Introduction: The disruption of postural control is one factor that can lead to falls for the geriatric population. Dual tasking can increase the likelihood of a fall for this population. Finding effective ways to lower falls in the geriatric population may increase quality of life. Hydrotherapy is a new therapeutic practice to increase balance performance. Purpose: The purpose is to determine the effectiveness of a six-week hydrotherapy program and its effects on dual-tasking, postural control, and balance in a geriatric population. Methods:11 elderly adults completed static/dynamic balance test with a Stroop Color and Word Test pre/post 6 weeks of dual-tasking balance training either in a land-based (LB) or hydrotherapy (HYDRO) group. Results:Both groups improved in dual tasking responses and overall static and dynamic balance. Conclusions: Both LB and HYDRO may show improvements in static and dynamic balance while under a dual tasking condition. The HYDRO group showed greater improvements in movement time after six weeks.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第22389号 / 人健博第75号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 黒木 裕士, 教授 桂 敏樹, 教授 横出 正之 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Performance on the Spatial Span subtest of the Wechsler Memory Scale has been viewed as an indicator of working memory and visuospatial processing. A number of factors including age and gender have been posited to effect performance on Spatial Span by older adults. The current study examined the impact of various forms of cognitive impairment and severity of impairment on Spatial Span performance. Five hundred thirty-eight individuals between the ages of 65 and 89 were evaluated in a university memory disorders clinic using a battery of neuropsychological tests that included Spatial Span. Participants were grouped by consensus diagnosis into type of cognitive impairment (Alzheimer's disease, vascular disease, amnestic mild cognitive impairment or non-amnestic mild cognitive impairment) or cognitively normal. As expected, an increase in severity of impairment results in a decrease in Spatial Span Total Score. Other findings included a weak relationship between age and Spatial Span Total Score. Gender, as well as age, did not fully account for the decline in Spatial Span Total Score. Spatial Span Forward score was not as good a predictor of severity in that reduction in score for Spatial Span Forward remains relatively stable regardless of level of impairment. Spatial Span Backward performance was found to be more sensitive to severity. No significant differences were found between performance of Alzheimer's disease and vascular disease suggesting they share similar deficit patterns with regard to the cognitive abilities measured by the Spatial Span subtest. A comparison between those diagnosed with mild cognitive impairment and individuals without such a diagnosis showed no significant difference suggesting that visuospatial processes are not affected early in the dementing process.

Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...

Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...