clinical care and the development of health services for older adults with dementia.