151
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Li LC, Sayre EC, Xie H, Falck RS, Best JR, Liu-Ambrose T, Grewal N, Hoens AM, Noonan G, Feehan LM. Efficacy of a Community-Based Technology-Enabled Physical Activity Counseling Program for People With Knee Osteoarthritis: Proof-of-Concept Study. J Med Internet Res 2018; 20:e159. [PMID: 29712630 PMCID: PMC5952118 DOI: 10.2196/jmir.8514] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Abstract
Background Current practice guidelines emphasize the use of physical activity as the first-line treatment of knee osteoarthritis; however, up to 90% of people with osteoarthritis are inactive. Objective We aimed to assess the efficacy of a technology-enabled counseling intervention for improving physical activity in people with either a physician-confirmed diagnosis of knee osteoarthritis or having passed two validated criteria for early osteoarthritis. Methods We conducted a proof-of-concept randomized controlled trial. The immediate group received a brief education session by a physical therapist, a Fitbit Flex, and four biweekly phone calls for activity counseling. The delayed group received the same intervention 2 months later. Participants were assessed at baseline (T0) and at the end of 2 months (T1), 4 months (T2), and 6 months (T3). Outcomes included (1) mean time on moderate-to-vigorous physical activity (MVPA ≥3 metabolic equivalents [METs], primary outcome), (2) mean time on MVPA ≥4 METs, (3) mean daily steps, (4) mean time on sedentary activities, (5) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (6) Partners in Health scale. Mixed-effects repeated measures analysis of variance was used to assess five planned contrasts of changes in outcome measures over measurement periods. The five contrasts were (1) immediate T1-T0 vs delayed T1-T0, (2) delayed T2-T1 vs delayed T1-T0, (3) mean of contrast 1 and contrast 2, (4) immediate T1-T0 vs delayed T2-T1, and (5) mean of immediate T2-T1 and delayed T3-T2. The first three contrasts estimate the between-group effects. The latter two contrasts estimate the effect of the 2-month intervention delay on outcomes. Results We recruited 61 participants (immediate: n=30; delayed: n=31). Both groups were similar in age (immediate: mean 61.3, SD 9.4 years; delayed: mean 62.1, SD 8.5 years) and body mass index (immediate: mean 29.2, SD 5.5 kg/m2; delayed: mean 29.2, SD 4.8 kg/m2). Contrast analyses revealed significant between-group effects in MVPA ≥3 METs (contrast 1 coefficient: 26.6, 95% CI 4.0-49.1, P=.02; contrast 3 coefficient: 26.0, 95% CI 3.1-49.0, P=.03), daily steps (contrast 1 coefficient: 1699.2, 95% CI 349.0-3049.4, P=.02; contrast 2 coefficient: 1601.8, 95% CI 38.7-3164.9, P=.045; contrast 3 coefficient: 1650.5, 95% CI 332.3-2968.7; P=.02), KOOS activity of daily living subscale (contrast 1 coefficient: 6.9, 95% CI 0.1-13.7, P=.047; contrast 3 coefficient: 7.2, 95% CI 0.8-13.6, P=.03), and KOOS quality of life subscale (contrast 1 coefficient: 7.4, 95% CI 0.0-14.7, P=.049; contrast 3 coefficient: 7.3, 95% CI 0.1-14.6, P=.048). We found no significant effect in any outcome measures due to the 2-month delay of the intervention. Conclusions Our counseling program improved MVPA ≥3 METs, daily steps, activity of daily living, and quality of life in people with knee osteoarthritis. These findings are important because an active lifestyle is an important component of successful self-management. Trial Registration ClinicalTrials.gov NCT02315664; https://clinicaltrials.gov/ct2/show/NCT02315664 (Archived by WebCite at http://www.webcitation.org/6ynSgUyUC)
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | | | - Hui Xie
- Arthritis Research Canada, Richmond, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Ryan S Falck
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - John R Best
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Navi Grewal
- Arthritis Research Canada, Richmond, BC, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Greg Noonan
- Mary Pack Arthritis Program, Vancouver General Hospital, Vancouver, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
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Boa Sorte Silva NC, Gill DP, Owen AM, Liu-Ambrose T, Hachinski V, Shigematsu R, Petrella RJ. Cognitive changes following multiple-modality exercise and mind-motor training in older adults with subjective cognitive complaints: The M4 study. PLoS One 2018; 13:e0196356. [PMID: 29698440 PMCID: PMC5919480 DOI: 10.1371/journal.pone.0196356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/11/2018] [Indexed: 01/27/2023] Open
Abstract
Background We investigated the effects of multiple-modality exercise with additional mind-motor training on cognition in community-dwelling older adults with subjective cognitive complaints. Methods Participants (n = 127, mean age 67.5 [7.3] years, 71% women) were randomized to receive 45 minutes of multiple-modality exercise with additional 15 minutes of either mind-motor training (M4, n = 63) or control (balance, range of motion and breathing exercises [M2, n = 64]). In total, both groups exercised 60 minutes/day, 3 days/week, for 24 weeks. Standardized global cognitive functioning (GCF), concentration, reasoning, planning, and memory were assessed at 24 weeks and after a 28-week no-contact follow-up. Results There were no significant differences in the study primary outcomes. The M4 group, however, showed trends for greater improvements in GCF and memory (both, P = .07) compared to the M2 group at 24 weeks. Significant differences between group in GCF (P = .03) and memory (P = .02) were observed after the 28-week no-contact follow-up favouring the M4 group. Discussion Additional mind-motor training did not impart immediate greater benefits to cognition among the study participants.
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Affiliation(s)
- Narlon Cassio Boa Sorte Silva
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Dawn P. Gill
- Lawson Health Research Institute, London, Ontario, Canada
- Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Ontario, Canada
- Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
| | - Adrian M. Owen
- The Brain and Mind Institute, Department of Psychology, Western University, London, Ontario, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, Ontario, Canada
| | | | - Robert J. Petrella
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Ontario, Canada
- Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
- * E-mail:
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153
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Montero-Odasso M, Almeida QJ, Burhan AM, Camicioli R, Doyon J, Fraser S, Li K, Liu-Ambrose T, Middleton L, Muir-Hunter S, McIlroy W, Morais JA, Pieruccini-Faria F, Shoemaker K, Speechley M, Vasudev A, Zou GY, Berryman N, Lussier M, Vanderhaeghe L, Bherer L. SYNERGIC TRIAL (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment. BMC Geriatr 2018; 18:93. [PMID: 29661156 PMCID: PMC5902955 DOI: 10.1186/s12877-018-0782-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/03/2018] [Indexed: 11/30/2022] Open
Abstract
Background Physical exercise, cognitive training, and vitamin D are low cost interventions that have the potential to enhance cognitive function and mobility in older adults, especially in pre-dementia states such as Mild Cognitive Impairment (MCI). Aerobic and progressive resistance exercises have benefits to cognitive performance, though evidence is somewhat inconsistent. We postulate that combined aerobic exercise (AE) and progressive resistance training (RT) (combined exercise) will have a better effect on cognition than a balance and toning control (BAT) intervention in older adults with MCI. We also expect that adding cognitive training and vitamin D supplementation to the combined exercise, as a multimodal intervention, will have synergistic efficacy. Methods The SYNERGIC trial (SYNchronizing Exercises, Remedies in GaIt and Cognition) is a multi-site, double-blinded, five-arm, controlled trial that assesses the potential synergic effect of combined AE and RT on cognition and mobility, with and without cognitive training and vitamin D supplementation in older adults with MCI. Two-hundred participants with MCI aged 60 to 85 years old will be randomized to one of five arms, four of which include combined exercise plus combinations of dual-task cognitive training (real vs. sham) and vitamin D supplementation (3 × 10,000 IU/wk. vs. placebo) in a quasi-factorial design, and one arm which receives all control interventions. The primary outcome measure is the ADAS-Cog (13 and plus modalities) measured at baseline and at 6 months of follow-up. Secondary outcomes include neuroimaging, neuro-cognitive performance, gait and mobility performance, and serum biomarkers of inflammation (C reactive protein and interleukin 6), neuroplasticity (brain-derived neurotropic factor), endothelial markers (vascular endothelial growth factor 1), and vitamin D serum levels. Discussion The SYNERGIC Trial will establish the efficacy and feasibility of a multimodal intervention to improve cognitive performance and mobility outcomes in MCI. These interventions may contribute to new approaches to stabilize and reverse cognitive-mobility decline in older individuals with MCI. Trial Registration Identifier: NCT02808676. https://www.clinicaltrials.gov/ct2/show/NCT02808676. Electronic supplementary material The online version of this article (10.1186/s12877-018-0782-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada. .,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada. .,Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Canada.
| | - Quincy J Almeida
- Sun Life Financial Movement Disorders Research Centre, Wilfrid Laurier University, Waterloo, Canada
| | - Amer M Burhan
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Richard Camicioli
- Geriatric and Cognitive Neurology, University of Alberta, Edmonton, Canada
| | - Julien Doyon
- Functional Neuroimaging Unit, University of Montreal, Montreal, Canada
| | - Sarah Fraser
- Department of Psychology-University of Ottawa, Ottawa, Canada
| | - Karen Li
- Department of Psychology and PERFORM Centre, Concordia University, Montreal, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, and Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Research Institute, University of British Columbia, Vancouver, Canada
| | - Laura Middleton
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Susan Muir-Hunter
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - William McIlroy
- Division of Neurology and Department of Medicine, University of Toronto. Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - José A Morais
- Division of Geriatrics and Centre of Excellence in Aging and Chronic Disease, McGill University, Montreal, Canada
| | - Frederico Pieruccini-Faria
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.,Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Canada
| | - Kevin Shoemaker
- Department of Kinesiology, University of Western Ontario, London, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Akshya Vasudev
- Department of Psychiatry, Division of Geriatric Psychiatry and Department of Medicine, Division of Clinical Pharmacology, University of Western Ontario, London, Canada
| | - G Y Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.,Robarts Clinical Trials Inc, London, Canada
| | - Nicolas Berryman
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.,Department of Sports Studies, Bishop's University, Sherbrooke, Canada
| | - Maxime Lussier
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.,Faculty of Medicine, University of Montreal, Montréal, Canada
| | | | - Louis Bherer
- Department of Psychology and PERFORM Centre, Concordia University, Montreal, Canada.,Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.,Faculty of Medicine, University of Montreal, Montréal, Canada.,Montreal Heart Institute, Research Centre, Montreal, Canada
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154
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Brennan AA, Bruderer AJ, Liu-Ambrose T, Handy TC, Enns JT. Lifespan changes in attention revisited: Everyday visual search. ACTA ACUST UNITED AC 2018; 71:160-171. [PMID: 28604052 DOI: 10.1037/cep0000130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study compared visual search under everyday conditions among participants across the life span (healthy participants in 4 groups, with average age of 6 years, 8 years, 22 years, and 75 years, and 1 group averaging 73 years with a history of falling). The task involved opening a door and stepping into a room find 1 of 4 everyday objects (apple, golf ball, coffee can, toy penguin) visible on shelves. The background for this study included 2 well-cited laboratory studies that pointed to different cognitive mechanisms underlying each end of the U-shaped pattern of visual search over the life span (Hommel et al., 2004; Trick & Enns, 1998). The results recapitulated some of the main findings of the laboratory study (e.g., a U-shaped function, dissociable factors for maturation and aging), but there were several unique findings. These included large differences in the baseline salience of common objects at different ages, visual eccentricity effects that were unique to aging, and visual field effects that interacted strongly with age. These findings highlight the importance of studying cognitive processes in more natural settings, where factors such as personal relevance, life history, and bodily contributions to cognition (e.g., limb, head, and body movements) are more readily revealed. (PsycINFO Database Record
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Affiliation(s)
| | - Alison J Bruderer
- School of Audiology and Speech Sciences, University of British Columbia
| | | | - Todd C Handy
- Department of Psychology, University of British Columbia
| | - James T Enns
- Department of Psychology, University of British Columbia
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155
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Best JR, Eng JJ, Davis JC, Hsiung R, Hall PA, Middleton LE, Graf P, Goldsmith CH, Liu-Ambrose T. Study protocol for Vitality: a proof-of-concept randomised controlled trial of exercise training or complex mental and social activities to promote cognition in adults with chronic stroke. BMJ Open 2018; 8:e021490. [PMID: 29550783 PMCID: PMC5875626 DOI: 10.1136/bmjopen-2018-021490] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke). Two potential intervention strategies are: (1) exercise training and (2) cognitive and social enrichment activities. METHODS AND ANALYSIS The aim of this proof-of-concept randomised controlled trial is to determine whether a 6-month targeted exercise training programme or a 6-month cognitive and social enrichment programme can efficaciously and efficiently improve cognitive function in older adults with chronic stroke compared with a 6-month stretch and tone programme (ie, control). The primary measurement periods will be baseline, month 6 (postintervention) and month 12 (6-month follow-up). The primary outcome measure will be performance on the Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus), a global measure of cognitive performance using multidimensional item response theory to summarise scores from the 13-item ADAS-Cog and other standard cognitive assessments. The primary analysis will compare changes in ADAS-Cog-Plus performance from baseline to month 6. Proof-of-concept outcomes relating to intervention feasibility will be analysed descriptively. The economic evaluation will examine the incremental costs and health outcome benefits generated by both interventions versus the control. ETHICS AND DISSEMINATION Ethical approval has been obtained from the University of British Columbia's Clinical Research Ethics Board (H13-00715, 26 July 2013). Any modifications to the protocol will require a formal amendment to the protocol and approval by the Research Ethics Board. Outcomes of this randomised controlled trial and the statistical code to generate those outcomes will be disseminated through publication in peer-reviewed journals as well as conference presentations. TRIAL REGISTRATION NUMBER NCT01916486.
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Affiliation(s)
- John R Best
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Faculty of Management, University of British Columbia, Kelowna, British Columbia, Canada
| | - Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
- Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Peter A Hall
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Laura E Middleton
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Peter Graf
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles H Goldsmith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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156
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Hsu CL, Best JR, Voss MW, Handy TC, Beauchet O, Lim C, Liu-Ambrose T. Functional Neural Correlates of Slower Gait Among Older Adults With Mild Cognitive Impairment. J Gerontol A Biol Sci Med Sci 2018; 74:513-518. [DOI: 10.1093/gerona/gly027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Michelle W Voss
- Health, Brain, & Cognition Lab, University of Iowa, Iowa City
- Department of Psychology, University of Iowa, Iowa City
| | - Todd C Handy
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Chris Lim
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
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157
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Ten Brinke LF, Best JR, Crockett RA, Liu-Ambrose T. The effects of an 8-week computerized cognitive training program in older adults: a study protocol for a randomized controlled trial. BMC Geriatr 2018; 18:31. [PMID: 29378515 PMCID: PMC5789628 DOI: 10.1186/s12877-018-0730-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/24/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Given the world's aging population, it is important to identify strategies that promote healthy cognitive aging and minimize cognitive decline. Currently, no curative pharmaceutical therapy exists for cognitive impairment and dementia. As a result, there is much interest in lifestyle approaches. Specifically, complex mental activity, such as cognitive training, may be a promising method to combat cognitive decline in older adults. As such, the industry of commercial computerized cognitive training (CCT) applications has rapidly grown in the last decade. However, the efficacy of these commercial products is largely not established. Moreover, exercise is a recognized strategy for promoting cognitive outcomes in older adults and may augment the efficacy of computerized cognitive training applications. Therefore, we propose a proof-of-concept randomized controlled trial (RCT) to examine the effect of a commercial CCT program in community-dwelling older adults. METHODS An 8-week RCT to examine the effect of a commercial CCT program, alone and preceded by a 15-min brisk walk, on cognitive function and explore the underlying neural mechanisms in adults aged 65-85 years old. Participants will be randomized to one of three intervention groups: 1) Computerized cognitive training (FBT); 2) A 15-min brisk walk followed by computerized cognitive training (Ex-FBT); or 3) A combination of educational classes, sham cognitive training, and balanced and tone exercises (active control, BAT). Participants in all intervention groups will attend three one-hour classes per week over the course of the intervention. Participants will be assessed at baseline, trial completion, and 1-year post study completion (1-year follow-up). DISCUSSION If results from this study show benefits for cognition at trial completion, CCT programs, alone or in combination with walking, might be a strategy to promote healthy cognitive aging in older adults. In addition, results from the 1-year follow-up measurement could provide important information regarding the long-term benefits of these CCT programs. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: NCT02564809; registered September 1, 2015.
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Affiliation(s)
- Lisanne F Ten Brinke
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Rachel A Crockett
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, Centre for Hip Health and Mobility, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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158
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Crockett RA, Hsu CL, Best JR, Liu-Ambrose T. Resting State Default Mode Network Connectivity, Dual Task Performance, Gait Speed, and Postural Sway in Older Adults with Mild Cognitive Impairment. Front Aging Neurosci 2017; 9:423. [PMID: 29311906 PMCID: PMC5742581 DOI: 10.3389/fnagi.2017.00423] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022] Open
Abstract
Aging is associated with an increased risk of falling. In particular, older adults with mild cognitive impairment (MCI) are more vulnerable to falling compared with their healthy counterparts. Major contributors to this increased falls risk include a decline in dual task performance, gait speed, and postural sway. Recent evidence highlights the potential influence of the default mode network (DMN), the frontoparietal network (FPN), and the supplementary motor area (SMA) on dual task performance, gait speed, and postural sway. The DMN is active during rest and deactivates during task-oriented processes, to maintain attention and stay on task. The FPN and SMA are involved in top-down attentional control, motor planning, and motor execution. The DMN shows less deactivation during task in older adults with MCI. This lack of deactivation is theorized to increase competition for resources between the DMN and task-related brain regions (e.g., the FPN and SMA), increasing distraction from the task and reducing task performance. However, no study has yet investigated the relationship between the between-network connectivity of the DMN with these regions and dual task walking, gait speed or postural sway. We hypothesized that greater functional connectivity both within the DMN and between DMN–FPN and DMN–SMA, will be associated with poorer performance during dual task walking, slower gait speed, and greater postural sway in older adults with MCI. Forty older adults with MCI were measured on a dual task-walking paradigm, gait speed over a 4-m walk, and postural sway using a sway-meter. Greater within-DMN connectivity was significantly correlated with poorer dual task performance. Furthermore, greater inter-network connectivity between the DMN and SMA was significantly correlated with slower gait speed and greater postural sway on the eyes open floor sway task. Thus, greater resting state DMN functional connectivity may be an underlying neural mechanism for reduced dual task ability, slower gait speed, and greater postural sway, resulting in the increased risk of mobility disability and falling in older adults with MCI.
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Affiliation(s)
- Rachel A Crockett
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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Barha CK, Hsiung GYR, Best JR, Davis JC, Eng JJ, Jacova C, Lee PE, Munkacsy M, Cheung W, Liu-Ambrose T. Sex Difference in Aerobic Exercise Efficacy to Improve Cognition in Older Adults with Vascular Cognitive Impairment: Secondary Analysis of a Randomized Controlled Trial. J Alzheimers Dis 2017; 60:1397-1410. [DOI: 10.3233/jad-170221] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Cindy K. Barha
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
| | - Ging-Yuek R. Hsiung
- Division of Neurology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
- Vancouver Coastal Health Research Institute and University of British ColumbiaHospital Clinic for Alzheimer Disease and Related Disorders, Vancouver, Canada
| | - John R. Best
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
| | - Jennifer C. Davis
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
| | - Janice J. Eng
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, Canada
| | - Claudia Jacova
- Division of Neurology, University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health Research Institute and University of British ColumbiaHospital Clinic for Alzheimer Disease and Related Disorders, Vancouver, Canada
| | - Philip E. Lee
- Vancouver Coastal Health Research Institute and University of British ColumbiaHospital Clinic for Alzheimer Disease and Related Disorders, Vancouver, Canada
| | | | - Winnie Cheung
- Centre for Hip Health and Mobility, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
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160
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Falck RS, Landry GJ, Best JR, Davis JC, Chiu BK, Liu-Ambrose T. Cross-Sectional Relationships of Physical Activity and Sedentary Behavior With Cognitive Function in Older Adults With Probable Mild Cognitive Impairment. Phys Ther 2017; 97:975-984. [PMID: 29029554 PMCID: PMC5803762 DOI: 10.1093/ptj/pzx074] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 07/17/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) represents a transition between normal cognitive aging and dementia and may represent a critical time frame for promoting cognitive health through behavioral strategies. Current evidence suggests that physical activity (PA) and sedentary behavior are important for cognition. However, it is unclear whether there are differences in PA and sedentary behavior between people with probable MCI and people without MCI or whether the relationships of PA and sedentary behavior with cognitive function differ by MCI status. OBJECTIVE The aims of this study were to examine differences in PA and sedentary behavior between people with probable MCI and people without MCI and whether associations of PA and sedentary behavior with cognitive function differed by MCI status. DESIGN This was a cross-sectional study. METHODS Physical activity and sedentary behavior in adults dwelling in the community (N = 151; at least 55 years old) were measured using a wrist-worn actigraphy unit. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (scores of ≥26/30). Cognitive function was indexed using the Alzheimer Disease Assessment Scale-Cognitive-Plus (ADAS-Cog Plus). Physical activity and sedentary behavior were compared based on probable MCI status, and relationships of ADAS-Cog Plus with PA and sedentary behavior were examined by probable MCI status. RESULTS Participants with probable MCI (n = 82) had lower PA and higher sedentary behavior than participants without MCI (n = 69). Higher PA and lower sedentary behavior were associated with better ADAS-Cog Plus performance in participants without MCI (β = -.022 and β = .012, respectively) but not in participants with probable MCI (β < .001 for both). LIMITATIONS This study was cross-sectional and therefore could not establish whether conversion to MCI attenuated the relationships of PA and sedentary behavior with cognitive function. The diagnosis of MCI was not confirmed with a physician; therefore, this study could not conclude how many of the participants categorized as having probable MCI would actually have been diagnosed with MCI by a physician. CONCLUSIONS Participants with probable MCI were less active and more sedentary. The relationships of these behaviors with cognitive function differed by MCI status; associations were found only in participants without MCI.
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Affiliation(s)
- Ryan S. Falck
- R.S. Falck, MSc, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Glenn J. Landry
- G.J. Landry, PhD, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - John R. Best
- J.R. Best, PhD, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C. Davis
- J.C. Davis, PhD, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bryan K. Chiu
- B.K. Chiu, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- T. Liu-Ambrose, PhD, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Centre for Hip Health and Mobility, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada.,Address all correspondence to Dr Liu-Ambrose at:
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161
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Dao E, Hsiung GYR, Liu-Ambrose T. The role of exercise in mitigating subcortical ischemic vascular cognitive impairment. J Neurochem 2017; 144:582-594. [PMID: 28833160 DOI: 10.1111/jnc.14153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 12/14/2022]
Abstract
Subcortical ischemic vascular cognitive impairment (SIVCI) is the most preventable form of cognitive dysfunction. There is converging evidence from animal and human studies that indicate vascular injury as the primary cause of SIVCI. Currently, there are no curative pharmaceutical treatments for vascular dementia; however, exercise may be a promising strategy to combat SIVCI. This review will focus on the role of exercise as a strategy to prevent or slow the progression of SIVCI, with particular emphasis on the mechanisms by which exercise may improve cerebrovascular function. We propose that exercise may be an effective strategy to combat SIVCI by improving cognitive function, increasing the bioavailability of neurotrophins, stimulating endothelial function, and controlling vascular risk factors. This article is part of the Special Issue "Vascular Dementia".
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Affiliation(s)
- Elizabeth Dao
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada
| | - Ging-Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Department of Medicine, Division of Neurology, UBC, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
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162
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Hsu CL, Best JR, Wang S, Voss MW, Hsiung RGY, Munkacsy M, Cheung W, Handy TC, Liu-Ambrose T. Corrigendum: The Impact of Aerobic Exercise on Fronto-Parietal Network Connectivity and Its Relation to Mobility: An Exploratory Analysis of a 6-Month Randomized Controlled Trial. Front Hum Neurosci 2017; 11:449. [PMID: 28900392 PMCID: PMC5591871 DOI: 10.3389/fnhum.2017.00449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/23/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chun L Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
| | - Shirley Wang
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
| | - Michelle W Voss
- Health, Brain and Cognition Lab, University of IowaIowa City, IA, United States.,Department of Psychology, University of IowaIowa City, IA, United States
| | - Robin G Y Hsiung
- Department of Medicine, University of British ColumbiaVancouver, BC, Canada
| | - Michelle Munkacsy
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
| | - Winnie Cheung
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
| | - Todd C Handy
- Department of Psychology, University of British ColumbiaVancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British ColumbiaVancouver, BC, Canada.,Department of Physical Therapy, University of British ColumbiaVancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British ColumbiaVancouver, BC, Canada.,Center for Hip Health and MobilityVancouver, BC, Canada
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163
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Gregory MA, Boa Sorte Silva NC, Gill DP, McGowan CL, Liu-Ambrose T, Shoemaker JK, Hachinski V, Holmes J, Petrella RJ. Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline1. J Alzheimers Dis 2017; 57:747-763. [PMID: 28304305 DOI: 10.3233/jad-161240] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This 6-month experimental case series study investigated the effects of a dual-task gait training and aerobic exercise intervention on cognition, mobility, and cardiovascular health in community-dwelling older adults without dementia. Participants exercised 40 min/day, 3 days/week for 26 weeks on a Biodex GaitTrainer2 treadmill. Participants were assessed at baseline (V0), interim (V1: 12-weeks), intervention endpoint (V2: 26-weeks), and study endpoint (V3: 52-weeks). The study outcomes included: cognition [executive function (EF), processing speed, verbal fluency, and memory]; mobility: usual & dual-task gait (speed, step length, and stride time variability); and vascular health: ambulatory blood pressure, carotid arterial compliance, and intima-media thickness (cIMT). Fifty-six participants [age: 70(6) years; 61% female] were included in this study. Significant improvements following the exercise program (V2) were observed in cognition: EF (p = 0.002), processing speed (p < 0.001), verbal fluency [digit symbol coding (p < 0.001), phonemic verbal fluency (p < 0.001)], and memory [immediate recall (p < 0.001) and delayed recall (p < 0.001)]; mobility: usual & dual-task gait speed (p = 0.002 and p < 0.001, respectively) and step length (p = 0.001 and p = 0.003, respectively); and vascular health: cIMT (p = 0.002). No changes were seen in the remaining outcomes. In conclusion, 26 weeks of dual-task gait training and aerobic exercise improved performance on a number of cognitive outcomes, while increasing usual & dual-task gait speed and step length in a sample of older adults without dementia.
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Affiliation(s)
- Michael A Gregory
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Narlon C Boa Sorte Silva
- Lawson Health Research Institute, London, ON, Canada.,School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Dawn P Gill
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Cheri L McGowan
- Lawson Health Research Institute, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada
| | - J Kevin Shoemaker
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada
| | - Jeff Holmes
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Robert J Petrella
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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164
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Beauchet O, Allali G, Sekhon H, Verghese J, Guilain S, Steinmetz JP, Kressig RW, Barden JM, Szturm T, Launay CP, Grenier S, Bherer L, Liu-Ambrose T, Chester VL, Callisaya ML, Srikanth V, Léonard G, De Cock AM, Sawa R, Duque G, Camicioli R, Helbostad JL. Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative. Front Hum Neurosci 2017; 11:353. [PMID: 28824393 PMCID: PMC5540886 DOI: 10.3389/fnhum.2017.00353] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities. Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the "Gait, cOgnitiOn & Decline" (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy-free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)-participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls declined with increasing age (mean values and CoV) and demonstrated sex differences (mean values). Conclusions: Based on an international multicenter collaboration, we propose consensus guidelines for gait assessment and spatiotemporal gait analysis based on the recorded footfalls, and reference values for healthy older adults.
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Affiliation(s)
- Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill UniversityMontreal, QC, Canada.,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill UniversityMontreal, QC, Canada.,Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health NetworkQC, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of GenevaGeneva, Switzerland.,Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva UniversityBronx, NY, United States
| | - Harmehr Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill UniversityMontreal, QC, Canada
| | - Joe Verghese
- Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva UniversityBronx, NY, United States
| | - Sylvie Guilain
- Geriatric Department, Liège University HospitalLiege, Belgium.,Laboratory of Human Motion Analysis, Liège UniversityLiege, Belgium
| | | | - Reto W Kressig
- Basel University Center for Medicine of Aging, Felix Platter Hospital and University of BaselBasel, Switzerland
| | - John M Barden
- Faculty of Kinesiology and Health Studies, Neuromechanical Research Centre, University of ReginaRegina, SK, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of ManitobaWinnipeg, MB, Canada
| | - Cyrille P Launay
- Division of Geriatrics, Angers University HospitalAngers, France
| | - Sébastien Grenier
- Centre de Recherche, Institut Universitaire de Gériatrie de MontréalMontreal, QC, Canada
| | - Louis Bherer
- Centre de Recherche, Institut Universitaire de Gériatrie de MontréalMontreal, QC, Canada.,Department of Medicine and Montreal Heart Institute, University of MontrealMontreal, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British ColumbiaVancouver, BC, Canada
| | - Vicky L Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New BrunswickFredericton, NB, Canada
| | - Michele L Callisaya
- Menzies Institute of Medical Research, University of TasmaniaHobart, TAS, Australia.,Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash UniversityMelbourne, VIC, Australia
| | - Velandai Srikanth
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash UniversityMelbourne, VIC, Australia
| | - Guillaume Léonard
- Research Center on Aging, CIUSSS de l'Estrie-CHUSSherbrooke, QC, Canada
| | - Anne-Marie De Cock
- Department of Geriatrics and Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp and AZ St. Maarten MechelenAntwerp, Belgium
| | - Ryuichi Sawa
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and WelfareNarita, Japan
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science, University of Melbourne and Western HealthSt. Albans, VIC, Australia
| | - Richard Camicioli
- Division of Neurology, Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Jorunn L Helbostad
- Department of Neuro-Medicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and TechnologyTrondheim, Norway.,Clinic for Clinical Services, St. Olav University HospitalTrondheim, Norway
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165
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Ten Brinke LF, Davis JC, Barha CK, Liu-Ambrose T. Effects of computerized cognitive training on neuroimaging outcomes in older adults: a systematic review. BMC Geriatr 2017; 17:139. [PMID: 28693437 PMCID: PMC5504817 DOI: 10.1186/s12877-017-0529-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 06/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background Worldwide, the population is aging and the number of individuals diagnosed with dementia is rising rapidly. Currently, there are no effective pharmaceutical cures. Hence, identifying lifestyle approaches that may prevent, delay, or treat cognitive impairment and dementia in older adults is becoming increasingly important. Computerized Cognitive Training (CCT) is a promising strategy to combat cognitive decline. Yet, the underlying mechanisms of the effect of CCT on cognition remain poorly understood. Hence, the primary objective of this systematic review was to examine peer-reviewed literature ascertaining the effect of CCT on both structural and functional neuroimaging measures among older adults to gain insight into the underlying mechanisms by which CCT may benefit cognitive function. Methods In accordance with PRISMA guidelines, we used the following databases: MEDLINE, EMBASE, and CINAHL. Two independent reviewers abstracted data using pre-defined terms. These included: main study characteristics such as the type of training (i.e., single- versus multi-domain), participant demographics (age ≥ 50 years; no psychiatric conditions), and the inclusion of neuroimaging outcomes. The Physiotherapy Evidence Database (PEDro) scale was used to assess quality of all studies included in this systematic review. Results Nine studies were included in this systematic review, with four studies including multiple MRI sequences. Results of this systematic review are mixed: CCT was found to increase and decrease both brain structure and function in older adults. In addition, depending on region of interest, both increases and decreases in structure and function were associated with behavioural performance. Conclusions Of all studies included in this systematic review, results from the highest quality studies, which were two randomized controlled trials, demonstrated that multi-domain CCT could lead to increases in hippocampal functional connectivity. Further high quality studies that include an active control, a sample size calculation, and an appropriate training dosage, are needed to confirm these findings and their relation to cognition.
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Affiliation(s)
- Lisanne F Ten Brinke
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Jennifer C Davis
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Cindy K Barha
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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166
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Barha C, Dao E, Best J, Hsiung R, Tam R, Liu-Ambrose T. SEX-DEPENDENT EFFECT OF EXERCISE ON BRAIN HEALTH IN OLDER ADULTS WITH VCI. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C. Barha
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
| | - E. Dao
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
| | - J. Best
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
| | - R.G. Hsiung
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
| | - R. Tam
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
| | - T. Liu-Ambrose
- Physical Therapy, University of British Columbia, Burnaby, British Columbia, Canada
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167
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ten Brinke L, Hsu C, Liu-Ambrose T. INCREASED CARDIOVASCULAR CAPACITY IS ASSOCIATED WITH CORTICAL THICKNESS IN OLDER ADULTS WITH VCI. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L. ten Brinke
- Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - C. Hsu
- Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - T. Liu-Ambrose
- Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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168
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Liu-Ambrose T. PHYSICAL ACTIVITY AND BRAIN HEALTH. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- T. Liu-Ambrose
- University of British Columbia, Vancouver, British Columbia, Canada
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169
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Hsu C, Best J, Wang S, Voss M, Hsiung R, Munkacsy M, Handy T, Liu-Ambrose T. GAINING INSIGHT TO THE UNDERLYING NEURAL MECHANISMS BY WHICH EXERCISE IMPROVES MOBILITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. Hsu
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility, and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada
| | - J. Best
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility, and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada
| | - S. Wang
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility, and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada
| | - M. Voss
- University of Iowa, Iowa City, Iowa,
| | - R.G. Hsiung
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
| | - M. Munkacsy
- Aging, Mobility, and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada
| | - T. Handy
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
| | - T. Liu-Ambrose
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility, and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada
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Davis J, Best J, Khan K, Dian L, Lord S, Delbaere K, Hsu C, Liu-Ambrose T. SLOW PROCESSING SPEED PREDICTS FALLS IN OLDER ADULTS WITH A FALLS HISTORY: 1-YEAR PROSPECTIVE COHORT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Davis
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - J. Best
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - K. Khan
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - L. Dian
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - S. Lord
- Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - K. Delbaere
- Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - C. Hsu
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - T. Liu-Ambrose
- University of British Columbia, Vancouver, British Columbia, Canada,
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171
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Dao E, Best J, Hsiung R, Sossi V, Jacova C, Tam R, Liu-Ambrose T. EFFECTS OF AMYLOID ON CHANGES IN COGNITIVE AND PHYSICAL FUNCTION IN VASCULAR COGNITIVE IMPAIRMENT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E. Dao
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - J. Best
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - R.G. Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - V. Sossi
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - C. Jacova
- Pacific University, Forest Grove, Oregon
| | - R. Tam
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - T. Liu-Ambrose
- University of British Columbia, Vancouver, British Columbia, Canada,
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172
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Hsu C, Best J, Davis J, Nagamatsu L, Wang S, Hsiung R, Voss M, Liu-Ambrose T. AEROBIC EXERCISE PROMOTES EXECUTIVE FUNCTIONING AND ASSOCIATED FUNCTIONAL NEUROPLASTICITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C. Hsu
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility,and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada,
- Djavad Mowafaghian Center for Brain Health, Vancouver, British Columbia, Canada,
| | - J. Best
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility,and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada,
- Djavad Mowafaghian Center for Brain Health, Vancouver, British Columbia, Canada,
| | - J.C. Davis
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Djavad Mowafaghian Center for Brain Health, Vancouver, British Columbia, Canada,
- Center for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - L. Nagamatsu
- University of Western Ontario, London, Ontario, Canada,
| | - S. Wang
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility,and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada,
- Djavad Mowafaghian Center for Brain Health, Vancouver, British Columbia, Canada,
| | - R.G. Hsiung
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
| | - M. Voss
- University of Iowa, Iowa City, Iowa
| | - T. Liu-Ambrose
- Rehabilitation Science, University of British Columbia, Vancouver, British Columbia, Canada,
- Aging, Mobility,and Cognitive Neuroscience Lab, Vancouver, British Columbia, Canada,
- Djavad Mowafaghian Center for Brain Health, Vancouver, British Columbia, Canada,
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173
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Liu-Ambrose T. WHICH PHYSICAL EXERCISES IMPROVE COGNITION IN MCI? LESSONS LEARNED FROM THE PROMOTE TRIAL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T. Liu-Ambrose
- University of British Columbia, Vancouver, British Columbia, Canada
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174
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Hsu CL, Best JR, Wang S, Voss MW, Hsiung RGY, Munkacsy M, Cheung W, Handy TC, Liu-Ambrose T. The Impact of Aerobic Exercise on Fronto-Parietal Network Connectivity and Its Relation to Mobility: An Exploratory Analysis of a 6-Month Randomized Controlled Trial. Front Hum Neurosci 2017; 11:344. [PMID: 28713255 PMCID: PMC5492161 DOI: 10.3389/fnhum.2017.00344] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/14/2017] [Indexed: 12/12/2022] Open
Abstract
Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)—and exercise-induced changes in FPN connectivity would correlate with changes in mobility. We focused on the FPN as it is involved in top-down attentional control as well as motor planning and motor execution. Participants were randomized either to usual-care (CON), which included monthly educational materials about VCI and healthy diet; or thrice-weekly aerobic training (AT), which was walking outdoors with progressive intensity. Functional magnetic resonance imaging was acquired at baseline and trial completion, where the participants were instructed to perform bilateral finger tapping task. At trial completion, compared with AT, CON showed significantly increased FPN connectivity strength during right finger tapping (p < 0.05). Across the participants, reduced FPN connectivity was associated with greater cardiovascular capacity (p = 0.05). In the AT group, reduced FPN connectivity was significantly associated with improved mobility performance, as measured by the Timed-Up-and-Go test (r = 0.67, p = 0.02). These results suggest progressive AT may improve mobility in older adults with SIVCI via maintaining intra-network connectivity of the FPN.
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Affiliation(s)
- Chun L Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Shirley Wang
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Michelle W Voss
- Health, Brain, and Cognition Lab, University of Iowa, Iowa CityIA, United States.,Department of Psychology, University of Iowa, Iowa CityIA, United States
| | - Robin G Y Hsiung
- Department of Medicine, University of British Columbia, VancouverBC, Canada
| | - Michelle Munkacsy
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Winnie Cheung
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Todd C Handy
- Department of Psychology, University of British Columbia, VancouverBC, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
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175
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Dao E, Best JR, Hsiung GYR, Sossi V, Jacova C, Tam R, Liu-Ambrose T. Associations between cerebral amyloid and changes in cognitive function and falls risk in subcortical ischemic vascular cognitive impairment. BMC Geriatr 2017; 17:133. [PMID: 28659161 PMCID: PMC5490153 DOI: 10.1186/s12877-017-0522-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/14/2017] [Indexed: 12/02/2022] Open
Abstract
Background To determine the association between amyloid-beta (Aβ) plaque deposition and changes in global cognition, executive functions, information processing speed, and falls risk over a 12-month period in older adults with a primary clinical diagnosis of subcortical ischemic vascular cognitive impairment (SIVCI). Methods This is a secondary analysis of data acquired from a subset of participants (N = 22) who were enrolled in a randomized controlled trial of aerobic exercise (NCT01027858). The subset of individuals completed an 11C Pittsburgh compound B (PIB) scan. Cognitive function and falls risk were assessed at baseline, 6-months, and 12-months. Global cognition, executive functions, and information processing speed were measured using: 1) ADAS-Cog; 2) Trail Making Test; 3) Digit Span Test; 4) Stroop Test, and 5) Digit Symbol Substitution Test. Falls risk was measured using the Physiological Profile Assessment. Hierarchical multiple linear regression analyses determined the unique contribution of Aβ on changes in cognitive function and falls risk at 12-months after controlling for experimental group (i.e. aerobic exercise training or usual care control) and baseline performance. To correct for multiple comparisons, we applied the Benjamini-Hochberg procedure to obtain a false discovery rate corrected threshold using alpha = 0.05. Results Higher PIB retention was significantly associated with greater decrements in set shifting (Trail Making Test, adjusted R2 = 35.3%, p = 0.002), attention and conflict resolution (Stroop Test, adjusted R2 = 33.4%, p = 0.01), and information processing speed (Digit Symbol Substitution Test, adjusted R2 = 24.4%, p = 0.001) over a 12-month period. Additionally, higher PIB retention was significantly associated with increased falls risk (Physiological Profile Assessment, adjusted R2 = 49.1%, p = 0.04). PIB retention was not significantly associated with change in ADAS-Cog and Verbal Digit Span Test (p > 0.05). Conclusions Symptoms associated with SIVCI may be amplified by secondary Aβ pathology. Trial registration ClinicalTrials.gov, NCT01027858, December 7, 2009.
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Affiliation(s)
- Elizabeth Dao
- Department of Physical Therapy, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - John R Best
- Department of Physical Therapy, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - Ging-Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada.,Department of Medicine, University of British Columbia, UBC Hospital S152, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1, Canada
| | - Claudia Jacova
- School of Graduate Psychology, Pacific University, 190 SE 8th Avenue, Hillsboro, OR, 97123, USA
| | - Roger Tam
- MS/MRI Research Group, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. .,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada. .,Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
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176
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Best JR, Rosano C, Aizenstein HJ, Tian Q, Boudreau RM, Ayonayon HN, Satterfield S, Simonsick EM, Studenski S, Yaffe K, Liu-Ambrose T. Long-term changes in time spent walking and subsequent cognitive and structural brain changes in older adults. Neurobiol Aging 2017. [PMID: 28648916 DOI: 10.1016/j.neurobiolaging.2017.05.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Previous studies have shown that more active older adults have better cognition and brain health based on a variety of structural neuroimaging measures. Nevertheless, the effects of maintaining physical activity (PA) over an extended period of time on future changes in older adults' cognition and brain structure are unknown. Participants were 141 initially well-functioning community-dwelling older adults (aged 70-79 years at baseline; 60% female; 42% black) studied over a 13-year period. PA (self-reported time spent walking) was assessed annually from years 1 to 10. Magnetic resonance imaging with diffusion tensor was performed at years 10 and 13. Time spent walking decreased on average by 8.4% annually from year 1 to year 10. Independent of initial time spent walking, demographics, and APOE e4 status, better maintenance of time spent walking over the decade predicted less reduction in hippocampal volume (p = 0.03), smaller increases in global gray matter mean diffusivity and white matter axial diffusivity (p < 0.01), and maintenance of general cognitive performance (p < 0.01). Maintenance of cognitive performance was associated with smaller increases in white matter axial diffusivity (p < 0.01). PA at baseline and at year 10, as well as changes in PA over a 5-year period, was less predictive of future changes in brain structure and cognition. Thus, how PA levels change over longer periods of aging may be an important contributor to cognitive and neural protection.
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Affiliation(s)
- John R Best
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hilsa N Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Stephanie Studenski
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Departments of Psychiatry and Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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177
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Tse CM, Carpenter MG, Liu-Ambrose T, Chisholm AE, Lam T. Attentional requirements of postural control in people with spinal cord injury: the effect of dual task. Spinal Cord 2017; 55:915-920. [DOI: 10.1038/sc.2017.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/25/2017] [Accepted: 03/28/2017] [Indexed: 11/09/2022]
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178
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Hsu CL, Best JR, Davis JC, Nagamatsu LS, Wang S, Boyd LA, Hsiung GR, Voss MW, Eng JJ, Liu-Ambrose T. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med 2017; 52:184-191. [PMID: 28432077 DOI: 10.1136/bjsports-2016-096846] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline. AIM To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI). METHODS Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed. RESULTS At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion. SUMMARY Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.
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Affiliation(s)
- Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Shirley Wang
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Lara A Boyd
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gy Robin Hsiung
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle W Voss
- Department of Psychology, University of Iowa, Iowa City, Iowa, USA.,Health, Brain, & Cognition Lab, University of Iowa, Iowa City, Iowa, USA
| | - Janice Jennifer Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
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179
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Davis JC, Best JR, Khan KM, Dian L, Lord S, Delbaere K, Hsu CL, Cheung W, Chan W, Liu-Ambrose T. Slow Processing Speed Predicts Falls in Older Adults With a Falls History: 1-Year Prospective Cohort Study. J Am Geriatr Soc 2017; 65:916-923. [DOI: 10.1111/jgs.14830] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jennifer C. Davis
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - John R. Best
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Karim M. Khan
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Department of Family Practice; University of British Columbia; Vancouver British Columbia Canada
| | - Larry Dian
- Division of Geriatrics; Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Stephen Lord
- Falls, Balance and Injury Research Centre; Neuroscience Research Australia; Sydney New South Wales Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre; Neuroscience Research Australia; Sydney New South Wales Australia
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Winnie Cheung
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Wency Chan
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab; Department of Physical Therapy; University of British Columbia; Vancouver British Columbia Canada
- Center for Hip Health and Mobility; Vancouver Coastal Health Research Institute; Vancouver British Columbia Canada
- Djavad Mowafaghian Centre for Brain Health; Vancouver British Columbia Canada
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180
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Davis JC, Hsiung GYR, Bryan S, Best JR, Eng JJ, Munkacsy M, Cheung W, Chiu B, Jacova C, Lee P, Liu-Ambrose T. Economic evaluation of aerobic exercise training in older adults with vascular cognitive impairment: PROMoTE trial. BMJ Open 2017; 7:e014387. [PMID: 28360247 PMCID: PMC5372066 DOI: 10.1136/bmjopen-2016-014387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/OBJECTIVES Evidence suggests that aerobic exercise may slow the progression of subcortical ischaemic vascular cognitive impairment (SIVCI) by modifying cardiovascular risk factors. Yet the economic consequences relating to aerobic training (AT) remain unknown. Therefore, our primary objective was to estimate the incremental cost per quality-adjusted life years (QALYs) gained of a thrice weekly AT intervention compared with usual care. DESIGN Cost-utility analysis alongside a randomised trial. SETTING Vancouver, British Columbia, Canada. PARTICIPANTS 70 adults (mean age of 74 years, 51% women) who meet the diagnostic criteria for mild SIVCI. INTERVENTION A 6-month, thrice weekly, progressive aerobic exercise training programme compared with usual care (CON; comparator) with a follow-up assessment 6 months after formal cessation of aerobic exercise training. MEASUREMENTS Healthcare resource usage was estimated over the 6-month intervention and 6-month follow-up period. Health status (using the EQ-5D-3L) at baseline and trial completion and 6-month follow-up was used to calculate QALYs. The incremental cost-utility ratio (cost per QALY gained) was calculated. RESULTS QALYs were both modestly greater, indicating a health gain. Total healthcare costs (ie, 1791±1369 {2015 $CAD} at 6 months) were greater, indicating a greater cost for the thrice weekly AT group compared with CON. From the Canadian healthcare system perspective, the incremental cost-utility ratios for thrice weekly AT were cost-effective compared with CON, when using a willingness to pay threshold of $CAD 20 000 per QALY gained or higher. CONCLUSIONS AT represents an attractive and potentially cost-effective strategy for older adults with mild SIVCI. TRIAL REGISTRATION NUMBER NCT01027858.
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Affiliation(s)
- Jennifer C Davis
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Ging-Yuek Robin Hsiung
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stirling Bryan
- Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Best
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle Munkacsy
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Winnie Cheung
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Bryan Chiu
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Claudia Jacova
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Philip Lee
- Department of Medicine, Division of Geriatric Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
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Best JR, Chiu BK, Hall PA, Liu-Ambrose T. Larger Lateral Prefrontal Cortex Volume Predicts Better Exercise Adherence Among Older Women: Evidence From Two Exercise Training Studies. J Gerontol A Biol Sci Med Sci 2017; 72:804-810. [DOI: 10.1093/gerona/glx043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/09/2017] [Indexed: 12/15/2022] Open
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Falck RS, Wilcox S, Best JR, Chandler JL, Liu-Ambrose T. The Association Between Physical Performance and Executive Function in a Sample of Rural Older Adults from South Carolina, USA. Exp Aging Res 2017; 43:192-205. [PMID: 28230419 DOI: 10.1080/0361073x.2017.1276379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Mobility and executive functions (EFs) decline with age, although associations between mobility and EFs are less clear. This study examined relationships between different mobility measures and EFs among rural older adults. METHODS This cross-sectional study recruited 56 older adults (60+ years) in rural South Carolina. Mobility was assessed via gait speed, timed up-and-go, chair stand, and as a composite physical performance score (PPS). EFs was assessed via Trail Making Test, semantic fluency, and phonemic fluency. Bivariate analyses were performed and regressions were calculated controlling for appropriate covariates, with PPS as the independent variable and each EF test as the dependent variable. RESULTS Mean age was 74.22 years (SD = 8.02), 80.40% were female and 64.71% were white. Bivariate analysis revealed associations between gait speed and Trail Making Test (r = -.33; p = .03), between timed up-and-go and Trail Making Test (r = .34; p = .01), and between PPS and Trail Making Test (r = -.33; p = .03). The regression models indicated higher PPS was associated with better performance on Trail Making Test (β = -1.12; p < 0.01), phonemic fluency (β = 0.68; p = .01), and semantic fluency (β = 0.81; p = .02). CONCLUSIONS In a rural setting, mobility is associated with multiple EF processes. Higher mobility and physical ability are desired for maintaining EFs capability.
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Affiliation(s)
- Ryan S Falck
- a Department of Physical Therapy , University of British Columbia , Vancouver , British Columbia , Canada
| | - Sara Wilcox
- b Department of Exercise Science , University of South Carolina , Columbia , South Carolina , USA
| | - John R Best
- a Department of Physical Therapy , University of British Columbia , Vancouver , British Columbia , Canada
| | - Jessica L Chandler
- b Department of Exercise Science , University of South Carolina , Columbia , South Carolina , USA
| | - Teresa Liu-Ambrose
- c Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine , University of British Columbia , Vancouver , British Columbia , Canada
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183
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Falck RS, Davis JC, Milosevic E, Liu-Ambrose T. How much will older adults exercise? A feasibility study of aerobic training combined with resistance training. Pilot Feasibility Stud 2017; 3:2. [PMID: 28138396 PMCID: PMC5267441 DOI: 10.1186/s40814-016-0116-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 12/12/2016] [Indexed: 12/17/2022] Open
Abstract
Background Both aerobic training (AT) and resistance training (RT) have multidimensional health benefits for older adults including increased life expectancy and decreased risk of chronic diseases. However, the volume (i.e., frequency*time) of AT combined with RT in which untrained older adults can feasibly and safely participate remains unclear. Thus, our primary objective was to investigate the feasibility and safety of a high-volume exercise program consisting of twice weekly AT combined with twice weekly RT (i.e., four times weekly exercise) on a group of untrained older adults. In addition, we investigated the effects of the program on physical function, aerobic capacity, muscular strength, and explored factors related to participant adherence. Methods We recruited eight inactive older adults (65+ years) to participate in a 6-week, single-group pre-post exercise intervention, consisting of 2 days/week of AT plus 2 days/week of progressive RT for 6 weeks. We recorded program attendance and monitored for adverse events during the course of the program. Participants were tested at both baseline and follow-up on the following: (1) physical function (i.e., timed-up-and-go test (TUG) and short physical performance battery (SPPB)), (2) aerobic capacity (VO2max) using the modified Bruce protocol; and (3) muscular strength on the leg press and lat pull-down. Post intervention, we performed qualitative semi-structured interviews of all participants regarding their experiences in the exercise program. We used these responses to examine themes that may affect continued program adherence to a high-volume exercise program. Results We recorded an average attendance rate of 83.3% with the lowest attendance for one session being five out of eight participants; no significant adverse events occurred. Significant improvements were observed for SPPB score (1.6; 95% CI: [0.3, 2.9]), VO2max (8.8 ml/kg/min; 95% CI: [2.8, 14.8]), and lat pull-down strength (11.8 lbs; 95% CI: [3.3, 20.2]). Qualitative results revealed two themes that promote older adults’ adherence: (1) convenience of the program and (2) the social benefits of exercise. Conclusions Our findings suggest untrained older adults can be successful at completing twice weekly AT combined with twice weekly progressive RT; however, these exercise programs should be group-based in order to maintain high adherence.
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Affiliation(s)
- Ryan S Falck
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Jennifer C Davis
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Elizabeth Milosevic
- Faculty of Medicine, School of Kinesiology, University of British Columbia, 6081 University Blvd, Vancouver, BC V6T 1Z1 Canada
| | - Teresa Liu-Ambrose
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
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184
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Tang A, Eng JJ, Krassioukov AV, Tsang TSM, Liu-Ambrose T. High- and low-intensity exercise do not improve cognitive function after stroke: A randomized controlled trial. J Rehabil Med 2017; 48:841-846. [PMID: 27786346 DOI: 10.2340/16501977-2163] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the effects of high versus low-intensity exercise on cognitive function following stroke. DESIGN Secondary analysis from a randomized controlled trial with blinded assessors. SUBJECTS 50-80 years old, living in the community, > 1 year post-stroke. METHODS Participants were randomized into a high-intensity Aerobic Exercise or low-intensity non-aerobic Balance/Flexibility program. Both programs were 6 months long, with 3 60-min sessions/week. Verbal item and working memory, selective attention and conflict resolution, set shifting were assessed before and after the program. RESULTS Forty-seven participants completed the study (22/25 in Aerobic Exercise group, 25/25 in Balance/Flexibility group). There was an improvement in verbal item memory in both groups (time effect p = 0.04), and no between-group differences in improvement in the other outcomes (p > 0.27). There was no association between pre-exercise cognitive function and post-exercise improvement. CONCLUSIONS In contrast to a small body of previous research suggesting positive benefits of exercise on cognition post-stroke, the current study found that 6 months of high or low intensity exercise was not effective in improving cognitive function, specifically executive functions. Further research in this area is warranted to establish the effectiveness of post-stroke exercise programs on cognition, and examine the mechanisms that underlie these changes.
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Affiliation(s)
- Ada Tang
- School of Rehabilitation Science, McMaster University, L8S 1C7 Hamilton, Canada.
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185
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Davis JC, Best JR, Dian L, Khan KM, Hsu CL, Chan W, Cheung W, Liu-Ambrose T. Are the EQ-5D-3L and the ICECAP-O responsive among older adults with impaired mobility? Evidence from the Vancouver Falls Prevention Cohort Study. Qual Life Res 2016; 26:737-747. [DOI: 10.1007/s11136-016-1487-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 01/23/2023]
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186
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Davis JC, Hsu CL, Cheung W, Brasher PMA, Li LC, Khan KM, Sykes J, Skelton DA, Liu-Ambrose T. Can the Otago falls prevention program be delivered by video? A feasibility study. BMJ Open Sport Exerc Med 2016; 2:e000059. [PMID: 27900151 PMCID: PMC5117025 DOI: 10.1136/bmjsem-2015-000059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 11/05/2022] Open
Abstract
Objectives We assessed the feasibility of delivering the Otago Exercise Programme (OEP) via an interactive DVD (ie, OEP-DVD) in combination with monthly physical therapist phone calls to older adults. Design This pre-post (baseline and 6-month follow-up) study included an intervention group (n=61) based in a rural location and a control group (n=21) based in a city. Setting Sechelt and Vancouver, British Columbia. Participants 82 community-dwelling adults ≥75 years. Intervention Individuals in the intervention group received the OEP-DVD and were instructed to do the exercises 3 times a week after their initial home physical therapist visit for 6 months. Primary and secondary outcomes Feasibility was ascertained by withdrawal rate and compliance to the OEP-DVD. The number of participants and the frequency (ie, number of times weekly) they performed the OEP exercises and walking were used to estimate compliance. The potential benefit of the OEP-DVD on falls risk profile (Physiological Profile Assessment (PPA)) and mobility were examined by comparing the change in the intervention group compared with the control group. Self-reported compliance to the exercise programme was assessed by monthly returned diary. Results Of the 82 participants, 2 withdrew from the OEP-DVD group and none withdrew from the control group. We obtained compliance data on 72% of participants in the intervention group. The mean OEP-DVD compliance was 87% and the mean walking compliance was 166%. After adjusting for baseline PPA, baseline age, sex, baseline comorbidities, baseline cognitive status and baseline falls-related self-efficacy, there was a significant between-group improvement in the overall PPA score (OEP group pre-PPA to post-PPA score: 0.79±1.2 to 0.7±0.9; p<0.05) at study completion. Conclusions Although the OEP-DVD resulted in significant reductions in falls risk among community-dwelling older adults, there was a notable loss to follow-up limiting the feasibility of this approach.
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Affiliation(s)
- Jennifer C Davis
- Centre for Clinical Epidemiology and Evaluation, University of British Columbia & Vancouver Coastal Health Research Institute (VCHRI) , Vancouver, British Columbia , Canada
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Winnie Cheung
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Penny M A Brasher
- Centre for Clinical Epidemiology and Evaluation, University of British Columbia & Vancouver Coastal Health Research Institute (VCHRI) , Vancouver, British Columbia , Canada
| | - Linda C Li
- Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karim M Khan
- Centre for Hip Health and Mobility, University of British Columbia , Vancouver, British Columbia , Canada
| | - Jonathan Sykes
- eMotionLab, Glasgow Caledonian University , Glasgow , UK
| | - Dawn A Skelton
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University , Glasgow , UK
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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187
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Barha CK, Galea LA, Nagamatsu LS, Erickson KI, Liu-Ambrose T. Personalising exercise recommendations for brain health: considerations and future directions. Br J Sports Med 2016; 51:636-639. [DOI: 10.1136/bjsports-2016-096710] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/27/2022]
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188
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Beauchet O, Launay CP, Barden J, Liu-Ambrose T, Chester VL, Szturm T, Grenier S, Léonard G, Bherer L, Annweiler C, Helbostad JL, Verghese J, Allali G. Association Between Falls and Brain Subvolumes: Results from a Cross-Sectional Analysis in Healthy Older Adults. Brain Topogr 2016; 30:272-280. [PMID: 27785698 DOI: 10.1007/s10548-016-0533-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/17/2016] [Indexed: 02/05/2023]
Abstract
Falls are a consequence of gait instability. Cortical and subcortical abnormalities have been associated with gait instability but not yet with falls. This study aims to compare the global and regional brain subvolumes between healthy older fallers and non-fallers. A total of 77 healthy older individuals (23 fallers and 54 non-fallers, 69.8 ± 3.5 years; 45.5 % female) were included in this study using a cross-sectional design. Based on an a priori hypothesis, the following brain subvolumes were quantified from three-dimensional T1-weighted MRI using FreeSurfer software: total white matter abnormalities, total white matter, total cortical and subcortical gray matter, hippocampus, motor cortex, somatosensory cortex, premotor cortex, prefrontal cortex and parietal cortex volumes. Gait performances were also recorded. Age, sex, body mass index, comorbidities, use of psychoactive drugs, far-distance visual acuity, lower-limb proprioception, depressive symptoms and cognitive scores (Mini-Mental State Examination, Frontal Assessment Battery) were used as covariates. Fallers have more frequently depressive symptoms (P = 0.048), a lower far distance visual acuity (P = 0.026) and a higher coefficient of variation of stride time (P = 0.008) compared to non-fallers. There was a trend to greater subvolumes for the somatosensory cortex (P = 0.093) and the hippocampus (P = 0.060) in the falls group. Multiple logistic regressions showed that subvolumes of the somatosensory cortex and the hippocampus (P < 0.042) were increased in fallers compared to non-fallers, even after adjustment for clinical and brain characteristics. The greater subvolumes of the somatosensory cortex and hippocampus reported in fallers compared to non-fallers suggests a possible brain compensatory mechanism involving spatial navigation and integration of sensory information.
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Affiliation(s)
- Olivier Beauchet
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada. .,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada. .,Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, QC, Canada.
| | - Cyrille P Launay
- Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.,University Memory Clinic of Angers, Angers, France.,UPRES EA 4638, University of Angers, UNAM, Angers, France
| | - John Barden
- Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Victoria L Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sébastien Grenier
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QUÉBEC, Canada
| | - Guillaume Léonard
- Research Center on Aging, Institut universitaire de gériatrie de Sherbrooke (IUGS), Sherbrooke, QUÉBEC, Canada
| | - Louis Bherer
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QUÉBEC, Canada.,PERFORM Centre and Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Cédric Annweiler
- Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.,University Memory Clinic of Angers, Angers, France.,UPRES EA 4638, University of Angers, UNAM, Angers, France
| | - Jorunn L Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Joe Verghese
- Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland
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Liu-Ambrose T, Best JR, Davis JC, Eng JJ, Lee PE, Jacova C, Boyd LA, Brasher PM, Munkacsy M, Cheung W, Hsiung GYR. Aerobic exercise and vascular cognitive impairment: A randomized controlled trial. Neurology 2016; 87:2082-2090. [PMID: 27760869 DOI: 10.1212/wnl.0000000000003332] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/05/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI). METHODS This was a proof-of-concept single-blind randomized controlled trial comparing a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function with a follow-up assessment 6 months after the formal cessation of aerobic exercise training. Primary outcomes assessed were general cognitive function (Alzheimer's Disease Assessment Scale-Cognitive subscale [ADAS-Cog]), executive functions (Executive Interview [EXIT-25]), and activities of daily living (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]). RESULTS Seventy adults randomized to aerobic exercise training or usual care were included in intention-to-treat analyses (mean age 74 years, 51% female, n = 35 per group). At the end of the intervention, the aerobic exercise training group had significantly improved ADAS-Cog performance compared with the usual care plus education group (-1.71 point difference, 95% confidence interval [CI] -3.15 to -0.26, p = 0.02); however, this difference was not significant at the 6-month follow-up (-0.63 point difference, 95% CI -2.34 to 1.07, p = 0.46). There were no significant between-group differences at intervention completion and at the 6-month follow-up in EXIT-25 or ADCS-ADL performance. Examination of secondary measures showed between-group differences at intervention completion favoring the AT group in 6-minute walk distance (30.35 meter difference, 95% CI 5.82 to 54.86, p = 0.02) and in diastolic blood pressure (-6.89 mm Hg difference, 95% CI -12.52 to -1.26, p = 0.02). CONCLUSIONS This study provides preliminary evidence for the efficacy of 6 months of thrice-weekly progressive aerobic training in community-dwelling adults with mild SIVCI, relative to usual care plus education. CLINICALTRIALSGOV IDENTIFIER NCT01027858. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for adults with mild SIVCI, an aerobic exercise program for 6 months results in a small, significant improvement in ADAS-Cog performance.
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Affiliation(s)
| | - John R Best
- Author affiliations are provided at the end of the article
| | | | - Janice J Eng
- Author affiliations are provided at the end of the article
| | - Philip E Lee
- Author affiliations are provided at the end of the article
| | - Claudia Jacova
- Author affiliations are provided at the end of the article
| | - Lara A Boyd
- Author affiliations are provided at the end of the article
| | | | | | - Winnie Cheung
- Author affiliations are provided at the end of the article
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190
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Nagamatsu LS, Hsu CL, Davis JC, Best JR, Liu-Ambrose T. White Matter Volume Mediates the Relationship Between Self-Efficacy and Mobility in Older Women. Exp Aging Res 2016; 42:460-470. [PMID: 27749206 DOI: 10.1080/0361073x.2016.1224657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background/Study Context: With our aging population, understanding determinants of healthy aging is a priority. One essential component of healthy aging is mobility. Although self-efficacy can directly impact mobility in older adults, it is unknown what role brain health may play in this relationship. METHODS The authors conducted a cross-sectional pilot analysis of community-dwelling women (N = 80, mean age = 69 years) to examine whether brain volume mediates the relationship between falls-related self-efficacy, as measured by the Activities-specific Balance Confidence (ABC) scale, and mobility, as measured by the Timed Up and Go (TUG) test. Age, depression, education, functional comorbidities, and Montreal Cognitive Assessment (MoCA) were included in the model as covariates. RESULTS The authors report that total white matter volume, specifically, significantly mediates the relationship between self-efficacy and mobility, where higher self-efficacy was associated with greater white matter volume (r = .28), which, in turn, was associated with better mobility (r = -.30). CONCLUSION This pilot study extends our understanding of the psychosocial and neurological factors that contribute to mobility and provides insight into effective strategies that may be used to improve functional independence among older adults. Future prospective and intervention studies are required to further elucidate the nature of the relationship between self-efficacy, mobility, and brain health.
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Affiliation(s)
- Lindsay S Nagamatsu
- a Beckman Institute for Advanced Science and Technology , University of Illinois at Urbana-Champaign , Urbana , Illinois , USA
| | - Chun Liang Hsu
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
| | - Jennifer C Davis
- c Aging, Mobility, and Cognitive Neuroscience Laboratory and Centre for Clinical Epidemiology and Evaluation , University of British Columbia, Vancouver, British Columbia, Canada; and Vancouver Coastal Health Research Institute , Vancouver , British Columbia , Canada
| | - John R Best
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
| | - Teresa Liu-Ambrose
- b Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, and Centre for Hip Health and Mobility , University of British Columbia , Vancouver , British Columbia , Canada
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191
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Dao E, Hsiung GYR, Sossi V, Jacova C, Tam R, Dinelle K, Best JR, Liu-Ambrose T. Erratum to: Exploring the effects of coexisting amyloid in subcortical vascular cognitive impairment. BMC Neurol 2016; 16:157. [PMID: 27581192 PMCID: PMC5007817 DOI: 10.1186/s12883-016-0673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Elizabeth Dao
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - Ging-Yuek Robin Hsiung
- Department of Medicine, University of British Columbia, UBC Hospital S152, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1, Canada
| | - Claudia Jacova
- School of Professional Psychology, Pacific University, 190 SE 8th Avenue, Hillsboro, OR, 97123, USA
| | - Roger Tam
- Department of Radiology, University of British Columbia, 3350-950W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.,MS/MRI Research Group, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - Katie Dinelle
- PET Group, Vancouver Hospital and Health Science Centre, Brain Research Centre, 2211 Westboork Mall, Vancouver, BC, V6T 2B5, Canada
| | - John R Best
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada. .,Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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192
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Beauchet O, Barden J, Liu-Ambrose T, Chester VL, Annweiler C, Szturm T, Grenier S, Léonard G, Bherer L, Allali G. Anti-Dementia Drugs, Gait Performance and Mental Imagery of Gait: A Non-Randomized Open-Label Trial. Drugs Aging 2016; 33:665-73. [DOI: 10.1007/s40266-016-0391-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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193
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Hsu CL, Best JR, Chiu BK, Voss MW, Handy TC, Bolandzadeh N, Liu-Ambrose T. P4‐186: Structural Neural Correlates of Impaired Mobility and Subsequent Decline in Executive Functions: A 12‐Month Prospective Study. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Chun Liang Hsu
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Center for Brain HealthVancouverBC Canada
| | - John R. Best
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | - Bryan K. Chiu
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | | | | | | | - Teresa Liu-Ambrose
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
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Barha CK, Best JR, Robin Hsiung GY, Liu-Ambrose T. P3‐103: Sex Differences in Aerobic Exercise Efficacy on Cognitive Health: Possible Role of
APOE‐E4. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cindy K. Barha
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | - John R. Best
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | - Ging-Yuek Robin Hsiung
- University of British ColumbiaVancouverBC Canada
- Clinic for Alzheimer’s Disease and Related DisordersVancouverBC Canada
| | - Teresa Liu-Ambrose
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
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195
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Best JR, Chiu BK, Liu-Ambrose T. P1‐301: Larger Lateral Prefrontal Cortex Volume Predicts Better Exercise Class Attendance Among Older Adults: Evidence from Three Exercise Training Studies. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- John R. Best
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
- University of British ColumbiaVancouverBC Canada
| | - Bryan K. Chiu
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
- University of British ColumbiaVancouverBC Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
- University of British ColumbiaVancouverBC Canada
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Barha CK, Best JR, Robin Hsiung GY, Tam R, Liu-Ambrose T. P4‐055: Sex and BDNF Polymorphism: Impact on Cognitive Decline and White Matter Lesion Load in Older Adults with Subcortical Vascular Cognitive Impairment. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cindy K. Barha
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | - John R. Best
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
| | - Ging-Yuek Robin Hsiung
- University of British ColumbiaVancouverBC Canada
- Clinic for Alzheimer’s Disease and Related DisordersVancouverBC Canada
| | - Roger Tam
- University of British ColumbiaVancouverBC Canada
| | - Teresa Liu-Ambrose
- University of British ColumbiaVancouverBC Canada
- Djavad Mowafaghian Centre for Brain HealthVancouverBC Canada
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197
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Falck RS, Davis JC, Liu-Ambrose T. What is the association between sedentary behaviour and cognitive function? A systematic review. Br J Sports Med 2016; 51:800-811. [DOI: 10.1136/bjsports-2015-095551] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 12/31/2022]
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198
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Falck RS, Landry GJ, Liu-Ambrose T. Physical Activity and Sedentary Behaviour are Associated with Cognitive Function in Healthy Older Adults But Not Older Adults with Mild Cognitive Impairment. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485954.51908.ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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199
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Hsu CL, Best JR, Chiu BK, Nagamatsu LS, Voss MW, Handy TC, Bolandzadeh N, Liu-Ambrose T. Structural neural correlates of impaired mobility and subsequent decline in executive functions: a 12-month prospective study. Exp Gerontol 2016; 80:27-35. [PMID: 27079333 DOI: 10.1016/j.exger.2016.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
Abstract
Impaired mobility, such as falls, may be an early biomarker of subsequent cognitive decline and is associated with subclinical alterations in both brain structure and function. In this 12-month prospective study, we examined whether there are volumetric differences in gray matter and subcortical regions, as well as cerebral white matter, between older fallers and non-fallers. In addition, we assessed whether these baseline volumetric differences are associated with changes in cognitive function over 12months. A total of 66 community-dwelling older adults were recruited and categorized by their falls status. Magnetic resonance imaging occurred at baseline and participants' physical and cognitive performances were assessed at baseline and 12-months. At baseline, fallers showed significantly lower volumes in gray matter, subcortical regions, and cerebral white matter compared with non-fallers. Notably, fallers had significantly lower left lateral orbitofrontal white matter volume. Moreover, lower left lateral orbitofrontal white matter volume at baseline was associated with greater decline in set-shifting performance over 12months. Our data suggest that falls may indicate subclinical alterations in regional brain volume that are associated with subsequent decline in executive functions.
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Affiliation(s)
- Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Bryan K Chiu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Michelle W Voss
- Health, Brain, & Cognition Lab, University of Iowa, Iowa City, Iowa, USA; Department of Psychology, University of Iowa, Iowa City, Iowa, USA
| | - Todd C Handy
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Niousha Bolandzadeh
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Center for Hip Health and Mobility, Vancouver, British Columbia, Canada.
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200
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Best JR, Liu-Ambrose T, Boudreau RM, Ayonayon HN, Satterfield S, Simonsick EM, Studenski S, Yaffe K, Newman AB, Rosano C. An Evaluation of the Longitudinal, Bidirectional Associations Between Gait Speed and Cognition in Older Women and Men. J Gerontol A Biol Sci Med Sci 2016; 71:1616-1623. [PMID: 27069098 DOI: 10.1093/gerona/glw066] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 03/20/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few cohort studies have examined longitudinal associations between age-related changes in cognition and physical performance. Further, whether these associations differ for men versus women or can be attributed to differences in physical activity (PA) is unknown. METHODS Participants were 2,876 initially well-functioning community-dwelling older adults (aged 70-79 years at baseline; 52% female; 39% black) studied over a 9-year period. Usual gait speed, self-reported PA, and two cognitive measures-Digit Symbol Substitution Test (DSST) and Mini-Modified Mental State examination (3MS)-were assessed years 0 (ie, baseline), 4, and 9. RESULTS Early decline between years 0 and 4 in gait speed predicted later decline between years 4 and 9 in performance on the 3MS (β = 0.10, p = .004) and on the DSST (β = 0.16, p < .001). In contrast, the associations between early decline in cognition and later decline in gait speed were weaker and were non-significant after correcting for multiple comparisons (β = 0.08, p = .019 for 3MS and β = .06, p = .051 for DSST). All associations were similar for women and men and were unaltered when accounting for PA levels. CONCLUSIONS The results indicate declining gait speed as a precursor to declining cognitive functioning, and suggest a weaker reciprocal process among older women and men.
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Affiliation(s)
- John R Best
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada. .,Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Hilsa N Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Stephanie Studenski
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco.,Departments of Psychiatry and Neurology, University of California, San Francisco
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
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