Purpose: Age-related decrements in visual attention have been shown to be predictive of crash risk in older drivers (Owsley et al., JAMA, 1998). The current study was conducted to determine whether training older adults on divided and selective visual attention tasks would result in improvements in visual attention, and if such improvements were obtained, whether they would be retained over time (18 months). Methods: Participants were 12 older adults ranging in age from 61 to 84 years (mean = 71.5). Participants were screened for visual attention ability, and then completed a series of six training sessions, each lasting about 30 minutes, during which they performed divided and selective visual attention tasks. Following training, a post-test was conducted. Retention tests were performed an average of 18 months following the post-testing session. Results: With training, the average divided attention score improved 27%, t(11) = 2.690, p = .021. The average selective attention score improved 42%, t(11) = 3.874, p = .003. The most dramatic improvements were obtained by participants whose initial performance was poorest. The results of the retention tests showed that the majority of the improvements in visual attention were retained over the 18 month interval. Participants retained 95% of the improvement gained in divided attention and 86% of the improvement in selective attention. Conclusions: Divided and selective visual attention skills have been shown to decline with normal aging. The results of this experiment indicate that this trend can be reversed through a brief training period and that these gains are long lasting.

Current trends among older adults are to compress morbidity and extend the time of living independently. Physical impairments are often not detected until there is a manifestation of loss of functional ability. The use of valid field-based physical performance measures to signal potential functional limitations holds a great promise for implementing appropriate intervention programs. However, there is much debate about which physical performance measures best predict the ability to live independently. PURPOSE To determine physical performance measures as predictors of functional independence based on the Activity of Daily Living (ADL) and Instrumental ADL (IADL) scales. METHODS Eighty-four independently living older adults (M Age = 86.1 SD = 5.53) were assessed using Fullerton's functional fitness test (30-s chair stand, 30-s arm curl, 6-min walk, chair sit-and-reach, back scratch, 8-ft up-and-go), Guralnik's Lower Extremity Performance (LEP) evaluation (8-ft walk, tandem balance, and 5-time chair stand), and Katz's ADL and Lawton's IADL scales. The use of canes and/or walkers was permitted in the assessment. All participants were screened by their physician prior to participation in the assessment. In addition, participants were screened for acceptable levels of cognition using the Clock Test and Digit Symbol Substitution test. RESULTS Scores from the ADL assessment indicated an overall ceiling effect. As a result, only the IADL was used in the analysis. Results indicate significant correlations between the IADL scores and the 6-min walk (r = .514, p < .001), chair stand (r = .336, p < .01), arm curl (r = .289, p < .01), sit-and-reach (r = .291, p < .01), 8-ft up-and-go (r = −.37, p < .01), LEP score (r = .53, p < .001). Regression analysis shows the 6-min walk to be the best predictor of functional independence accounting for 25% of the variance. CONCLUSION In this sample, the 6-min walk proved to be the best predictor of daily functioning as measured by the IADL. The Guralnik's LEP score and 8-ft up-and-go also proved to be valid predictors.

Finding practical cost effective ways to help maintain functional fitness in older adults is of utmost importance as it contributes significantly to preserving functional independence. PURPOSE To determine the impact of participation in a chair-based exercise class using 4-inch wide Therabands on physical performance in older adults. METHODS Upon entry to an independent living retirement community, residents have the option to participate in a variety of physical fitness activities, one of which is a chair-based exercise class using Therabands. Twenty residents (M Age = 88.78, Range = 81–95) participated in the 35-minute three times a week class for one year. Participants averaging at least 2 classes a week were included in the study. Class participants were compared using several different physical performance measures to 18 non-active residents of comparable age (M = 87.00, Range=79–99) and cognitive ability, as assessed by the Clock test and Digit Symbol Substitution test. All participants in the study were screened by their physician for participation. The use of canes and/or walkers was permitted during the assessment. The components of the assessment included Fullerton's functional fitness test (30-s chair stand, 30-s arm curl, 6-min walk, chair sit-and-reach, back scratch, 8-ft up-and-go), Guralnik's Lower Extremity Performance (LEP) evaluation (8-ft walk, tandem balance, and 5-time chair stand), and other fitness tests (4-m walk, total grip strength). RESULTS Results indicate significantly better performance for the exercise group in the 8-ft up-and-go (9.54s vs. 12.54s, p < .01), arm curl (14.35 vs 10.87, p < .01), 6-min walk (429.09yds vs 349.25yds, p < .01), LEP score (9.67 vs 6.94, p < .01), 4-m walk (3.56s vs 4.91s, p < .01) and total grip strength (41.81kg vs 30.56kg, p < .01). CONCLUSION Based on a variety of physical performance measures, this study shows that regular participation in a chair-based exercise class using Therabands is a practical and cost-effective way to keep older adults functionally fit.

PURPOSE:To determine the effectiveness of an intervention programme utilizing modules specifically designed to challenge mobility in older adults.METHOD:Twelve older adults aged 79-90 years (84.3+/-3.2; mean+/-SD) living in a retirement community participated in a 10-week (3 sessions per week, 50 minutes per session) training programme. Performance on a modular course, comprised of nine stations representing common environmental conditions, provided information about dynamic balance and mobility before and after the intervention programme. Stations consisted of walking across carpet and foam pathways, walking up and down ramps and stairs, walking through a slalom course of eight plastic cones, and stepping over foam props. Performance on the mobility course was videotaped to determine the time to complete each station. The training intervention consisted of performing sections of the mobility course and standing on foam pads with the eyes open or closed.RESULTS:Using the Bonferroni-adjusted level of significance for multiple comparisons (p+/-0.005), paired sample t-tests indicated significant improvement for total time to complete the course (pre=100.9+/-40.5 s, post=79.6+/-40.3 s) and for all individual stations except stepping over props.CONCLUSIONS:These results indicate that an intervention programme utilizing functionally-oriented modules can improve mobility in older adults.

Electric Scooters are assistive devices that have been well received by the older adult population (65 years and older). The increase in usage of these scooters is causing a number of problems for Continuing Care Retirement Communities (CCRC) that allow residents to operate them within their facilities. Due to a lack of literature addressing the use of electric scooters, interviews were conducted with three Kansas CCRC s and secondary data sources were analyzed to begin identifying the problems associated with the use of electric scooters. A number of important issues surrounding the use of scooters in CCRC facilities were identified including: 1) an apparent discrepancy between the problems identified in government databases and those reported by staff at CCRC facilities, 2) limited or non-existent driver training and education, 3) the misuse of scooters by drivers, and 4) an incompatibility between the scooters design and the target population.

Several studies have indicated that impaired postural stability is associated with an increased risk of falling in older adults. Traditional exercise programs consisting of stretching and full body movements have typically failed to show an effect on stability. Therefore, it has been recommended that training programs be customized to target the specific physiological systems involved in balance control, specifically the visual, vestibular, somatosensory, motor, and musculoskeletal systems. To determine the effectiveness of such a program, 13 older adults aged 79–90y (84.2y ± 3.8; mean ± SD) living in a retirement community participated in a 10-wk (3d/wk, 50 min/d) balance training program. Training was performed standing on 2ö- and 4ö-thick upholstery foam with the eyes open (EO) or eyes closed (EC), stepping over foam obstacles, walking on 12' foam pathways, standing from a chair, climbing four stairs, and walking around cones. To determine postural sway, participants completed the modified CTSIB on the NeuroCom Balance Master System. Tests consisted of three 10 s trials on four conditions performed with bare feet: EO-Firm surface, EC-Firm surface, EO-Foam (5ö thick) surface, EC-Foam surface. A 2 × 2 × 2 (Time × Surface × Vision) randomized block design revealed a three-way interaction (F = 12.66, p < 0.005). Of more interest were significant findings for Time × Surface (F = 9.85, p < 0.01) and non-significant findings of Time × Vision (F = 0.88, p = 0.37). Results suggest the balance program was successful in reducing sway while standing on different surfaces, but did not affect sway during the visual conditions. Other significant findings include Surface × Vision (F = 33.23, p < 0.001) and Time, Surface, and Vision main effects (F = 14.67, F = 54.15, F = 147.87, respectively; p < 0.001). Further studies are needed to evaluate the effects of similar training protocols on balance, functional performance, and the incidence of falls.

Older adults often have difficulty making compensatory adjustments in balance control when challenged with different surfaces or negotiating objects. Although older adults may be capable of independent walking, significant declines in their ability to control equilibrium may contribute to falls. Typical strategies to improve balance and mobility include assistive devices (canes, walkers) and general exercise programs. Little information is available on the effectiveness of exercise programs specifically designed to improve balance and mobility. To address this, 12 older adults aged 79–90y (84.3y ± 3.2; mean ± SD) living in a retirement community participated in a 10-wk (3d/wk, 50min/d) balance training program. Performance on a modular obstacle course, comprised of stations representing common environmental conditions, provided functionally-oriented information about dynamic balance and mobility before and after the balance program. Stations consisted of walking over four 2ft × 12ft flooring surfaces - low and deep pile carpet, 2ö and 4ö thick foam - presented in order of increasing difficulty, walking up and down a ramp, climbing and descending high and low stairs, rising from a chair, walking through a slalom course of 8 plastic cones, and stepping over 3 cylindrical foam props. Performance on the obstacle course was videotaped to determine all obstacle course times. The training intervention consisted of performing the obstacle course activities and standing on foam pads with the eyes open or closed. Using the Bonferroni-adjusted level of significance for multiple comparisons (p < 0.004), paired sample t-tests indicated significant improvement for total time to complete the course (pre = 100.9 ± 40.5 s, post = 79.6 ± 40.3 s) and for all individual stations except stepping over objects. These results indicate that a specific balance intervention can improve-dynamic balance and mobility in older adults.

Purpose : The purpose of this study was to report normative values of the amplitude of joint wrist motions and grip strength for older age groups.Method: Volunteers, (N = 147) were divided into four age groups, 60-69, 70-79, 80-89 and 90-years, with a total of 62 men and 85 women. Maximum range motion values were obtained for wrist flexion, extension and ulnar deviation. In addition, grip strength measures were obtained for each participant.Results: In general, the strength and ROM values for the oldest participants in this study were lower than those of the younger age group (age 60 to 69) and significantly lower than those published for subjects between 25 and 54 years of age. Furthermore, across all age groups males were significantly stronger than females. However, females tended to have greater ROM than males, particularly for wrist extension and ulnar deviations. Joint ROM and grip strength declined significantly with age for both males and females. Comparisons with published data for younger subjects (age 25-35) indicate that a 60-69 year old male, will on average experience a decline in wrist flexion, extension and ulnar deviation of 12%, 41%, and 22% respectively. By age 90, an individual may be expected to have ROM values that are only similar to 60% of an average 30 year old individual.Conclusion: The results suggest that the ageing population (particularly men) may face greater difficulty using an input device such as a mouse that relies on motions of the wrist. In addition, the reduced ROM of the wrist may put the elderly at greater risk of developing cumulative trauma disorders. The implications of these findings for the design of input devices are discussed.

1942 Declines in functional ability and the prevalence of falling are problems in the aged, particularly those over the age of 75 y. In the elderly, the fear of falling (FOF) may be as limiting as falling itself in terms of restricting daily physical activity. Therefore, measures of functional fitness may be related to FOF. Participants (N=87) were older (85±4 y, mean±SD; range=76-99 y) men (n=34) and women (n=53) in a continuing care retirement community. Lower extremity function was assessed by four measures: 1) tandem standing balance (TSB) for 10 s; 2) walking speed (WS), a timed 8-foot (2.4-m) walk; 3) chair rise (CR), a timed test of five repetitions of rising from a chair and sitting down; and 4) chair sit-and-reach (CSR), a test of hamstring flexibility. The FOF was assessed by a Falls Efficacy Scale (Tinetti, 1990) containing 10 ADL- and IADL-related questions, each on a 10-point continuum for rating. The FOF was correlated (p<.01) with TSB (r = .568), CR (r= .688), and WS (r = .629). The CSR (r= .083) and age (r = −.170) were not correlated with FOF. Regression analysis indicated that the strongest predictors of FOF to be CR (R2 = .465) and CR + WS (R2 = .563; p<.01). Results suggest that, among very old persons living independently, measures of lower extremity function are correlated to, and predictive of, FOF Age was not correlated with FOF; indicating that, for the very old, FOF is determined by functional ability and not age. The efficacy of intervention programs (e.g., exercise and balance training) to reduce the FOF in people who have reached the 9th and 10th decade of life requires further attention.

It is estimated that there are 3 million Americans with visual impairment (best corrected acuity of 20/40). How many persons with visual impairment drive and how their driving habits differ from elderly drivers without visual impairment is not known. To address this issue a driving survey was administered to a group of elderly (mean age = 78.69, SD=10.73) recruited from a retirement home community and an agency providing services to persons with visual impairment. The survey solicited demographic information (age, sex, education level), information about driving habits (miles driven yearly, frequency of driving at night, during rush-hour etc.), and ratings of either the level or frequency of difficulty experienced with different driving tasks (seeing the instrument panel, difficulty is glare produced by headlights, judging speed, reading signs etc.). We found that ∼50% and 83% of elderly, respectively with and without visual impairment continue to drive. The low vision drivers report significantly greater difficulty with glare caused by headlights, reading street signs, seeing past a dirty windshield and seeing their instrument panel clearly. Analysis of the driving habits revealed that the drivers with and without visual impairment reported similar levels of rush-hour driving, and drove approximately the same number of miles a year. However, visually impaired elderly drivers were significantly less likely to drive at night than their elderly counterparts with normal vision.