The association between change in motor function and cognition in older adults: a descriptive review

Purpose: This paper provides a descriptive review of research in the area of motor functioning in older adults with mild cognitive impairment (MCI) and early Alzheimer's disease (AD). The specific aims of this paper are to examine: (1) the correlation between clinical measures of motor function and cognitive change in older adults; (2) clinical measures of motor function as predictors of conversion to cognitive impairment in healthy older adults and progression of cognitive impairment in people with MCI; (3) clinical measures of motor function as predictors of rate of decline in cognitive function in healthy older adults, people with MCI, and those with early AD. An additional objective is to discuss the relevance of this information to the practice of physical therapy. Methods: A literature search was conducted using Psych Info, CINAHL, Medline and Pubmed databases. Mild cognitive impairment (MCI), AD and cog* were each combined with gait, balance, fine motor, gross motor and extrapyramidal signs. Studies were included if they met the inclusion and exclusion criteria for the current review. Results: Review of the literature revealed that various domains of physical function such as gait, balance, fine and gross motor skills, and extrapyramidal signs change in tandem with or as a predecessor to declines in cognitive impairment. Furthermore, measures in several of these domains have been found to be predictive of future cognitive and functional decline in non-demented adults as well as those with MCI. Conclusions: Identification of specific motor impairments may differentiate between cognitively unimpaired older adults and those with MCI or AD. These impairments may also predict future cognitive decline and increase diagnostic sensitivity when included in cognitive assessment batteries, thus providing increased opportunities for early intervention.