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Background Physical activity plays a pivotal role in the development of disability and may modify the negative effect of vascular risk factors on progression of both cardio and cerebrovascular disorders. The aim of this study was to evaluate the activity level in people with age-related white matter changes as identified on magnetic resonance imaging (MRI) in relation to motor performance, cognition and perceived health. Methods Data came from the first year follow up of one participating centers of the LADIS study. Fifty one subjects were first enrolled in the study. Complete first year follow up data was available for 41 subjects. Information on comorbidity, physical activity level, physical function, cognition, level of white matter changes and perceived health was collected. Physical activity level was classified with a yes or no question and with the Frenchay Activities Index (FAI). Results Only 36% of the subjects in this study were physically active according to the yes/no question. 27.5% of the subjects were active according to the FAI score which evaluates the everyday activities. Being active discriminated subjects with better physical function. Subjects active according to the FAI score had a higher cognitive level (p ≤ 0.01), lower comorbidity (p = 0.02) and performed better on all motor function tasks as assessed by walking speed (p ≤ 0.01) and the Short Physical Performance battery (SPPB) (p ≤ 0.01). Conclusions Being physically active seems to be a long term protective factor. In our study, the majority of subjects with Age Related White Mattter Changes (ARWMC) with no or mild Instrumental Activity of Daily Living (IADL) disability did not attain recommended level of activity at first year follow up. Whether or not increasing physical activity may slow down cognitive decline and lessen development of disability in physically inactive subjects with manifest ARWC remains to be studied. Trial registration: not applicable.

Objective: To evaluate the effects of a new, individually adjusted, progressive and specific balance group training programme on fear of falling, step execution, and gait in healthy elderly people with fear of falling and tend to fall. Design: Randomized controlled trial. Setting: The study was conducted in Stockholm County, Sweden. Subjects: Fifty-nine community dwelling elderly people were recruited by advertisement, and allocated at random to an intervention group ( n = 38) or a control group ( n = 21). Intervention: Individually adjusted, progressive and specific balance group training was given three times a week for three months. The training incorporated elements included in, and required for, independent activities of daily living, and for reactions to loss of balance during dual or multiple tasks. Main measures: Fear of falling was assessed with Falls Efficacy Scale International (FES-I). The reaction time of step execution was measured with the step-execution test, and gait was measured with GAITRite®. Results: After three months the intervention group showed significant positive changes in the FES-I ( P = 0.008), in the step-execution phase of dual-task performance ( P = 0.012), and in gait at preferred speed during single-task performance; in cadence ( P = 0.030) and, at fast speed, in velocity ( P = 0.004) and cadence ( P = 0.001). Significant decreases were also found for the likelihood of depression after participating in the training programme. Conclusion: This new balance training programme is feasible and leads to decreased fear of falling, decreased time for step execution during dual-task performance and increased velocity during fast walking.

A professional career may extend over a period of 40 years. Although learning is a feature of professional competence, little is known about learning and development after professional entry education.Narrative inquiry was used to understand how physiotherapists learned and developed over time, and stories from a purposeful sample of 12 physiotherapists were collected. Stories were thematically analyzed with regard to key elements related to learning and development, and common themes were identified across stories.Four themes emerged from the analysis where physiotherapists learned and developed in working life: (1) facing challenges; (2) contrasting perspectives; (3) drawing on hundreds of educators; and (4) building on personal experience.Non-formal ways of learning in working life may help physiotherapists learn and develop confidence, communication strategies and different approaches to treatment. Besides reflection on personal experience and patient encounters, learning and development may be promoted and supported by taking on challenges and changing settings.

The aim of this study was to investigate the influence of cognition on motor function using 2 simple everyday tasks, talking and walking, in younger subjects with Alzheimer’s disease and mild cognitive impairment. A second aim was to evaluate reliability for the dual-task test Talking While Walking. Walking speed during single and dual task and time change between single and dual task were compared between groups. The test procedure was repeated after 1 week. Subjects with AD had lower walking speed and greater time change between single and dual task compared with healthy controls. Reliability for Talking While Walking was very good. The results show that motor function in combination with a cognitive task, as well as motor function alone, influences subjects with Alzheimer’s disease in a negative way and that decreased walking speed during single- and dual-task performance may be an early symptom in Alzheimer’s disease.

Basic mobility, balance, gait and dual-task performance were characterised in 140 consecutive subjects referred to a multidisciplinary university hospital in a geriatric setting for cognitive symptoms and possible dementia. After completion of an extensive diagnostic evaluation, subjects were classified into four diagnostic categories: no cognitive impairment, mild cognitive impairment, Alzheimer’s disease (AD) and other dementia. Mean age was 57 ± 9.2, 60 ± 7.3, 68 ± 9.9 and 64 ± 10.5, respectively. Data on motor function, medication use and presence of white matter changes were evaluated and compared between the diagnostic groups. Motor function seems to be affected in very mild AD but not in mild cognitive impairment, as assessed with performance-based tests. AD subjects were slowed and had difficulties in dual-task performance requiring concurrently performing a cognitive task while walking.

To clarify if Alzheimer’s disease has an impact on activity level and postural control, we examined 17 elderly diagnosed with mild Alzheimer’s disease (MMSE scores 21–29) and 18 age- and gender-matched healthy controls (MMSE scores 27–30) using the Frenchay Activities Index, Bergs Balance Scale, Timed Up & Go and Walking in a Figure of Eight. Mild AD subjects were less active and had lower scores on Bergs Balance Scale, performed Timed Up & Go in longer time and took more steps outside the Figure of Eight, as compared to healthy elderly. This study shows that motor performance is affected already at mild stages of Alzheimer’s disease and also that functional performance other than gait may also be impaired.