Abstract

Background and Purpose

Alzheimer disease (AD) is the most common form of dementia and the sixth leading cause of death in the United States. Falls are associated with AD and can lead to injury. The Balance Evaluation Systems Test (BESTest) is a balance measure used in other neurological conditions to predict fall risk. The purpose of this study is to examine the relationship between MiniBestest, BESTest, and BESTest subsection scores and fall incidence among individuals with a diagnosis of mild AD.

Methods

The study was a single centre, prospective, observational cohort study. Participants completed baseline questionnaires including a demographic form, a fall history questionnaire and the Barthel Index of Activities of Daily Living (ADLs). Balance and gait were assessed using the MiniBESTest and BESTest. After completing baseline assessment, participants were given monthly fall calendars to track falls for the next 12 months.

Results

MiniBESTest total raw score for fallers was 13.4 out of 28 (SD = 3.6) and for non-fallers was 18.4 of out 28 (SD = 3.7). MiniBESTest total percentage score for fallers was 47.8% (SD = 12.8%) and for non-fallers was 65.5% (SD = 13.1%). BESTest total percentage scores for fallers was 58.2% (SD = 3.9%) and for non-fallers was 73.9% (SD = 7.9%). Subsections II-IV of the BESTest correlated with faller status.

Discussion and Conclusions

Among individuals with mild AD, fall status was associated with certain balance deficits on the BESTest including moving body outside base of support (subsection II), changing centre of mass (subsection III), and reacting to external perturbations (subsection IV). Future studies could explore differences between AD and other neurological conditions and how physical therapy could improve these areas to reduce fall risk.

中文翻译：

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阿尔茨海默病跌倒与平衡评估系统测试 (BESTest) 和 MiniBESTest 得分之间的关​​联

摘要

背景和目的

阿尔茨海默病 (AD) 是最常见的痴呆症形式，也是美国第六大死因。跌倒与 AD 相关并可能导致受伤。平衡评估系统测试 (BESTest) 是在其他神经系统疾病中用于预测跌倒风险的平衡测量。本研究的目的是检查 MiniBestest、BESTest 和 BESTest 分项评分与诊断为轻度 AD 的个体的跌倒发生率之间的关系。

方法

该研究是一项单中心、前瞻性、观察性队列研究。参与者完成了基线问卷，包括人口统计表、跌倒历史问卷和 Barthel 日常生活活动指数 (ADL)。使用 MiniBESTest 和 BESTest 评估平衡和步态。完成基线评估后，参与者获得每月秋季日历，以跟踪接下来 12 个月的跌倒情况。

结果

跌倒者的 MiniBESTest 总原始分数为 13.4 分（共 28 分）（SD = 3.6），非跌倒者的总原始分数为 18.4 分（共 28 分（标准差 = 3.7））。MiniBESTest 跌倒者的总百分比得分为 47.8% (SD = 12.8%)，非跌倒者的总百分比得分为 65.5% (SD = 13.1%)。跌倒者的最佳总百分比得分为 58.2% (SD = 3.9%)，非跌倒者为 73.9% (SD = 7.9%)。BESTest 的 II-IV 小节与跌倒者状态相关。

讨论和结论

在轻度 AD 患者中，跌倒状态与 BESTest 的某些平衡缺陷有关，包括在支撑基础外移动身体（第 II 小节）、改变重心（第 III 小节）和对外部扰动做出反应（第 IV 小节）。未来的研究可以探索 AD 和其他神经系统疾病之间的差异，以及物理治疗如何改善这些领域以降低跌倒风险。