Changes in cognitive function in a randomized trial of physical activity: results of the lifestyle interventions and independence for elders pilot study. Stability of physical assessment of older drivers over 1 year. The effects of an exercise program on several abilities associated with driving performance in older adults. Recommended Measures for the Assessment of Cognitive and Physical Performance in Older Patients with Dementia: A Systematic Review Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. A Randomized Trial of a Physical Conditioning Program to Enhance the Driving Performance of Older Persons Validity and Reliability of the Short Physical Performance Battery in Two Diverse Older Adult Populations in Quebec and Brazil The Performance Enhancement Project: improving physical performance in older persons. Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. The Effects of Cognitive Activity Combined with Active Extremity Exercise on Balance, Walking Activity, Memory Level and Quality of Life of an Older Adult Sample with Dementia Single versus combined cognitive and physical activity effects on fluid cognitive abilities of healthy older adults: a 4-month randomized controlled trial with follow-up. Effects of the Addition of a Dual Task to a Supervised Physical Exercise Program on Older Adults' Cognitive Performance. Examination of cognitive and instrumental functional performance as indicators for driving cessation risk across 3 years. Enhancing physical function in HIV-infected older adults: A randomized controlled clinical trial. Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: A randomized-controlled cross-over design The transfer of skills from cognitive and physical training to activities of daily living: a randomised controlled study
BACKGROUND Cognitive impairment is an important contributor to disability . Limited clinical trial evidence exists regarding the impact of physical exercise on cognitive function ( CF ) . We report results of a pilot study to provide estimates of the relative impact of physical activity ( PA ) on 1-year changes in cognitive outcomes and to characterize relationships between changes in mobility disability and changes in cognition in older adults at increased risk for disability . METHODS Sedentary persons ( 102 ) at increased risk for disability ( aged 70 - 89 years ) were r and omized to moderate-intensity PA or health education .  Participants were administered the  Digit Symbol Substitution Test ( DSST ) , Rey Auditory Verbal Learning Test ( RAVLT ) , modified Stroop test , and Modified Mini-Mental State Examination  at baseline and 1 year . RESULTS Group differences were not significant but improvements in cognitive scores were associated with improvements in physical function . Specifically , the DSST significantly correlated with change in the Short Physical Performance Battery score ( r = .38 , p = .0002 ) , in chair st and score ( r = .26 , p = .012 ) , in balance score ( r = .21 , p = .046 ) , and in 400-m gait speed ( r = .15 , p = .147 ) . Change recall on the RAVLT and in the Stroop test was also positively correlated with changes in chair st and and balance , respectively . CONCLUSIONS These results provide further support for the benefits of exercise on CF in older adults . An adequately powered clinical trial of PA involving older adults at increased risk for cognitive disability is needed to exp and the indications for prescribing exercise for prevention of decline in brain function Older adults represent the fastest-growing population of drivers with a valid driver 's licence . Also common in this age group are multiple chronic medical conditions that may have an effect on physical function and driving ability . Determining the reliability of physical measures used to assess older drivers ' functional ability is important to identifying those who are safe to continue driving . Most previous reliability studies of clinical physical measures of health used test-retest intervals shorter than those between patient visits with a clinician . In the present study we examined a more clinical ly representative interval of 1 year to determine the stability of commonly used physical measures collected during the C and rive II prospect i ve cohort study of older drivers .  Reliability statistics indicate that the  sequential finger-thumb opposition , rapid pace walk  and the  Pelli-Robson contrast sensitivity tests  have adequate stability over 1 year . Poor stability was observed for the one-legged stance and Snellen visual acuity test . Several assessment s with nominal data ( Marottoli method [ functional neck range of motion ] , whispered voice test , range of motion and strength testing ) lacked sufficient variability to conduct reliability analyses ; however , a lack of variability between test days suggests consistency over a 1-year time frame . Our results provide evidence that specific physical measures are stable in monitoring functional ability over the course of a year The purpose of this study was to investigate the effects of participation in an exercise program on several abilities associated with driving performance in older adults . Thirty-two subjects were r and omly assigned to either an  exercise group ( 60 - 81 years , n=16 ) or a control group ( 60 - 82 years , n=16 ) . The exercise program was planned to stress perceptive , cognitive , and physical abilities . It lasted 12 weeks with a periodicity of three sessions of 60 min per week . Assessment s were conducted before and after the intervention on behavioral speed ( in single- and dual-task conditions ) , visual attention , psychomotor performance , speed perception ( time-to-contact ) , and executive functioning . Significant positive effects were found at 12-week follow-up result ing from participation in the exercise program .  Behavioral speed improvements were found in reaction time , movement time , and response time ( both in single- and dual-task conditions ) ; visual attention improvements took place in speed processing and divided attention ; psychomotor performance improvements occurred in lower limb mobility . These results showed that exercise is capable of enhancing several abilities relevant for driving performance and safety in older adults and , therefore , should be promoted Aim / Goal : To recommend a set of neuropsychological and physical exercise tests for research ers to assess cognition and physical fitness in clinical trials with older patients with dementia ; to create consensus , decrease heterogeneity , and improve research quality . Methods : A literature search ( 2005–2011 ) yielded 89 r and omized controlled trials . To provide information on test recommendations the frequency of test use , effect size of the test outcome , study quality , and psychometric properties of tests were analyzed . Results : Fifty-nine neuropsychological tests ( cognitive domains : global cognition , executive functioning , memory , and attention ) and 10  exercise tests ( physical domains : endurance capacity , muscle strength , balance , and mobility ) were found . Conclusion : The Severe Impairment Battery , Mini Mental State Examination , and Alzheimer Disease Assessment Scale – cognitive subscale were recommended to measure global cognition . The Verbal Fluency Test Category/Letters , Clock Drawing Test , and Trail Making Test-B were recommended to measure executive functioning . No specific memory test could be recommended . The Digit Span Forward , Digit Span Backward , and Trail Making Test-A were recommended to measure attention . As physical exercise tests , the Timed Up and Go and Six Meter Walk for mobility , the Six Minute Walk Distance for endurance capacity , and the Tinetti Balance Scale were recommended BACKGROUND Japan is one of the most rapidly ageing societies in the world . A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals , but the effectiveness of these services is currently insufficient . Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects . METHOD We administered a 12-week intervention programme consisting of physical and leisure activities aim ed at enhancing participants ' motivation to participate and support one another by providing a pleasant atmosphere , empathetic communication , praise , and errorless support . This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi . All participants underwent the Five-Cog test , which evaluated the cognitive domains of attention , memory , visuospatial function , language , and reasoning . Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test . Subjective health status , level of social support , functional capacity , subjective quality of life , and depressive symptoms were assessed with a question naire . Grip strength test , timed up- and -go test , 5-m maximum walking times test , and functional reach test were performed to evaluate physical function . Fifty-two participants were r and omly allocated to  intervention ( n = 26 ) and control ( n = 26 ) groups . Twenty-six participants , aged between 65 - 87 years , received intervention once a week at a community centre . The programme was conducted by health-care professionals , with the help of senior citizen volunteers . RESULTS The intervention group ( n = 19 ) showed significant improvement on the analogy task of the Five-Cog test ( F(1,38 ) = 4.242 , P = 0.046 ) and improved quality of life ( F(1,38 ) = 4.773 , P = 0.035 ) as compared to the control group ( n = 24 ) . CONCLUSION A community-based 12-week intervention programme that aim ed to enhance motivation to participate in activities result ed in improvements in some aspects of cognitive function and quality of life .  Senior citizens who volunteered in the present intervention enabled the smooth implementation of the programme and alleviated the burden on professional staff Background As the number of older drivers increases , concern has been raised about the potential safety implication s. Flexibility , coordination , and speed of movement have been associated with older drivers ’ on road performance . Objective To determine whether a multicomponent physical conditioning program targeted to axial and extremity flexibility , coordination , and speed of movement could improve driving performance among older drivers . Design R and omized controlled trial with blinded assignment and end point assessment . Participants r and omized to intervention underwent graduated exercises ; controls received home , environment safety modules . Participants Drivers , 178 , age ≥ 70 years with physical , but without substantial visual ( acuity 20/40 or better ) or cognitive ( Mini Mental State Examination score ≥24 ) impairments were recruited from clinics and community sources . Measurements On-road driving performance assessed by experienced evaluators in dual-brake equipped vehicle in urban , residential , and highway traffic . Performance rated three ways : ( 1 ) 36-item scale evaluating driving maneuvers and traffic situations ; ( 2 ) evaluator ’s overall rating ; and ( 3 ) critical errors committed . Driving performance reassessed at 3 months by evaluator blinded to treatment group . Results Least squares mean change in road test scores at 3 months compared to baseline was 2.43 points higher in intervention than control participants ( P = .03 ) . Intervention drivers committed 37 % fewer critical errors ( P = .08 ) ; there were no significant differences in evaluator ’s overall ratings ( P = .29 ) . No injuries were reported , and complaints of pain were rare . Conclusions This safe , well-tolerated intervention maintained driving performance , while controls declined during the study period . Having interventions that can maintain or enhance driving performance may allow clinician – patient discussion s about driving to adopt a more positive tone , rather than focusing on driving limitation or cessation Objectives : To assess the validity and reliability of the Short Physical Performance Battery ( SPPB ) in adults 65 to 74 years old , capable in all basic activities of daily living ( ADL ) , in Quebec and Brazil . Methods : Participants were recruited in St. Bruno ( Quebec ) by local advertisements ( n = 60 ) and in Santa Cruz ( Brazil ) by r and om sampling ( n = 64 ) . The SPPB includes tests of gait , balance , and lower-limb strength . Disability status was categorized as intact mobility , limited mobility , and difficulty in any of ADL . Results : There was a grade d decrease in mean SPPB scores with increasing limitation of lower limbs , disability , and poor health . Using the test – retest reliability the authors evaluated the intraclass correlation coefficient , which was high in both sample s : .89 ( 95 % CI : 0.83 , 0.93 ) in St. Bruno and .83 in Santa Cruz ( 95 % CI : 0.73 , 0.89 ) . Discussion : This study provides evidence for the validity and reliability of SPPB in diverse population OBJECTIVE To determine the effects of center-based exercise on physical performance in older persons at risk for decline in physical functioning . DESIGN R and omized controlled trial . SETTING Senior centers . PARTICIPANTS A total of 155 community-dwelling persons , 78.7 % women , ages 70 years and older ( mean + /- st and ard deviation , 77.0+/-4.5y ) , with mobility impairments . INTERVENTION Intervention volunteers ( n=80 ) exercised at a center ( endurance , strength , balance , flexibility ) 3 times weekly , for months 1 to 6 ; once weekly , for months 7 to 12 with home exercise 2 sessions a week ; and at home only , for months 13 to 18 . Home control volunteers ( n=75 ) were instructed in home endurance exercise . MAIN OUTCOME MEASURES MacArthur battery , Physical Performance Test ( PPT-8 ) , and 6-Minute Walk Test ( 6MWT ) at baseline and 3 , 6 , 12 , and 18 months . RESULTS MacArthur battery scores improved in intervention compared with home control at 3 , 6 , and 12 months ( repeated- measures analysis of variance : group x time , P<.05 ) but not 18 months . PPT-8 and 6MWT did not improve . Intervention group assignment , younger age , and better baseline physical function and self-perceived health were independent predictors of long-term MacArthur battery score improvement . CONCLUSIONS Compared with home control , center-based exercise improved gait , chair rise time , and balance over 1 year . Improvements were not sustained with transition to home exercise for months 13 to 18 . Classes may be necessary to maintain improvements in older persons attending center-based exercise Aims : This study aim ed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program ( MCP ) on the cognitive function of older adults with moderate to severe Alzheimer 's disease ( AD ) . Methods : We included 33 participants with AD in a 6-month r and omized controlled trial . The intervention group participated in physical exercise and received a MCP . The control group received only the MCP . Before and after the intervention , cognitive outcomes were assessed using the Alzheimer 's Disease Assessment Scale-Cognitive Subscale ( ADAS-cog ) , Mini-Mental State Examination , and the Clock Drawing Test . Physical performance was evaluated by exercise time , the number of pedal rotation , total load , grip strength , and the Berg Balance Scale ( BBS ) . Results : In all cognitive measures , there were no significant improvements between the two groups after 6 months in the baseline value-adjusted primary analysis . However , the ADAS-cog score was significantly lower between the two groups in secondary analysis adjusted for baseline value , age , sex , and education years . All physical outcomes were significantly higher in the intervention group except for total load compared with baseline measurements . Conclusion : This study indicates that it is possible to improve cognitive function in older adults with moderate to severe AD through 6-month physical exercise with a multicomponent cognitive intervention OBJECTIVES To compare the practicality , reliability , validity , and responsiveness of the timed up and go ( TUG ) , one-leg st and ( OLS ) , functional reach ( FR ) , and Tinetti balance ( TB ) performance measures in people aged 65 and older . DESIGN A prospect i ve study . SETTING Shin-Sher Township of Taichung County , west- central Taiwan . PARTICIPANTS Twelve hundred community-dwelling older people . MEASUREMENTS During an initial assessment at their residences , participants were interviewed for demographics , cognition , fall history , use of a walking aid , and activities of daily living ( ADLs )  , in addition to completing the four balance tests . Falls were ascertained by telephone every 3 months for a 1-year follow-up ; the four balance measures and ADLs were also reassessed at the end of the follow-up year . RESULTS Of the four balance measures , the OLS had the lowest participation rate , and participation of people who were cognitively impaired had fallen in the previous year , used a walking aid , or suffered from an ADL disability was lower than for their counterparts . The time to complete the tests ranged from 58 seconds for OLS , to 160 seconds for the TB . All four balance measures exhibited excellent test-retest reliability and discriminant validity but poor responsiveness to fall status . The TB showed better discriminant , convergent , and predictive validities and responsiveness to ADL changes than the other three tests . CONCLUSION According to psychometric properties , the most suitable performance measure for evaluating balance in community-dwelling older people was the TB , followed by the TUG [ Purpose ] The purpose of this study was to compare the effectiveness of cognitive activity combined with active physical exercise for a sample of older adults with dementia . [ Subjects ] A convenience sample of 30 patients with dementia ( Mini-Mental State Examination score between 16 and 23 ) was used . Participants were r and omly allocated to one of two groups : cognitive activity combined with physical exercise CAE , n=11 ) , and only cognitive activity CA , n=9 ) . [ Methods ] Both groups participated in a therapeutic exercise program for 30 minutes , three days a week for 12 weeks . The CAE group performed an additional exercise for 30 minutes a day , three days a week for 12 weeks . A Wii Balance Board ( WBB , Nintendo , Japan ) was used to evaluate postural sway as an assessment of balance . The Berg Balance Scale ( BBS ) and Modified Falls Efficacy Scale ( MFES ) were used to assess dynamic balance abilities . The Timed Up- and -Go test ( TUG ) was used to assess gait , and the Digit Span Test ( DST ) and 7 Minute Screening Test ( 7MST ) were used to measure memory performance . The Mini-Mental Status Exam-Korean version ( MMSE-K ) , Kenny Self-Care Evaluation ( KSCE ) , and Short Geriatric Depression Scale ( GDS ) were used to assess quality of life ( QOL ) . [ Results ] There were significant beneficial effects of the therapeutic program on balance ( velocity in EOWB , path length in ECNB , BBS , and MMFE ) , QOL ( MMSE-KC , GDS , KSCE ) , and memory performance ( DSB ) in the CAE group compared to CA group , and between pre-test and post-test . [ Conclusion ] A 12-week CAE program result ed in improvements in balance , memory and QOL . Therefore , some older adults with dementia have the ability to acquire effective skills relevant to daily living BACKGROUND Physical and cognitive activity seems to be an effective strategy by which to promote age-sensitive fluid cognitive abilities in older adults . METHOD In this r and omized controlled trial , 70 healthy senior citizens ( age 60 - 75 ) were allocated to a physical , cognitive , combined physical plus cognitive , and waiting control group . The trial assessed information processing speed , short-term memory , spatial relations , concentration , reasoning , and cognitive speed . RESULTS In contrast to the control group , the physical , cognitive , and combined training groups enhanced their concentration immediately after intervention . Only the physical training group showed improved concentration 3 months later . The combined training group displayed improved cognitive speed both immediately and three months after intervention . The cognitive training group displayed improved cognitive speed 3 months after intervention . CONCLUSIONS Physical , cognitive , and combined physical plus cognitive activity can be seen as cognition-enrichment behaviors in healthy older adults that show different rather than equal intervention effects The purpose of this study was to investigate the effects of the addition of a dual task to multicomponent training on cognition of active older adults . Eighty physically active older adults were divided into an intervention group ( IG ) and a control group ( CG ) . Both groups performed multicomponent training over 12 weeks . The IG simultaneously performed exercises and cognitive tasks . The  Mini-Mental State Examination , the Montreal Cognitive Assessment , and the Clock Drawing Test  were used for cognitive assessment s. The  Timed Up and Go Test associated with a cognitive task  was used for dual-task assessment . Significant interactions were not observed between groups in terms of the cognitive variables or the dual-task performance . An interaction was observed only for Timed Up and Go Test performance , which was better in the CG than in the IG . Active older adults showed no improvement in cognition following the addition of the dual task to the multicomponent training PURPOSE The purpose of this study was to prospect ively examine the role of cognitive and instrumental functional performance in driving cessation while simultaneously accounting for any contributions of demographics , vision , physical performance , and health among a sample of older adults without dementia . DESIGN AND METHODS Included in the analyses were 1,838 participants from the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) study who were drivers at baseline and completed the third-year assessment . Participants completed baseline assessment s of sociodemographic characteristics , health , sensory function , physical function , cognitive abilities , instrumental functional performance , and depressive symptoms . Driving status was again ascertained 3 years later . RESULTS We used Cox proportional hazard analyses to examine prospect i ve predictors of driving cessation over a 3-year period . The final model indicated four significant risk factors for driving cessation : older age ( hazard ratio [ HR ] = 1.06 , p = .009 ) , poorer balance as measured by the Turn 360 degrees test ( HR = 1.17 , p = .002 ) , slower cognitive speed of processing as measured by the Useful Field of View test ( HR = 1.37 , p = .004 ) , and poorer instrumental functional performance as assessed by the Everyday Problems Test ( HR = 1.59 , p < .001 ) . IMPLICATION S Although vision , health , and physical abilities are commonly considered when determining driving capacity , cognitive speed of processing and instrumental functional performance may be better indicators of subsequent likelihood of driving cessation across 3 years among older adults . Poor health and vision may only impact driving cessation to the extent that cognitive speed of processing and instrumental functioning are affected OBJECTIVE HIV-infected older adults ( HOA ) are at risk of functional decline . Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority . We conducted a r and omized , controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory ( SDT ) improves physical function , autonomous motivation , depression and the quality of life ( QOL ) in HOA . METHOD In total , 67 community-dwelling HOA with mild-to-moderate functional limitations were r and omized to 1 of 2 groups : a physical activity counseling group or the usual care control group . We used SDT to guide the development of the experimental intervention . Outcome measures that were collected at baseline and final study visits included a battery of physical function tests , levels of physical activity , autonomous motivation , depression , and QOL . RESULTS The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups . Overall physical performance , gait speed , measures of endurance and strength , and levels of physical activity improved in the treatment group compared to the control group ( p < .05 ) . Measures of autonomous regulation such as identified regulation , and measures of depression and QOL improved significantly in the treatment group compared with the control group ( p < .05 ) . Across the groups , improvement in intrinsic regulation and QOL correlated with an improvement in physical function ( p < .05 ) . CONCLUSION Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function , autonomous motivation , depression , and QOL in HOA with functional limitations . ( PsycINFO Data base Background Older adults have the highest rates of disability , functional dependence and use of healthcare re sources . Training interventions for older individuals are of special interest where regular physical activity ( PA ) has many health benefits . The main purpose of this study was to assess the immediate and long-term effects of a 6-month multimodal training intervention ( MTI ) on functional fitness in old adults . Methods For this study , 117 participants , 71 to 90 years old , were r and omized in immediate intervention group and a control group ( delayed intervention group ) . The intervention consisted of daily endurance and twice-a-week strength training . The method was based on a r and omized-controlled cross-over design . Short Physical Performance Battery ( SPPB ) , 8 foot up- and -go test , strength performance , six min walking test ( 6 MW ) , physical activity , BMI and quality of life were obtained at baseline , after a 6-month intervention- and control phase , again after 6-month crossover- and delayed intervention phase , and after anadditional 6-month follow-up . Results After 6 months of MTI , the intervention group improved in physical performance compared with the control group via Short Physical Performance Battery ( SPPB ) score ( mean diff = 0.6 , 95 % CI : 0.1 , 1.0 ) and 8-foot up- and -go test ( mean diff = −1.0 s , 95 % CI : -1.5 , -0.6 ) , and in endurance performance via 6-minute walking test ( 6 MW ) ( mean diff = 44.2 meters , 95 % CI : 17.1 , 71.2 ) . In strength performance via knee extension the intervention group improved while control group declined ( mean diff = 55.0 Newton , 95 % CI : 28.4 , 81.7 ) , and also in PA ( mean diff = 125.9 cpm , 95 % CI : 96.0 , 155.8 ) . Long-term effects of MTI on the particpants was assesed by estimating the mean difference in the variables measured between time-point 1 and 4 : SPPB ( 1.1 points , 95 % CI : 0.8 , 1.4 ) ; 8-foot up- and -go ( −0.9 s , 95 % CI : -1.2 , -0.6 ) ; 6 MW ( 18.7 m , 95 % CI : 6.5 , 31.0 ) ; knee extension ( 4.2 Newton , 95 % CI : -10.0 , 18.3 ) ; h and grip ( 6.7 Newton , 95 % CI : -4.4 , 17.8 ) ; PA ( −4.0 cpm , 95 % CI : -33.9 , 26.0 ) ; BMI ( −0.6 kg/m2 , 95 % CI : -0.9 , -0.3 ) and Icel and ic quality of life ( 0.3 points , 95 % CI : -0.7 , 1.4 ) . Conclusions Our results suggest that regular MTI can improve and prevent decline in functional fitness  in older individuals , influence their lifestyle and positively affect their ability to stay independent , thus reducing the need for institutional care . Trial registration This study was approved by the National Bioethics Committee in Icel and , VSNb20080300114/03 - Ageing is associated with the deterioration of all cognitive functions , including attention , memory and psychomotor speed . It has not yet been clearly confirmed whether the effects of cognitive and physical interventions can improve activities of daily living ( ADL ) . This study compared the effectiveness of cognitive and physical training on cognitive functions and the transfer to ADL .  Eighty older people with mild cognitive impairment ( mean age 67.07 ± 4.3 years ) were r and omly divided into an experimental group ( n = 40 ) and a control group ( n = 40 ) . Data were collected in an outpatient psychiatric clinic in a r and omised controlled trial . Primary outcome measures included the following : cognitive functions were evaluated using the mini mental state examination , the AVLT — Auditory verbal learning test , the Stroop test , the TMT — trail making test , the DRT — disjunctive reaction time and the NHPT — nine hole peg test . Secondary outcome measure was the Bristol activities of daily living scale . The experimental group underwent a CogniPlus and physical training ; consisting of 20 training sessions over 10 weeks . Both groups went through 30 min of daily physical training for 10 weeks . After the training , significant differences in favour of the experimental group were found in almost all the tests . In memory ( AVLT ) ( p ≤ 0.0001 , effect size ( ES ) η2 = 0.218 . In reduction of the response time on attention tasks ( Stroop tasks ) ( p ≤ 0.006 , ES = 0.092–0.115 ) . In lower error rates in all tests : Stroop tasks , DRT , TMT , NHPT ( p ≤ 0.02–0.001 , ES = 0.062–0.176 ) . In ADL ( p ≤ 0.0001 , ES = 0.176 ) . The combined cognitive and physical training  had better efficacy for most cognitive functions and for ADL when compared with the physical training only
Conclusions The Timed Up- and -Go test measure appears not to be a useful measure of physical functioning for the driving outcomes included here .
The Rapid Pace Walk may be useful in studies of driving ability and exposure .
Background Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer .
This systematic review assesses the evidence on the association between three physical functioning measures : the Short Physical Performance Battery , the Timed Up- and -Go test , and the Rapid Pace Walk with driving outcomes in older adults .