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Kerminen H, Marzetti E, D’Angelo E. Biological and Physical Performance Markers for Early Detection of Cognitive Impairment in Older Adults. J Clin Med 2024; 13:806. [PMID: 38337499 PMCID: PMC10856537 DOI: 10.3390/jcm13030806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Dementia is a major cause of poor quality of life, disability, and mortality in old age. According to the geroscience paradigm, the mechanisms that drive the aging process are also involved in the pathogenesis of chronic degenerative diseases, including dementia. The dissection of such mechanisms is therefore instrumental in providing biological targets for interventions and new sources for biomarkers. Within the geroscience paradigm, several biomarkers have been discovered that can be measured in blood and that allow early identification of individuals at risk of cognitive impairment. Examples of such markers include inflammatory biomolecules, markers of neuroaxonal damage, extracellular vesicles, and DNA methylation. Furthermore, gait speed, measured at a usual and fast pace and as part of a dual task, has been shown to detect individuals at risk of future dementia. Here, we provide an overview of available biomarkers that may be used to gauge the risk of cognitive impairment in apparently healthy older adults. Further research should establish which combination of biomarkers possesses the highest predictive accuracy toward incident dementia. The implementation of currently available markers may allow the identification of a large share of at-risk individuals in whom preventive interventions should be implemented to maintain or increase cognitive reserves, thereby reducing the risk of progression to dementia.
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Affiliation(s)
- Hanna Kerminen
- Faculty of Medicine and Health Technology, Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland;
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy;
| | - Emanuela D’Angelo
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy;
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Poosri T, Boripuntakul S, Sungkarat S, Kamnardsiri T, Soontornpun A, Pinyopornpanish K. Gait smoothness during high-demand motor walking tasks in older adults with mild cognitive impairment. PLoS One 2024; 19:e0296710. [PMID: 38241332 PMCID: PMC10798528 DOI: 10.1371/journal.pone.0296710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024] Open
Abstract
Early signs of Mild Cognitive Impairment (MCI)-related gait deficits may be detected through the performance of complex walking tasks that require high gait control. Gait smoothness is a robust metric of overall body stability during walking. This study aimed to explore gait smoothness during complex walking tasks in older adults with and without MCI. Participants were 18 older adults with MCI (mean age = 67.89 ± 4.64 years) and 18 cognitively intact controls (mean age = 67.72 ± 4.63 years). Gait assessment was conducted under four complex walking tasks: walking a narrow path, walking around an obstacle, horizontal head turns while walking, and vertical head turns while walking. The index of harmonicity (IH), representing gait smoothness associated with overall body stability, was measured in anteroposterior, mediolateral, and vertical directions. A multivariate analysis was employed to compare the differences in IH between groups for each complex walking task. The MCI group demonstrated a reduction of IH in the mediolateral direction during the horizontal head turns than the control group (MCI group = 0.64 ± 0.16, Control group = 0.74 ± 0.12, p = 0.04). No significant differences between groups were found for the IH in other directions or walking conditions. These preliminary findings indicate that older adults with MCI have a decline in step regularity in the mediolateral direction during walking with horizontal head turns. Assessment of the smoothness of walking during head turns may be a useful approach to identifying subtle gait alterations in older adults with MCI, which may facilitate timely gait intervention.
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Affiliation(s)
- Thanpidcha Poosri
- Faculty of Associated Medical Sciences, Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Sirinun Boripuntakul
- Faculty of Associated Medical Sciences, Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Somporn Sungkarat
- Faculty of Associated Medical Sciences, Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Teerawat Kamnardsiri
- Department of Digital Game, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Atiwat Soontornpun
- Faculty of Medicine, Department of Internal Medicine, Chiang Mai University and Northern Neuroscience Center, Chiang Mai, Thailand
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Byun S, Lee HJ, Kim JS, Choi E, Lee S, Kim TH, Kim JH, Han JW, Kim KW. Exploring shared neural substrates underlying cognition and gait variability in adults without dementia. Alzheimers Res Ther 2023; 15:206. [PMID: 38012628 PMCID: PMC10680297 DOI: 10.1186/s13195-023-01354-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND High gait variability is associated with neurodegeneration and cognitive impairments and is predictive of cognitive impairment and dementia. The objective of this study was to identify cortical or subcortical structures of the brain shared by gait variability measured using a body-worn tri-axial accelerometer (TAA) and cognitive function. METHODS This study is a part of a larger population-based cohort study on cognitive aging and dementia. The study included 207 participants without dementia, with a mean age of 72.6, and 45.4% of them are females. We conducted standardized diagnostic interview including a detailed medical history, physical and neurological examinations, and laboratory tests for cognitive impairment. We obtained gait variability during walking using a body-worn TAA along and measured cortical thickness and subcortical volume from brain magnetic resonance (MR) images. We cross-sectionally investigated the cortical and subcortical neural structures associated with gait variability and the shared neural substrates of gait variability and cognitive function. RESULTS Higher gait variability was associated with the lower cognitive function and thinner cortical gray matter but not smaller subcortical structures. Among the clusters exhibiting correlations with gait variability, one that included the inferior temporal, entorhinal, parahippocampal, fusiform, and lingual regions in the left hemisphere was also associated with global cognitive and verbal memory function. Mediation analysis results revealed that the cluster's cortical thickness played a mediating role in the association between gait variability and cognitive function. CONCLUSION Gait variability and cognitive function may share neural substrates, specifically in regions related to memory and visuospatial navigation.
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Affiliation(s)
- Seonjeong Byun
- Department of Neuropsychiatry, College of Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyang Jun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
| | - Jun Sung Kim
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Euna Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Subin Lee
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea.
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Duan Q, Zhang Y, Zhuang W, Li W, He J, Wang Z, Cheng H. Gait Domains May Be Used as an Auxiliary Diagnostic Index for Alzheimer's Disease. Brain Sci 2023; 13:1599. [PMID: 38002557 PMCID: PMC10669801 DOI: 10.3390/brainsci13111599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disorder with cognitive dysfunction and behavioral impairment. We aimed to use principal components factor analysis to explore the association between gait domains and AD under single and dual-task gait assessments. METHODS A total of 41 AD participants and 41 healthy control (HC) participants were enrolled in our study. Gait parameters were measured using the JiBuEn® gait analysis system. The principal component method was used to conduct an orthogonal maximum variance rotation factor analysis of quantitative gait parameters. Multiple logistic regression was used to adjust for potential confounding or risk factors. RESULTS Based on the factor analysis, three domains of gait performance were identified both in the free walk and counting backward assessments: "rhythm" domain, "pace" domain and "variability" domain. Compared with HC, we found that the pace factor was independently associated with AD in two gait assessments; the variability factor was independently associated with AD only in the counting backwards assessment; and a statistical difference still remained after adjusting for age, sex and education levels. CONCLUSIONS Our findings indicate that gait domains may be used as an auxiliary diagnostic index for Alzheimer's disease.
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Affiliation(s)
- Qi Duan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Yinuo Zhang
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou 325000, China;
| | - Weihao Zhuang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Wenlong Li
- Radiotherapy Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Zhen Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Haoran Cheng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
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Aznielle-Rodríguez T, Galán-García L, Ontivero-Ortega M, Aguilar-Mateu K, Castro-Laguardia AM, Fernández-Nin A, García-Agustín D, Valdés-Sosa M. Relationship between gait parameters and cognitive indexes in adult aging. PLoS One 2023; 18:e0291963. [PMID: 37733718 PMCID: PMC10513272 DOI: 10.1371/journal.pone.0291963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE This study aimed to identify the most effective summary cognitive index predicted from spatio-temporal gait features (STGF) extracted from gait patterns. METHODS The study involved 125 participants, including 40 young (mean age: 27.65 years, 50% women), and 85 older adults (mean age: 73.25 years, 62.35% women). The group of older adults included both healthy adults and those with Mild Cognitive Impairment (MCI). Participant´s performance in various cognitive domains was evaluated using 12 cognitive measures from five neuropsychological tests. Four summary cognitive indexes were calculated for each case: 1) the z-score of Mini-Mental State Examination (MMSE) from a population norm (MMSE z-score); 2) the sum of the absolute z-scores of the patients' neuropsychological measures from a population norm (ZSum); 3) the first principal component scores obtained from the individual cognitive variables z-scores (PCCog); and 4) the Mahalanobis distance between the vector that represents the subject's cognitive state (defined by the 12 cognitive variables) and the vector corresponding to a population norm (MDCog). The gait patterns were recorded using a body-fixed Inertial Measurement Unit while participants executed four walking tasks (normal, fast, easy- and hard-dual tasks). Sixteen STGF for each walking task, and the dual-task costs for the dual tasks (when a subject performs an attention-demanding task and walks at the same time) were computed. After applied Principal Component Analysis to gait measures (96 features), a robust regression was used to predict each cognitive index and individual cognitive variable. The adjusted proportion of variance (adjusted-R2) coefficients were reported, and confidence intervals were estimated using the bootstrap procedure. RESULTS The mean values of adjusted-R2 for the summary cognitive indexes were as follows: 0.0248 for MMSE z-score, 0.0080 for ZSum, 0.0033 for PCCog, and 0.4445 for MDCog. The mean adjusted-R2 values for the z-scores of individual cognitive variables ranged between 0.0009 and 0.0693. Multiple linear regression was only statistically significant for MDCog, with the highest estimated adjusted-R2 value. CONCLUSIONS The association between individual cognitive variables and most of the summary cognitive indexes with gait parameters was weak. However, the MDCog index showed a stronger and significant association with the STGF, exhibiting the highest value of the proportion of the variance that can be explained by the predictor variables. These findings suggest that the MDCog index may be a useful tool in studying the relationship between gait patterns and cognition.
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Affiliation(s)
| | | | - Marlis Ontivero-Ortega
- Department of Neuroinformatics, Cuban Center for Neuroscience, Havana, Cuba
- Department of Data Analysis, Faculty of Psychological and Educational Sciences, Ghent University, Ghent, Belgium
| | - Karen Aguilar-Mateu
- Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba
| | | | - Ana Fernández-Nin
- Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba
| | - Daysi García-Agustín
- Centro de Investigaciones Sobre Longevidad, Envejecimiento y Salud, CITED, Havana, Cuba
| | - Mitchell Valdés-Sosa
- Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba
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Young F, Mason R, Morris RE, Stuart S, Godfrey A. IoT-Enabled Gait Assessment: The Next Step for Habitual Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:4100. [PMID: 37112441 PMCID: PMC10144082 DOI: 10.3390/s23084100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 06/19/2023]
Abstract
Walking/gait quality is a useful clinical tool to assess general health and is now broadly described as the sixth vital sign. This has been mediated by advances in sensing technology, including instrumented walkways and three-dimensional motion capture. However, it is wearable technology innovation that has spawned the highest growth in instrumented gait assessment due to the capabilities for monitoring within and beyond the laboratory. Specifically, instrumented gait assessment with wearable inertial measurement units (IMUs) has provided more readily deployable devices for use in any environment. Contemporary IMU-based gait assessment research has shown evidence of the robust quantifying of important clinical gait outcomes in, e.g., neurological disorders to gather more insightful habitual data in the home and community, given the relatively low cost and portability of IMUs. The aim of this narrative review is to describe the ongoing research regarding the need to move gait assessment out of bespoke settings into habitual environments and to consider the shortcomings and inefficiencies that are common within the field. Accordingly, we broadly explore how the Internet of Things (IoT) could better enable routine gait assessment beyond bespoke settings. As IMU-based wearables and algorithms mature in their corroboration with alternate technologies, such as computer vision, edge computing, and pose estimation, the role of IoT communication will enable new opportunities for remote gait assessment.
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Affiliation(s)
- Fraser Young
- Department of Computer and Information Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
| | - Rachel Mason
- Department of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
| | - Rosie E. Morris
- Department of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
| | - Samuel Stuart
- Department of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
| | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
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Sacco G, Ben-Sadoun G, Gautier J, Simon R, Goupil M, Laureau P, Terrien J, Annweiler C. Comparison of spatio-temporal gait parameters between the GAITRite® platinum plus classic and the GAITRite® CIRFACE among older adults: a retrospective observational study. BMC Geriatr 2023; 23:132. [PMID: 36882705 PMCID: PMC9993600 DOI: 10.1186/s12877-023-03811-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND The GAITRite® system is one of the gold standards for gait electronic analysis, especially for older adults. Previous GAITRite® systems were composed of an electronic roll-up walkway. Recently, a new GAITRite® electronic walkway, named CIRFACE, was commercialized. It is composed of a changeable association of stiff plates, unlike previous models. Are the gait parameters measured similar between these two walkways among older adults and according to the cognitive status, the history of falls, and the use of walking aids? METHODS In this retrospective observational study, 95 older ambulatory participants (mean, 82.6 ± 5.8 years) were included. Ten spatio-temporal gait parameters were measured simultaneously with the two GAITRite® systems in older adults while walking at comfortable self-selected pace. The GAITRite® Platinum Plus Classic (26') was superimposed on the GAITRite® CIRFACE (VI). Comparisons between the parameters of the two walkways were performed using Bravais-Pearson correlation, between-method differences (corresponding to bias), percentage errors and Intraclass Correlation Coefficients (ICC2,1). Subgroup analyses were performed according to the cognitive status, the history of falls in the last 12 months and the use of walking aids. RESULTS The whole walk parameters recorded by the two walkways were extremely correlated with a Bravais-Pearson correlation coefficient ranging from 0.968 to 0.999, P < .001, indicating a very high correlation. According to the ICC2,1 calculated for absolute agreement, all gait parameters had excellent reliability (ranging from 0.938 to 0.999). Mean bias for 9 parameters out of 10 were ranged from - 0.27 to 0.54, with clinically acceptable percentage errors (1.2-10.1%). Step length showed a substantially higher bias (1.4 ± 1.2 cm), nevertheless the percentage errors remained clinically acceptable (5%). CONCLUSION When walking at comfortable self-selected pace, the standard spatio-temporal walk parameters provided by both the GAITRite® PPC and the GAITRite® CIRFACE seem similar and very highly correlated in older adults with various cognitive or motor status. The data of studies using these systems can be compared and mixed with a very low risk of bias in a meta-analytic process. Also, the geriatric care units can choose the most ergonomic system according to their infrastructure without affecting their gait data. TRIAL REGISTRATION NCT04557592 (21/09/2020).
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Affiliation(s)
- Guillaume Sacco
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de soins ambulatoires, Nice, France.,Université Côte d'Azur, CoBTek, Nice, France.,LPPL, Laboratoire de Psychologie des Pays de la Loire, Univ Angers, Université de Nantes, EA 4638 LPPL, SFR CONFLUENCES, Angers, F-49000, France
| | - Grégory Ben-Sadoun
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France. .,Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France. .,Centre de Recherche sur l'Autonomie et la Longévité (CeRAL), Service de Gériatrie, CHU d'Angers, 4, rue Larrey, 49933, Angers Cedex 9, France.
| | - Jennifer Gautier
- LPPL, Laboratoire de Psychologie des Pays de la Loire, Univ Angers, Université de Nantes, EA 4638 LPPL, SFR CONFLUENCES, Angers, F-49000, France.,Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Romain Simon
- LPPL, Laboratoire de Psychologie des Pays de la Loire, Univ Angers, Université de Nantes, EA 4638 LPPL, SFR CONFLUENCES, Angers, F-49000, France.,Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Maude Goupil
- School of Medicine, Health Faculty, University of Angers, Angers, France
| | - Pauline Laureau
- School of Medicine, Health Faculty, University of Angers, Angers, France
| | - Jade Terrien
- School of Medicine, Health Faculty, University of Angers, Angers, France
| | - Cédric Annweiler
- LPPL, Laboratoire de Psychologie des Pays de la Loire, Univ Angers, Université de Nantes, EA 4638 LPPL, SFR CONFLUENCES, Angers, F-49000, France. .,Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France. .,School of Medicine, Health Faculty, University of Angers, Angers, France. .,Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada. .,UMR-S 1075 Inserm, COMETE, Pôle des Formations et de Recherche en Santé, 2 Rue des Rochambelles, CS 14032, 14 032, CAEN Cedex, France.
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Wang Y, Yang Q, Tian C, Zeng J, Yang M, Li J, Mao J. A dual-task gait test detects mild cognitive impairment with a specificity of 91.2. Front Neurosci 2023; 16:1100642. [PMID: 36825213 PMCID: PMC9942944 DOI: 10.3389/fnins.2022.1100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/30/2022] [Indexed: 02/10/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is a valuable intervention window in the progress of senile dementia, but the question of how to easily and conveniently detect MCI in the community remains unanswered. Gait performance reflects cognitive function, but how to reliably detect MCI through gait testing is still being explored. Objective To develop a dual-task gait testing method that could reliably detect MCI in the community. Methods A cross-sectional diagnostic study was conducted in 111 older adults (mean age = 72.14 ± 6.90 years) from five communities in Wuhan, China. A novel dual-task gait testing method, walking while identifying animals in pictures (AniP-DT gait test), was developed. The participants were classified into MCI or cognitively intact based on their performance on the Montreal Cognitive Assessment Scale (MoCA). Gait performance was assessed using both single-task and the AniP-DT gait test. Multiple linear regression and binary logistic regression were used to model the association between gait speed and cognitive status, and receiver operating characteristic (ROC) curve analysis was used to assess the discrimination ability. Results Compared to the cognitively intact group, the gait speed of the MCI group was lower in both single-task and the AniP-DT gait tests. The gait speed of the AniP-DT gait test was significantly associated with MoCA scores after adjusting the covariates and exhibited good discrimination ability in MCI detection (AUC = 0.814), with a specificity of 91.2%. ROC analysis of the logistic models revealed better discrimination ability of dual-task gait velocity when adjusted with age and years of education (AUC = 0.862). Conclusion The evidence in this study suggested that the AniP-DT gait test could be an easy and reliable screening tool for MCI in community older adults.
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Affiliation(s)
- Yuxin Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Chong Tian,
| | - Jing Zeng
- Centers for Disease Control and Prevention of Wuhan Economic and Technological Development Zone, Wuhan, Hubei, China
| | - Mengshu Yang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Lindh-Rengifo M, Jonasson SB, Ullén S, Palmqvist S, van Westen D, Stomrud E, Mattsson-Carlgren N, Nilsson MH, Hansson O. Effects of Brain Pathologies on Spatiotemporal Gait Parameters in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2023; 96:161-171. [PMID: 37742636 PMCID: PMC10657715 DOI: 10.3233/jad-221303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Impaired gait can precede dementia. The associations between gait parameters and brain pathologies are therefore of interest. OBJECTIVE To explore how different brain pathologies (i.e., vascular and Alzheimer's) are associated with specific gait parameters from various gait components in persons with mild cognitive impairment (MCI), who have an increased risk of developing dementia. METHODS This cross-sectional study included 96 patients with MCI (mean 72, ±7.5 years; 52% women). Gait was evaluated by using an electronic walkway, GAITRite®. Four gait parameters (step velocity variability; step length; step time; stance time asymmetry) were used as dependent variables in multivariable linear regression analyses. Independent variables included Alzheimer's disease pathologies (amyloid-β and tau) by using PET imaging and white matter hyperintensities (WMH) by using MRI. Covariates included age, sex, comorbidities (and intracranial volume in analyses that includedWMH). RESULTS Increased tau-PET (Braak I-IV region of interest [ROI]) was associated with step velocity variability (standardized regression coefficient, β= 0.383, p < 0.001) and step length (β= 0.336, p < 0.001), which remained significant when using different Braak ROIs (I-II, III-IV, V-VI). The associations remained significant when adjusting for WMH (p < 0.001). When also controlling for gait speed, tau was no longer significantly (p = 0.168) associated with an increased step length. No significant associations between gait and Aβ-PET load or WMH were identified. CONCLUSIONS The results indicate that one should pay specific attention to assess step velocity variability when targeting single task gait in patients with MCI. Future studies should address additional gait variability measures and dual tasking in larger cohorts.
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Affiliation(s)
- Magnus Lindh-Rengifo
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Susann Ullén
- Clinical Studies Sweden – Forum South, Skåne University Hospital, Lund, Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Clinical Sciences Lund, Lund University, Lund, Sweden
- Image and Function, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Maria H. Nilsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
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10
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Le Floch M, Gautier J, Annweiler C. Vitamin D Concentration and Motoric Cognitive Risk in Older Adults: Results from the Gait and Alzheimer Interactions Tracking (GAIT) Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13086. [PMID: 36293666 PMCID: PMC9602422 DOI: 10.3390/ijerph192013086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR would exhibit hypovitaminosis D more often compared to Cognitively Healthy Individuals (CHI). The objective of this cross-sectional analysis was to determine whether hypovitaminosis D was associated with MCR. METHODS Participants without dementia from the GAIT (Gait and Alzheimer Interactions Tracking) cohort study were classified into MCR or Cognitively Healthy Individuals (CHI) groups. Hypovitaminosis D was defined as the lowest quartile of serum 25-hydroxyvitamin D (25OHD) concentration compared to the other three combined. Age, sex, body mass index (BMI), the Frontal Assessment Battery (FAB) score, the Mini-Mental Short Examination (MMSE) score, education level, use of psychoactive drugs, and the number of chronic diseases were used as covariates. RESULTS Among 244 nondemented and nonMCInonMCR participants from the GAIT cohort (mean age 71.4 ± 3.7 years, 40.6% women), 66 participants were classified as MCR (36.9%) and 178 as CHI (63.1%). The lowest quartile of 25OHD concentration was directly associated with MCR (unadjusted OR = 2.85, p = 0.003) even after adjustment for studied potential confounders (fully adjusted OR = 2.61, p = 0.025). The BMI (adjusted OR = 6.65, p < 0.001), MMSE score (adjusted OR = 0.74, p = 0.009), FAB score (adjusted OR = 0.51, p < 0.001), number of chronic diseases (adjusted OR = 1.29, p = 0.043) and use of psychoactive drugs (adjusted OR = 2.55, p = 0.044) were also associated with MCR. CONCLUSIONS Hypovitaminosis D was associated with MCR in older community-dwellers without dementia.
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Affiliation(s)
- Maxime Le Floch
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
- Health Faculty, School of Medicine, University of Angers, F-49000 Angers, France
| | - Jennifer Gautier
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
| | - Cédric Annweiler
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
- Health Faculty, School of Medicine, University of Angers, F-49000 Angers, France
- Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
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11
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Bruderer-Hofstetter M, Gorus E, Cornelis E, Meichtry A, De Vriendt P. Influencing factors on instrumental activities of daily living functioning in people with mild cognitive disorder - a secondary investigation of cross-sectional data. BMC Geriatr 2022; 22:791. [PMID: 36217106 PMCID: PMC9552428 DOI: 10.1186/s12877-022-03476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors. METHODS We performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer's Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model. RESULTS We included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern. CONCLUSION Our results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
| | - Ellen Gorus
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Elise Cornelis
- Department of Occupational Therapy and Research & Development in Health & Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - Patricia De Vriendt
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Mental Health and Wellbeing (MENT) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Programme, Ghent University, Ghent, Belgium
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12
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Aznielle-Rodríguez T, Ontivero-Ortega M, Galán-García L, Sahli H, Valdés-Sosa M. Stable Sparse Classifiers predict cognitive impairment from gait patterns. Front Psychol 2022; 13:894576. [PMID: 36051195 PMCID: PMC9425080 DOI: 10.3389/fpsyg.2022.894576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although gait patterns disturbances are known to be related to cognitive decline, there is no consensus on the possibility of predicting one from the other. It is necessary to find the optimal gait features, experimental protocols, and computational algorithms to achieve this purpose. Purposes To assess the efficacy of the Stable Sparse Classifiers procedure (SSC) for discriminating young and healthy older adults (YA vs. HE), as well as healthy and cognitively impaired elderly groups (HE vs. MCI-E) from their gait patterns. To identify the walking tasks or combinations of tasks and specific spatio-temporal gait features (STGF) that allow the best prediction with SSC. Methods A sample of 125 participants (40 young- and 85 older-adults) was studied. They underwent assessment with five neuropsychological tests that explore different cognitive domains. A summarized cognitive index (MDCog), based on the Mahalanobis distance from normative data, was calculated. The sample was divided into three groups (young adults, healthy and cognitively impaired elderly adults) using k-means clustering of MDCog in addition to Age. The participants executed four walking tasks (normal, fast, easy- and hard-dual tasks) and their gait patterns, measured with a body-fixed Inertial Measurement Unit, were used to calculate 16 STGF and dual-task costs. SSC was then employed to predict which group the participants belonged to. The classification's performance was assessed using the area under the receiver operating curves (AUC) and the stable biomarkers were identified. Results The discrimination HE vs. MCI-E revealed that the combination of the easy dual-task and the fast walking task had the best prediction performance (AUC = 0.86, sensitivity: 90.1%, specificity: 96.9%, accuracy: 95.8%). The features related to gait variability and to the amplitude of vertical acceleration had the largest predictive power. SSC prediction accuracy was better than the accuracies obtained with linear discriminant analysis and support vector machine classifiers. Conclusions The study corroborated that the changes in gait patterns can be used to discriminate between young and healthy older adults and more importantly between healthy and cognitively impaired adults. A subset of gait tasks and STGF optimal for achieving this goal with SSC were identified, with the latter method superior to other classification techniques.
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Affiliation(s)
- Tania Aznielle-Rodríguez
- Department of Electronics, Cuban Center for Neuroscience, Havana, Cuba
- Electronics and Informatics Department, Vrije Universiteit Brussels, Brussels, Belgium
| | - Marlis Ontivero-Ortega
- Department of Neuroinformatics, Cuban Center for Neuroscience, Havana, Cuba
- Department of Data Analysis, Faculty of Psychological and Educational Sciences, Ghent University, Ghent, Belgium
| | | | - Hichem Sahli
- Electronics and Informatics Department, Vrije Universiteit Brussels, Brussels, Belgium
- Interuniversity Microelectronics Centre, Heverlee, Belgium
| | - Mitchell Valdés-Sosa
- Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba
- *Correspondence: Mitchell Valdés-Sosa
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13
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Nascimento MDM, Gouveia ÉR, Gouveia BR, Marques A, Marconcin P, França C, Ihle A. The Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation Study. Geriatrics (Basel) 2022; 7:geriatrics7040073. [PMID: 35893320 PMCID: PMC9326626 DOI: 10.3390/geriatrics7040073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Age and mobility are interrelated. In this context, cognitive performance (CP) and physical functions (PF) play a mediating role. However, these concepts are multifaceted, and their interrelationships need further investigations. Thus, our study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of older Brazilian adults. The findings show that low levels of CP and PF were associated with a greater chance of the older individual presenting a slow GS. Moreover, the mediation model indicated that CP and PF mediated, by approximately 12% and 98%, respectively, the association between age and GS. Abstract Introduction: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. Methods: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. Results: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. Conclusions: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
- Correspondence: ; Tel.: +55-(87)-21016856
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (É.R.G.); (C.F.)
- LARSYS-Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
| | - Bruna R. Gouveia
- LARSYS-Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Adilson Marques
- CIPER-Interdisciplinary Centre for the Study of Human Performance Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal; (A.M.); (P.M.)
- ISAMB-Environmental Health Institute, Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Priscila Marconcin
- CIPER-Interdisciplinary Centre for the Study of Human Performance Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal; (A.M.); (P.M.)
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, 2805-059 Almada, Portugal
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (É.R.G.); (C.F.)
- LARSYS-Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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14
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Gait Speed as a Biomarker of Cognitive Vulnerability: A Population-Based Study with Cognitively Normal Older Adults. SUSTAINABILITY 2022. [DOI: 10.3390/su14127348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We aimed to examine associations between cognitive vulnerability and gait speed (GS) in a large older sample. A cross-sectional study analyzed data from the “Health, Lifestyle and Fitness in Adults and Seniors in Amazonas” (SEVAAI) project. In total, 697 participants were included (mean age 70.35 ± 6.86 years). Usual and fast GS were evaluated, and cognitive performance was examined by the COGTEL test battery. There was a positive and large correlation between cognition (COGTEL score) and usual GS (r = 0.510; p < 0.001) and fast GS (r = 0.503; p < 0.001). The usual GS, as a continuous variable, indicated a chance of improved cognitive performance by up to 55%, and fast GS by up to 82%. After controlling for potential confounders (i.e., sex, age, MMSE and years of education), usual and fast GS indicated a chance of improving cognition, respectively, in 57% and 85%. Analysis of GS in quartiles (Q) showed high and significant associations between usual and fast GS and cognitive vulnerability. GS classified as Q1 (slower), Q2 and Q3 represented a greater chance of presenting cognitive deficits, respectively, than in participants with both GS classified as Q4 (highest). Cognitive vulnerability was associated with low GS. Usual and fast GS can be used as complementary measures for the evaluation of cognitively normal Brazilian older adults.
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15
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Abellán-Aynés O, López-Plaza D, Martínez-Aranda LM, Alacid F. Inter-stroke steadiness: a new kinematic variable related to 200m performance in young canoeists. Sports Biomech 2022:1-13. [PMID: 35575636 DOI: 10.1080/14763141.2022.2071327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
Abstract
Traditionally, canoeing analyses have always been carried out by calculating mean values over a certain distance. However, a simple analysis of mean values in cyclic actions, such as canoe paddling, can lead to the loss of decisive data. Therefore, the objective of this study was to investigate whether the relationship between the periods of consecutive strokes can be an important aspect in all-out 200-m canoeing performance. A total of 22 young male canoeists aged 13.51 ± 0.43 years old voluntarily participated in the present study. Lateral recordings were taken from all participants when performing an all-out 200 m to subsequently analyse the kinematic variables of time, speed and cycle frequency, length and index. The time of each stroke was calculated by the frame differencesbetween two successive paddles. Likewise, short-term and long-term steadiness of consecutive strokes were analysed. Positive correlations were observed between all-out 200-m time and inter-stroke steadiness, identifying significant associations with long-term (r ≈ 0.8; p < 0.05) and short-term steadiness (r ≈ 0.7; p < 0.05). In conclusion, the present investigation defines and identifies inter-stroke steadiness as a new original kinematic variable that might be considered for performance analysis since it seems to be a key factor in all-out 200-m canoeing.
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Affiliation(s)
- Oriol Abellán-Aynés
- Faculty of Sport, Catholic University of Murcia, Murcia, Spain
- International Chair of Sports Medicine, Catholic University of Murcia, Murcia, Spain
| | - Daniel López-Plaza
- International Chair of Sports Medicine, Catholic University of Murcia, Murcia, Spain
| | | | - Fernando Alacid
- Department of Education, Health Research Center, University of Almeria, Almería, Spain
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16
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Detection of mild cognitive Impairment from gait using Adaptive Neuro-Fuzzy Inference system. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Grabiner MD, Kaufman KR. Developing and Establishing Biomechanical Variables as Risk Biomarkers for Preventable Gait-Related Falls and Assessment of Intervention Effectiveness. Front Sports Act Living 2021; 3:722363. [PMID: 34632378 PMCID: PMC8492908 DOI: 10.3389/fspor.2021.722363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/26/2021] [Indexed: 01/17/2023] Open
Abstract
The purpose of this review is to position the emerging clinical promise of validating and implementing biomechanical biomarkers of falls in fall prevention interventions. The review is framed in the desirability of blunting the effects of the rapidly growing population of older adults with regard to the number of falls, their related injuries, and health care costs. We propose that biomechanical risk biomarkers may be derived from systematic study of the responses to treadmill-delivered perturbations to both identify individuals with a risk of specific types of falls, such as trips and slips as well as quantifying the effectiveness of interventions designed to reduce that risk. The review follows the evidence derived using a specific public health approach and the published biomedical literature that supports trunk kinematics as a biomarker as having met many of the criteria for a biomarker for trip-specific falls. Whereas, the efficacy of perturbation training to reduce slip-related falls by older adults appears to have been confirmed, its effectiveness presently remains an open and important question. There is a dearth of data related to the efficacy and effectiveness of perturbation training to reduce falls to the side falls by older adults. At present, efforts to characterize the extent to which perturbation training can reduce falls and translate the approaches to the clinic represents an important research opportunity.
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Affiliation(s)
- Mark D Grabiner
- Biomechanics and Clinical Biomechanics Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - K R Kaufman
- Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States
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18
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Discriminative Mobility Characteristics between Neurotypical Young, Middle-Aged, and Older Adults Using Wireless Inertial Sensors. SENSORS 2021; 21:s21196644. [PMID: 34640963 PMCID: PMC8512820 DOI: 10.3390/s21196644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 10/03/2021] [Indexed: 11/23/2022]
Abstract
Age-related mobility research often highlights significant mobility differences comparing neurotypical young and older adults, while neglecting to report mobility outcomes for middle-aged adults. Moreover, these analyses regularly do not determine which measures of mobility can discriminate groups into their age brackets. Thus, the current study aimed to provide a comprehensive analysis for commonly performed aspects of mobility (walking, turning, sit-to-stand, and balance) to determine which variables were significantly different and furthermore, able to discriminate between neurotypical young adults (YAs), middle-aged adults (MAAs), and older adults (OAs). This study recruited 20 YAs, 20 MAAs, and 20 OAs. Participants came into the laboratory and completed mobility testing while wearing wireless inertial sensors. Mobility tests assessed included three distinct two-minute walks, 360° turns, five times sit-to-stands, and a clinical balance test, capturing 99 distinct mobility metrics. Of the various mobility tests assessed, only 360° turning measures demonstrated significance between YAs and MAAs, although the capacity to discriminate between groups was achieved for gait and turning measures. A variety of mobility measures demonstrated significance between MAAs and OAs, and furthermore discrimination was achieved for each mobility test. These results indicate greater mobility differences between MAAs and OAs, although discrimination is achievable for both group comparisons.
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19
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Blumen HM, Schwartz E, Allali G, Beauchet O, Callisaya M, Doi T, Shimada H, Srikanth V, Verghese J. Cortical Thickness, Volume, and Surface Area in the Motoric Cognitive Risk Syndrome. J Alzheimers Dis 2021; 81:651-665. [PMID: 33867359 DOI: 10.3233/jad-201576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The motoric cognitive risk (MCR) syndrome is a pre-clinical stage of dementia characterized by slow gait and cognitive complaint. Yet, the brain substrates of MCR are not well established. OBJECTIVE To examine cortical thickness, volume, and surface area associated with MCR in the MCR-Neuroimaging Consortium, which harmonizes image processing/analysis of multiple cohorts. METHODS Two-hundred MRIs (M age 72.62 years; 47.74%female; 33.17%MCR) from four different cohorts (50 each) were first processed with FreeSurfer 6.0, and then analyzed using multivariate and univariate general linear models with 1,000 bootstrapped samples (n-1; with resampling). All models adjusted for age, sex, education, white matter lesions, total intracranial volume, and study site. RESULTS Overall, cortical thickness was lower in individuals with MCR than in those without MCR. There was a trend in the same direction for cortical volume (p = 0.051). Regional cortical thickness was also lower among individuals with MCR than individuals without MCR in prefrontal, insular, temporal, and parietal regions. CONCLUSION Cortical atrophy in MCR is pervasive, and include regions previously associated with human locomotion, but also social, cognitive, affective, and motor functions. Cortical atrophy in MCR is easier to detect in cortical thickness than volume and surface area because thickness is more affected by healthy and pathological aging.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Emily Schwartz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gilles Allali
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Switzerland
| | - Olivier Beauchet
- Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital & Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine McGill University, Montreal, Quebec, Canada
| | - Michele Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Takehiko Doi
- Section for Health Promotion, Department of Preventive Gerontology
| | - Hiroyuki Shimada
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Velandai Srikanth
- Peninsula Clinical School, Central Clinical School, Monash University, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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20
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Ali P, Labriffe M, Paisant P, Custaud MA, Annweiler C, Dinomais M. Associations between gait speed and brain structure in amnestic mild cognitive impairment: a quantitative neuroimaging study. Brain Imaging Behav 2021; 16:228-238. [PMID: 34338997 DOI: 10.1007/s11682-021-00496-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients with amnestic mild cognitive impairment (aMCI) present gait disturbances including slower speed and higher variability when compared to cognitively healthy individuals (CHI). Brain neuroimaging could explore higher levels of motor control. Our purpose was to look for an association between morphometrics and gait parameters in each group. We hypothesized that the relation between morphological cerebral alteration and gait speed are different following the group. METHODS Fifty-three participants (30 with aMCI and 23 CHI) were recruited in this French cross-sectional study (mean 72 ± 5 years, 38% female). Gait speed and gait variability (coefficients of variation of stride time (STV) and stride length (SLV)) were measured using GAITrite® system. CAT12 software was used to analyse volume and surface morphometry like gray matter volume (GMV) and cortical thickness (CT). Age, gender and education level were used as potential cofounders. RESULTS aMCI had slower gait speed and higher STV when compared to CHI. In aMCI the full adjusted linear regression model showed that lower gait speed was associated with decreased GMV and lower CT in bilateral superior temporal gyri (p < 0.36). In CHI, no association was found between gait speed and brain structure. Higher SLV was correlated with reduced GMV in spread regions (p < 0.05) and thinner cortex in the middle right frontal gyrus (p = 0.001) in aMCI. In CHI, higher SLV was associated with reduced GMV in 1 cluster: the left lingual (p = 0.041). CONCLUSIONS These findings indicate that lower gait speed is associated with specific brain structural changes as reduced GMV and CT during aMCI.
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Affiliation(s)
- Pauline Ali
- Laboratoire Angevin de Recherche en Ingénierie Des Systèmes, EA7315, University of Angers, Angers, France. .,Department of Physical and Rehabilitation Medicine, Angers University Hospital, Angers, France. .,Les Capucins, Centre de Réadaptation Spécialisée et Soins Longue Durée, 11 Boulevard Jean Sauvage, F-49100, Angers, France.
| | - Matthieu Labriffe
- Laboratoire Angevin de Recherche en Ingénierie Des Systèmes, EA7315, University of Angers, Angers, France.,Department of Radiology, Angers University Hospital, University of Angers, Angers, France
| | - Paul Paisant
- Les Capucins, Centre de Réadaptation Spécialisée et Soins Longue Durée, 11 Boulevard Jean Sauvage, F-49100, Angers, France
| | - Marc Antoine Custaud
- CRC, Clinical Research Center, Angers University Hospital, Angers, France.,MITOVASC Institute, UMR CNRS 6015, UMR INSERM 1083, University of Angers, Angers, France
| | - Cédric Annweiler
- Department of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, University of Angers, Angers, France.,Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Mickaël Dinomais
- Laboratoire Angevin de Recherche en Ingénierie Des Systèmes, EA7315, University of Angers, Angers, France.,Department of Physical and Rehabilitation Medicine, Angers University Hospital, Angers, France.,Les Capucins, Centre de Réadaptation Spécialisée et Soins Longue Durée, 11 Boulevard Jean Sauvage, F-49100, Angers, France
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Liu Y, Huo C, Lu K, Liu Q, Xu G, Ji R, Zhang T, Shang P, Lv Z, Li Z. Correlation Between Gait and Near-Infrared Brain Functional Connectivity Under Cognitive Tasks in Elderly Subjects With Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:482447. [PMID: 34177547 PMCID: PMC8226222 DOI: 10.3389/fnagi.2021.482447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Older adults with mild cognitive impairment (MCI) have a high risk of developing Alzheimer’s disease. Gait performance is a potential clinical marker for the progression of MCI into dementia. However, the relationship between gait and brain functional connectivity (FC) in older adults with MCI remains unclear. Forty-five subjects [MCI group, n = 23; healthy control (HC) group, n = 22] were recruited. Each subject performed a walking task (Task 01), counting backward–walking task (Task 02), naming animals–walking task (Task 03), and calculating–walking task (Task 04). The gait parameters and cerebral oxygenation signals from the left prefrontal cortex (LPFC), right prefrontal cortex (RPFC), left motor cortex (LMC), right motor cortex (RMC), left occipital leaf cortex (LOL), and right occipital leaf cortex (ROL) were obtained simultaneously. Wavelet phase coherence was calculated in two frequency intervals: low frequency (interval I, 0.052–0.145 Hz) and very low frequency (interval II, 0.021–0.052 Hz). Results showed that the FC of RPFC–RMC is significantly lower in interval I in Task 03 compared with that in Task 02 in the MCI group (p = 0.001). Also, the right relative symmetry index (IDpsR) is significantly lower in Task 03 compared with that in Task 02 (p = 0.000). The IDpsR is positively correlated with the FC of RPFC–RMC in interval I in the MCI group (R = 0.205, p = 0.041). The gait symmetry such as left relative symmetry index (IDpsL) and IDpsR is significantly lower in the dual-task (DT) situation compared with the single task in the two groups (p < 0.05). The results suggested that the IDpsR might reflect abnormal change in FC of RPFC–RMC in interval I in the MCI population during Task 03. The gait symmetry is affected by DTs in both groups. The findings of this study may have a pivotal role in the early monitoring and intervention of brain dysfunction among older adults with MCI.
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Affiliation(s)
- Ying Liu
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of The Ministry of Civil Affairs, Beijing, China
| | - Congcong Huo
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Kuan Lu
- China Academy of Information and Communications Technology, Beijing, China
| | - Qianying Liu
- China Electronics Standardization Institute, Beijing, China
| | - Gongcheng Xu
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Run Ji
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Tengyu Zhang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Pan Shang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Zeping Lv
- Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of The Ministry of Civil Affairs, Beijing, China
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22
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Teixeira E, Fonseca H, Diniz-Sousa F, Veras L, Boppre G, Oliveira J, Pinto D, Alves AJ, Barbosa A, Mendes R, Marques-Aleixo I. Wearable Devices for Physical Activity and Healthcare Monitoring in Elderly People: A Critical Review. Geriatrics (Basel) 2021; 6:38. [PMID: 33917104 PMCID: PMC8167657 DOI: 10.3390/geriatrics6020038] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/25/2021] [Accepted: 04/02/2021] [Indexed: 01/22/2023] Open
Abstract
The availability of wearable devices (WDs) to collect biometric information and their use during activities of daily living is significantly increasing in the general population. These small electronic devices, which record fitness and health-related outcomes, have been broadly utilized in industries such as medicine, healthcare, and fitness. Since they are simple to use and progressively cheaper, they have also been used for numerous research purposes. However, despite their increasing popularity, most of these WDs do not accurately measure the proclaimed outcomes. In fact, research is equivocal about whether they are valid and reliable methods to specifically evaluate physical activity and health-related outcomes in older adults, since they are mostly designed and produced considering younger subjects' physical and mental characteristics. Additionally, their constant evolution through continuous upgrades and redesigned versions, suggests the need for constant up-to-date reviews and research. Accordingly, this article aims to scrutinize the state-of-the-art scientific evidence about the usefulness of WDs, specifically on older adults, to monitor physical activity and health-related outcomes. This critical review not only aims to inform older consumers but also aid researchers in study design when selecting physical activity and healthcare monitoring devices for elderly people.
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Affiliation(s)
- Eduardo Teixeira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Faculty of Psychology, Education and Sports, Lusófona University of Porto, 4000-098 Porto, Portugal
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, 4900-347 Viana do Castelo, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Florêncio Diniz-Sousa
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Lucas Veras
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Giorjines Boppre
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Diogo Pinto
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University Institute of Maia, 4475-690 Maia, Portugal
| | - Alberto Jorge Alves
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University Institute of Maia, 4475-690 Maia, Portugal
| | - Ana Barbosa
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Romeu Mendes
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
- Northern Region Health Administration, 4000-477 Porto, Portugal
| | - Inês Marques-Aleixo
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Faculty of Psychology, Education and Sports, Lusófona University of Porto, 4000-098 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
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23
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Masse FAA, Ansai JH, Fiogbe E, Rossi PG, Vilarinho ACG, Takahashi ACDM, Pires de Andrade L. Progression of Gait Changes in Older Adults With Mild Cognitive Impairment: A Systematic Review. J Geriatr Phys Ther 2021; 44:119-124. [PMID: 33534339 DOI: 10.1519/jpt.0000000000000281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The identification of altered gait and its progression over time is important to gaining a better understanding of the clinical aspects of mild cognitive impairment (MCI) in older adults. The aim of the present systematic review was to determine changes in gait variables over time among older adults with MCI. METHODS The PubMed, Web of Science, Scopus, and Science Direct databases were searched for relevant articles using the following keywords and Medical Subject Headings: Aged AND "Mild cognitive impairment" AND (gait OR locomotion). A hand search was also performed of the reference lists of the selected articles in an attempt to find additional records. The following were the inclusion criteria: longitudinal studies and clinical trials involving a control group without intervention; samples of individuals 65 years or older; and characterization of gait using a single or dual task. RESULTS AND DISCUSSION The initial search led to the retrieval of 6979 studies, 9 of which met the inclusion criteria. The duration of follow-up among the studies ranged from 6 months to 2 years. Most trials investigated gait speed. Other gait variables were step length, time required to walk a given distance, and mean weekly gait speed. Altered gait progressed in older adults with MCI. The main alterations were gait speed and variability in daily number of steps in follow-up periods lasting more than 1 year. No significant changes in gait variables were found in shorter follow-up periods (up to 6 months). CONCLUSIONS The progression of gait changes in older adults with MCI has been underinvestigated. MCI leads to reduced gait speed in longer follow-up periods. Such information can contribute to the determination of motor interventions for older adults with MCI, especially in the early stages.
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Affiliation(s)
| | - Juliana Hotta Ansai
- Course of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Elie Fiogbe
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Paulo Giusti Rossi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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24
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Le Floch M, Ali P, Asfar M, Sánchez-Rodríguez D, Dinomais M, Annweiler C. Volumetric Brain Changes in Older Fallers: A Voxel-Based Morphometric Study. Front Bioeng Biotechnol 2021; 9:610426. [PMID: 33777908 PMCID: PMC7987921 DOI: 10.3389/fbioe.2021.610426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/15/2021] [Indexed: 01/04/2023] Open
Abstract
Background Falls are frequent and severe in older adults, especially among those with cognitive impairments due to altered motor control. Which brain areas are affected among fallers remains yet not elucidated. The objective of this cross-sectional analysis was to determine whether the history of falls correlated with focal brain volume reductions in older adults. Methods Participants from the MERE study (n = 208; mean, 71.9 ± 5.9 years; 43% female; 38% cognitively healthy, 41% with mild cognitive impairment and 21% with dementia) were asked about their history of falls over the preceding year and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, use of psychoactive drugs, cognitive status, and total intracranial volume were used as covariates. Results Fifty-eight participants (28%) reported history of falls. Fallers were older (P = 0.001), used more often psychoactive drugs (P = 0.008) and had more often dementia (P = 0.004) compared to non-fallers. After adjustment, we found correlations between the history of falls and brain subvolumes; fallers exhibiting larger gray matter subvolumes in striatum, principally in bilateral caudate nucleus, than non-fallers. By stratifying on cognitive status, these neuroanatomical correlates were retrieved only in participants with MCI or dementia. There were no correlations with the subvolumes of white matter. Conclusion Older fallers had larger subvolumes in bilateral striatum than non-fallers, principally within the caudate nucleus. This suggests a possible brain adaptative mechanism of falls in people with neurocognitive decline.
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Affiliation(s)
- Maxime Le Floch
- Department of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, University of Angers, Angers, France.,School of Medicine, Faculty of Health, University of Angers, Angers, France
| | - Pauline Ali
- School of Medicine, Faculty of Health, University of Angers, Angers, France.,Department of Physical and Rehabilitation Medicine, Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Angers University Hospital, Université d'Angers, Angers, France
| | - Marine Asfar
- Department of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, University of Angers, Angers, France.,School of Medicine, Faculty of Health, University of Angers, Angers, France
| | | | - Mickaël Dinomais
- School of Medicine, Faculty of Health, University of Angers, Angers, France.,Department of Physical and Rehabilitation Medicine, Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Angers University Hospital, Université d'Angers, Angers, France
| | - Cédric Annweiler
- Department of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, University of Angers, Angers, France.,School of Medicine, Faculty of Health, University of Angers, Angers, France.,Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
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25
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Abdul Jabbar K, Seah WT, Lau LK, Pang BWJ, Ng DHM, Tan QLL, Chen KK, Mallya Ullal J, Ng TP, Wee SL. Fast gait spatiotemporal parameters in adults and association with muscle strength - The Yishun study. Gait Posture 2021; 85:217-223. [PMID: 33610825 DOI: 10.1016/j.gaitpost.2021.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/21/2020] [Accepted: 01/01/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is limited data on fast gait speed and spatial-temporal parameters across age groups among Asian adults, and the associations between upper and lower extremity muscle strength with gait. RESEARCH QUESTION What values characterise fast gait spatiotemporal parameters across the age groups of an Asian population? Are hand grip strength (HGS) and knee extension strength (KES) associated with fast gait speed and spatiotemporal parameters? METHODS Healthy community-living adults between 21-90 years (n = 487) were recruited. Fast gait was assessed using a 6 m instrumented walkway, and spatiotemporal parameters including variability for fast gait speed, stride length, stride width, stride time, stance time, swing time, single support time and double support time were analysed. Maximum HGS and KES were also assessed. Linear regression modelling was used to explore the association of HGS and KES with fast gait speed, spatiotemporal parameters and their variability. RESULTS Age reduced fast gait speed and stride length, but increased stride width, stance time, stride time and double support time. Age increased all investigated gait variabilities except stride width variability. Gender differences were observed for all gait features except for fast gait speed and double support time. Both HGS and KES were positively associated with fast gait speed in both young and old adults. KES was positively associated with spatiotemporal variations in stride length, stride time, stance time and double support time. HGS was also significantly associated with two additional temporal parameters - positively with swing time and negatively with double support time variability. SIGNIFICANCE The data from this study contributes to reference values database for the use of fast gait assessments in adults.
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Affiliation(s)
| | - Wei-Ting Seah
- Geriatric Education and Research Institute (GERI), Singapore
| | - Lay Khoon Lau
- Geriatric Education and Research Institute (GERI), Singapore
| | | | | | | | | | - Jagadish Mallya Ullal
- Geriatric Education and Research Institute (GERI), Singapore; Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Tze-Pin Ng
- Geriatric Education and Research Institute (GERI), Singapore; Department of Psychological Medicine, National University of Singapore, Singapore
| | - Shiou-Liang Wee
- Geriatric Education and Research Institute (GERI), Singapore; Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore.
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26
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Kumar H, Chatterjee K, Choudhury S, Siddique U, Mondal B, Kulsum M, Haldar S, Basu P, Banerjee R. Semantic fluency predicts gait velocity in PSP. Ann Indian Acad Neurol 2021; 24:896-900. [PMID: 35359519 PMCID: PMC8965940 DOI: 10.4103/aian.aian_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/21/2021] [Accepted: 04/23/2021] [Indexed: 11/04/2022] Open
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27
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Frazier HN, Anderson KL, Ghoweri AO, Lin RL, Hawkinson TR, Popa GJ, Sompol P, Mendenhall MD, Norris CM, Thibault O. Molecular elevation of insulin receptor signaling improves memory recall in aged Fischer 344 rats. Aging Cell 2020; 19:e13220. [PMID: 32852134 PMCID: PMC7576226 DOI: 10.1111/acel.13220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 12/24/2022] Open
Abstract
As demonstrated by increased hippocampal insulin receptor density following learning in animal models and decreased insulin signaling, receptor density, and memory decline in aging and Alzheimer's diseases, numerous studies have emphasized the importance of insulin in learning and memory processes. This has been further supported by work showing that intranasal delivery of insulin can enhance insulin receptor signaling, alter cerebral blood flow, and improve memory recall. Additionally, inhibition of insulin receptor function or expression using molecular techniques has been associated with reduced learning. Here, we sought a different approach to increase insulin receptor activity without the need for administering the ligand. A constitutively active, modified human insulin receptor (IRβ) was delivered to the hippocampus of young (2 months) and aged (18 months) male Fischer 344 rats in vivo. The impact of increasing hippocampal insulin receptor expression was investigated using several outcome measures, including Morris water maze and ambulatory gait performance, immunofluorescence, immunohistochemistry, and Western immunoblotting. In aged animals, the IRβ construct was associated with enhanced performance on the Morris water maze task, suggesting that this receptor was able to improve memory recall. Additionally, in both age-groups, a reduced stride length was noted in IRβ-treated animals along with elevated hippocampal insulin receptor levels. These results provide new insights into the potential impact of increasing neuronal insulin signaling in the hippocampus of aged animals and support the efficacy of molecularly elevating insulin receptor activity in vivo in the absence of the ligand to directly study this process.
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Affiliation(s)
| | - Katie L. Anderson
- Department of Pharmacology and Nutritional SciencesLexingtonKentuckyUSA
| | - Adam O. Ghoweri
- Department of Pharmacology and Nutritional SciencesLexingtonKentuckyUSA
| | - Ruei-Lung Lin
- Department of Pharmacology and Nutritional SciencesLexingtonKentuckyUSA
| | - Tara R. Hawkinson
- Department of Pharmacology and Nutritional SciencesLexingtonKentuckyUSA
| | - Gabriel J. Popa
- Department of Molecular and Cellular BiochemistryLexingtonKentuckyUSA
| | - Pradoldej Sompol
- Sanders-Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | | | | | - Olivier Thibault
- Department of Pharmacology and Nutritional SciencesLexingtonKentuckyUSA
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28
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Bruderer-Hofstetter M, Sikkes SAM, Münzer T, Niedermann K. Development of a model on factors affecting instrumental activities of daily living in people with mild cognitive impairment - a Delphi study. BMC Neurol 2020; 20:264. [PMID: 32611388 PMCID: PMC7329426 DOI: 10.1186/s12883-020-01843-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction The level of function of instrumental activities of daily living (IADL) is crucial for a person’s autonomy. A clear understanding of the nature of IADL and its limitations in people with mild cognitive impairment (MCI) is lacking. Literature suggests numerous possible influencing factors, e.g. cognitive function, but has not considered other domains of human functioning, such as environmental factors. Our aim was to develop a comprehensive model of IADL functioning that depicts the relevant influencing factors. Methods We conducted a four-round online Delphi study with a sample of international IADL experts (N = 69). In the first round, panelists were asked to mention all possible relevant cognitive and physical function factors, as well as environmental and personal factors, that influence IADL functioning. In the subsequent rounds, panelists rated the relevance of these factors. Consensus was defined as: 1) ≥70% agreement between panelists on a factor, and 2) stability over two successive rounds. Results Response rates from the four rounds were high (83 to 100%). In the first round, 229 influencing factors were mentioned, whereof 13 factors reached consensus in the subsequent rounds. These consensual factors were used to build a model of IADL functioning. The final model included: five cognitive function factors (i.e. memory, attention, executive function, and two executive function subdomains -problem solving / reasoning and organization / planning); five physical function factors (i.e. seeing functions, hearing functions, balance, gait / mobility functions and functional mobility functions); two environmental factors (i.e. social network / environment and support of social network / environment); and one personal factor (i.e. education). Conclusions This study proposes a comprehensive model of IADL functioning in people with MCI. The results from this Delphi study suggest that IADL functioning is not merely affected by cognitive function factors, but also by physical function factors, environmental factors and personal factors. The multiplicity of factors mentioned in the first round also underlines the individuality of IADL functioning in people with MCI. This model may serve as a basis for future research in IADL functioning in people with MCI.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Helath Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Centers / Department of Clinical, Neuro and Developmental Psychology, VU University / Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Thomas Münzer
- Geriatrische Klinik St.Gallen, St.Gallen, Switzerland.,Department of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
| | - Karin Niedermann
- School of Helath Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
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29
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Sheikh M, Hosseini HA. Investigating the relationship between spatiotemporal gait variability and falls self-efficacy in individuals with chronic stroke. Physiother Theory Pract 2020; 38:543-551. [PMID: 32482118 DOI: 10.1080/09593985.2020.1771799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To investigate the relationship between spatiotemporal gait variability and falls self-efficacy after chronic stroke while taking into account the effect of some known potential confounders including fall numbers and gait velocity. METHODS Participants (n = 62) walked at their preferred speed to calculate gait variability for stride time, stride length, swing time, and double-support percent. The Falls Efficacy Scale-International (FES-I) assessed falls self-efficacy. The linear regression tests were used for statistical analysis. Age, sex, time since stroke, paretic side, motor impairments, fall numbers, and gait velocity were considered as independent variables. RESULTS Increased FES-I score was related to higher stride time variability (R2 = 0.65, F(8,53) = 15.44, P < .05). Increased FES-I was associated with higher stride length variability (R2 = 0.42, F(6,55) = 8.44, P < .05). However, further adjustment on gait velocity and fall numbers made the association non-significant (R2 = 0.41, F(8,53) = 6.4, P > .05). No significant relationship was identified between FES-I and swing time (R2 = 0.08, F(8,53) = 0.39, P > .05) and FES-I and double-support percent variability (R2 = 0.04, F(8,53) = 0.67, P > .05). CONCLUSION The results indicate that increased FES-I score may be related to increased stride variability post stroke.
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Affiliation(s)
- Mania Sheikh
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, University Campus, Azadi Square, Mashhad, Iran
| | - Hossein Asghar Hosseini
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, University Campus, Azadi Square, Mashhad, Iran
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30
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Knapstad MK, Steihaug OM, Aaslund MK, Nakling A, Naterstad IF, Fladby T, Aarsland D, Giil LM. Reduced Walking Speed in Subjective and Mild Cognitive Impairment: A Cross-Sectional Study. J Geriatr Phys Ther 2020; 42:E122-E128. [PMID: 29298174 DOI: 10.1519/jpt.0000000000000157] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Walking speed is reduced in people with dementia, but less is known about predementia conditions. We, therefore, studied the relationship between walking speed, cognition, and cerebrospinal fluid biomarkers in persons with subjective (SCI) and mild cognitive impairment (MCI). METHODS We conducted a cross-sectional study of 22 healthy controls, 30 SCI and 17 MCI (N = 69). Walking speed was measured by a 10-m gait test at usual and fast pace. We analyzed the association between walking speed and the ordered categories of controls, SCI, and MCI in a generalized proportional odds model. Neuropsychological tests, Consortium to Establish a Registry for Alzheimer's Disease (delayed recall), and Trail Making (TMT) A and B, were analyzed by negative binomial, linear, and robust regression for association with walking speed. RESULTS Walking speed at usual pace was slower moving from controls to SCI (odds ratio: 0.46, P = 0.031) and MCI (odds ratio: 0.44, P = .019) on an ordinal scale. In MCI, walking speed was reduced at fast speed (odds ratio: 0.46, P = 0.04). There were significant associations between walking speeds and neuropsychological test performance. Usual walking speed was associated with slower test performance on TMT-A (β: -.02, P = .04) and fast pace with slower performance on TMT-B (β: -.01, P = .03). There were no associations between cerebrospinal fluid biomarkers and walking speeds. CONCLUSION Usual walking speed is reduced in a graded fashion with the early symptoms of cognitive impairment. Our results suggest that reduced walking speed at both usual and fast speed is associated with impaired cognitive function, and that walking speed could be affected at very early stages of neurodegeneration.
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Affiliation(s)
- Mari Kalland Knapstad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Centre for Vestibular Disorders, Department of Otorhinolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ole Martin Steihaug
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Mona Kristin Aaslund
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Arne Nakling
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Betanien Diaconal Hospital, Bergen, Norway
| | | | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Loerenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, United Kingdom
| | - Lasse Melvaer Giil
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
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Noh B, Youm C, Lee M, Park H. Age-specific differences in gait domains and global cognitive function in older women: gait characteristics based on gait speed modification. PeerJ 2020; 8:e8820. [PMID: 32211246 PMCID: PMC7081786 DOI: 10.7717/peerj.8820] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/28/2020] [Indexed: 01/14/2023] Open
Abstract
Background Several studies have reported the association between gait and global cognitive function; however, there is no study explaining the age-specific gait characteristics of older women and association between those characteristics and global cognitive function by age-specific differences and gait speed modification. The aim of this study was to examine age-specific differences in gait characteristics and global cognitive function in older women as well as identify gait domains strongly associated with global cognitive function in older women based on gait speed modification. Methods One hundred sixty-four female participants aged 65–85 years were examined. Participants were assessed for global cognitive function through the mini-mental state examination. They also performed three trials of the overground walking test along a straight 20 m walkway. Inertial measurement unit sensors with shoe-type data loggers on both the left and right outsoles were used to measure gait characteristics. Results The pace at all speeds and the variability and phase at faster speeds were altered in women aged >75 years (all pace domain parameters, p < 0.05); variability and phase highly depended on age (all p < 0.05). Variability at slower speeds (β = −0.568 and p = 0.006) and the phase at the preferred (β = −0.471 and p = 0.005) and faster speeds (β = −0.494 and p = 0.005) were associated with global cognitive function in women aged >75 years. Discussion The variability and phase domains at faster speeds were considered to identify gait changes that accompany aging. In addition, the decreases in global cognitive function are associated with increased variability and phase domains caused by changes in gait speed in older women. Conclusion Our results are considered useful for understanding age-related gait characteristics with global cognitive function in old women.
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Affiliation(s)
- Byungjoo Noh
- Department of Health Care and Science, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Changhong Youm
- Department of Health Care and Science, College of Health Sciences, Dong-A University, Busan, Republic of Korea.,Biomechanics Laboratory, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Myeounggon Lee
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Busan, Republic of Korea
| | - Hwayoung Park
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Busan, Republic of Korea
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32
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Allali G, Montembeault M, Brambati SM, Bherer L, Blumen HM, Launay CP, Liu-Ambrose T, Helbostad JL, Verghese J, Beauchet O. Brain Structure Covariance Associated With Gait Control in Aging. J Gerontol A Biol Sci Med Sci 2020; 74:705-713. [PMID: 29846517 DOI: 10.1093/gerona/gly123] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Structural and functional brain imaging methods have identified age-related changes in brain structures involved in gait control. This cross-sectional study aims to investigate gray matter networks associated with gait control in aging using structural covariance analysis. METHODS Walking speed were measured in 326 nondemented older community-dwellers (age 71.3 ± 4.5; 41.7% female) under three different walking conditions: normal walking and two challenging tasks: motor (ie, fast speed) and an attention-demanding dual task (ie, backward counting). RESULTS Three main individual gray matter regions were positively correlated with walking speed (ie, slower walking speed was associated with lower brain volumes): right thalamus, right caudate nucleus, and left middle frontal gyrus for normal walking, rapid walking, and dual-task walking condition, respectively. The structural covariance analysis revealed that prefrontal regions were part of the networks associated with every walking condition; the right caudate was associated specifically with the hippocampus, amygdala and insula for the rapid walking condition, and the left middle frontal gyrus with a network involving the cuneus for the dual-task condition. CONCLUSION Our results suggest that brain networks associated with gait control vary according to walking speed and depend on each walking condition. Gait control in aging involved a distributed network including regions for emotional control that are recruited in challenging walking conditions.
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Affiliation(s)
- Gilles Allali
- Department of Neurology, Geneva University Hospital, University of Geneva, Switzerland.,Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York
| | - Maxime Montembeault
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Quebec, Canada.,Département de psychologie, Institut de cardiologie de Montréal et centre EPIC, Université de Montreal, Quebec, Canada
| | - Simona M Brambati
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Quebec, Canada
| | - Louis Bherer
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Quebec, Canada.,Département de Médecine, Institut de cardiologie de Montréal et centre EPIC, Université de Montreal, Quebec, Canada
| | - Helena M Blumen
- Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Cyrille P Launay
- Division of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Switzerland
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, Canada
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Joe Verghese
- Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, Montreal, Quebec, Canada.,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, Quebec, Canada
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Xie H, Wang Y, Tao S, Huang S, Zhang C, Lv Z. Wearable Sensor-Based Daily Life Walking Assessment of Gait for Distinguishing Individuals With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2019; 11:285. [PMID: 31695605 PMCID: PMC6817674 DOI: 10.3389/fnagi.2019.00285] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/03/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives: To characterize gait disorders in patients with amnestic mild cognitive impairment (aMCIs) and determine the association between the performance of the gait function and cognition. Methodology: In this study, we enrolled 38 patients with aMCI and 30 cognitively normal individuals normal controls (NC). Neuropsychological assessments included tests of memory, executive function, language, and attention. Using an inertial-sensor-based wearable instrument, we collected the gait data dynamically for at least 1 h/day for 2 weeks. The gait parameters included walking velocity, stride length, stride time, cadence, and stride time variability. Results: The aMCI patients had reduced walking velocity and stride length and increased stride time variability compared with the NCs. The total number of steps, stride time, and cadence did not differ between the two groups. For all the subjects, walking velocity and stride length was positively associated with memory and executive function. Stride time variability was negatively correlated with the cognitive domains including memory, executive function and attention. Conclusion: This study suggested that cognitive impairment-related gait disorders occur (reduced gait speed, gait length, and gait stability) in daily life walking among the aMCI patients. A sensor-based wearable device for gait measurement may be an alternative and convenient tool for screening cognitive impairment.
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Affiliation(s)
- Haiqun Xie
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Yukai Wang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, China
| | - Shuyun Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Chengguo Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Zeping Lv
- National Research Center for Rehabilitation Technical Aids, Rehabilitation Hospital, Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Intelligent Control and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing, China
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Allali G, Montembeault M, Saj A, Wong CH, Cooper-Brown LA, Bherer L, Beauchet O. Structural Brain Volume Covariance Associated with Gait Speed in Patients with Amnestic and Non-Amnestic Mild Cognitive Impairment: A Double Dissociation. J Alzheimers Dis 2019; 71:S29-S39. [DOI: 10.3233/jad-190038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland
- Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Maxime Montembeault
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Arnaud Saj
- Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Chek Hooi Wong
- Geriatric Education and Research Institute, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Liam Anders Cooper-Brown
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis – Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Louis Bherer
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Département de Médecine, Université de Montréal, Québec, Canada
- Centre de recherche, Institut de Cardiologie de Montréal, Université de Montréal, Québec, Canada
| | - Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis – Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Serra-Añó P, Pedrero-Sánchez JF, Hurtado-Abellán J, Inglés M, Espí-López GV, López-Pascual J. Mobility assessment in people with Alzheimer disease using smartphone sensors. J Neuroeng Rehabil 2019; 16:103. [PMID: 31412893 PMCID: PMC6694667 DOI: 10.1186/s12984-019-0576-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/08/2019] [Indexed: 01/20/2023] Open
Abstract
Background Understanding the functional status of people with Alzheimer Disease (AD), both in a single (ST) and cognitive dual task (DT) activities is essential for identifying signs of early-stage neurodegeneration. This study aims to compare the performance quality of several tasks using sensors embedded in an Android device, among people at different stages of Alzheimer and people without dementia. The secondary aim is to analyze the effect of cognitive task performance on mobility tasks. Methods This is a cross-sectional study including 22 participants in the control group (CG), 18 in the group with mild AD and 22 in the group with moderate AD. They performed two mobility tests, under ST and DT conditions, which were registered using an Android device. Postural control was measured by medial-lateral and anterior-posterior displacements of the COM (MLDisp and APDisp, respectively) and gait, with the vertical and medial-lateral range of the COM (Vrange and MLrange). Further, the sit-to-stand (PStand) and turning and sit power (PTurnSit), the total time required to complete the test and the reaction time were measured. Results There were no differences between the two AD stages either for ST or DT in any of the variables (p > 0.05). Nevertheless, people at both stages showed significantly lower values of PStand and PTurnSit and larger Total time and Reaction time compared to CG (p < 0.05). Further, Vrange is also lower in CDR1G than in CG (p < 0.05). The DT had a significant deleterious effect on MLDisp in all groups (p < 0.05) and on APDisp only in moderate AD for DT. Conclusions Our findings indicate that AD patients present impairments in some key functional abilities, such as gait, turning and sitting, sit to stand, and reaction time, both in mild and moderate AD. Nevertheless, an exclusively cognitive task only influences the postural control in people with AD.
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Affiliation(s)
- Pilar Serra-Añó
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - José Francisco Pedrero-Sánchez
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain
| | - Juan Hurtado-Abellán
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Marta Inglés
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Gemma Victoria Espí-López
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Juan López-Pascual
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain.
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Fusco A, Iasevoli L, Iosa M, Gallotta MC, Padua L, Tucci L, Antonucci G, Baldari C, Guidetti L. Dynamic motor imagery mentally simulates uncommon real locomotion better than static motor imagery both in young adults and elderly. PLoS One 2019; 14:e0218378. [PMID: 31242209 PMCID: PMC6594612 DOI: 10.1371/journal.pone.0218378] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/31/2019] [Indexed: 12/02/2022] Open
Abstract
A new form of Motor Imagery (MI), called dynamic Motor Imagery (dMI) has recently been proposed. The dMI adds to conventional static Motor Imagery (sMI) the presence of simultaneous actual movements partially replicating those mentally represented. In a previous research conducted on young participants, dMI showed to be temporally closer than sMI in replicating the real performance for some specific locomotor conditions. In this study, we evaluated if there is any influence of the ageing on dMI. Thirty healthy participants were enrolled: 15 young adults (27.1±3.8 y.o.) and 15 older adults (65.9±9.6y.o.). The performance time and the number of steps needed to either walk to a target (placed at 10m from participants) or to imagine walking to it, were assessed. Parameters were measured for sMI, dMI and real locomotion (RL) in three different locomotor conditions: forward walking (FW), backward walking (BW), and lateral walking (LW). Temporal performances of sMI and dMI did not differ between RL in the FW, even if significantly different to each other (p = 0.0002). No significant differences were found for dMI with respect to RL for LW (p = 0.140) and BW (p = 0.438), while sMI was significantly lower than RL in LW (p<0.001). The p-value of main effect of age on participants’ temporal performances was p = 0.055. The interaction between age and other factors such as the type of locomotion (p = 0.358) or the motor condition (p = 0.614) or third level interaction (p = 0.349) were not statistically significant. Despite a slight slowdown in the performance of elderly compared to young participants, the temporal and spatial accuracy was better in dMI than sMI in both groups. Motor imagery processes may be strengthened by the feedback generated through dMI, and this effect appears to be unaffected by age.
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Affiliation(s)
- Augusto Fusco
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- * E-mail:
| | - Luigi Iasevoli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Marco Iosa
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Maria Chiara Gallotta
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Sacred Heart Catholic University, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Livia Tucci
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Gabriella Antonucci
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Laura Guidetti
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Rome, Italy
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Beauchet O, Montembeault M, Barden JM, Szturm T, Bherer L, Liu-Ambrose T, Chester VL, Li K, Helbostad JL, Allali G. Brain gray matter volume associations with gait speed and related structural covariance networks in cognitively healthy individuals and in patients with mild cognitive impairment: A cross-sectional study. Exp Gerontol 2019; 122:116-122. [PMID: 31075383 DOI: 10.1016/j.exger.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/29/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Gait speed is slower in patients with mild cognitive impairment (MCI) compared to cognitively healthy individuals (CHI). We examined the patterns of brain gray matter (GM) volume association and covariance with gait speed in CHI and in patients with MCI. METHODS A total of 96 CHI and 99 patients with MCI were recruited in this cross-sectional study. Brain GM volumes measured with voxel-based morphometry and self-paced gait speed were used as outcomes. RESULTS The right middle frontal and precentral gyri volumes were positively associated with gait speed in CHI and covariated with frontal cortex. Striatum (i.e. left putamen and bilateral caudate nuclei) volumes were positively associated with gait speed in patients with MCI and covariated with striatal structures. CONCLUSIONS Two different patterns of brain GM volume association and covariance with gait speed were found and involving frontal cortex in CHI and the striatum in patients with MCI.
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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 University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity, McGill integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - Maxime Montembeault
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - John M Barden
- Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Louis Bherer
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria L Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Karen Li
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland; Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA
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Gao CC, Chern JS, Chang CJ, Lai PL, Lung CW. Center of pressure progression patterns during level walking in adolescents with idiopathic scoliosis. PLoS One 2019; 14:e0212161. [PMID: 31009471 PMCID: PMC6476471 DOI: 10.1371/journal.pone.0212161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/29/2019] [Indexed: 12/05/2022] Open
Abstract
The purpose of this study was to determine whether functional walking performance measured with Timed Up-and-Go (TUG) and center of pressure (CoP) progression pattern is different across adolescents with various curve severity of idiopathic scoliosis (IS). The CoP coordinates during a stance phase for self-paced level walking between adolescent with three different severities of IS (mild IS, moderate IS, and severe IS) and age-matched normal subjects were measured with foot pressure measurement. The average data of three trials were compared among groups with repeated measure analysis of variance. Results showed that the TUG was different between normal and AIS subjects, indicating use of TUG as a marker of functional walking performance in AIS is plausible but studies with larger sample size is needed before using TUG to identify AIS with different scoliosis severity. The results also showed that the CoP displacement, velocity and acceleration during a stance phase was different across groups, and with the most prominent deviations found in the moderate IS group. The medial-lateral shifting of the CoP trajectory at mid-foot regions in all IS groups deviated the most. A tendency of asymmetry in CoP progression pattern between feet in IS groups was also found. The deviation of the spine alignment in frontal plane could change the CoP progression patterns during level walking, suggesting the risk of the locomotors subjecting to abnormal loading during daily walking. Education and conservative interventions might be needed for preservation of medical outcome and prevention of back pain and/or musculoskeletal consequences later in the lives of AIS with and without surgical correction.
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Affiliation(s)
- Chia-Chi Gao
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Occupational Therapy in Rehabilitation Department, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
- * E-mail:
| | - Chun-Ju Chang
- Master of Business Administration Program, Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Wen Lung
- Department of Creative Product Design, Asia University, Taichung, Taiwan
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Blumen HM, Brown LL, Habeck C, Allali G, Ayers E, Beauchet O, Callisaya M, Lipton RB, Mathuranath PS, Phan TG, Pradeep Kumar VG, Srikanth V, Verghese J. Gray matter volume covariance patterns associated with gait speed in older adults: a multi-cohort MRI study. Brain Imaging Behav 2019; 13:446-460. [PMID: 29629501 PMCID: PMC6177326 DOI: 10.1007/s11682-018-9871-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Accelerated gait decline in aging is associated with many adverse outcomes, including an increased risk for falls, cognitive decline, and dementia. Yet, the brain structures associated with gait speed, and how they relate to specific cognitive domains, are not well-understood. We examined structural brain correlates of gait speed, and how they relate to processing speed, executive function, and episodic memory in three non-demented and community-dwelling older adult cohorts (Overall N = 352), using voxel-based morphometry and multivariate covariance-based statistics. In all three cohorts, we identified gray matter volume covariance patterns associated with gait speed that included brain stem, precuneus, fusiform, motor, supplementary motor, and prefrontal (particularly ventrolateral prefrontal) cortex regions. Greater expression of these gray matter volume covariance patterns linked to gait speed were associated with better processing speed in all three cohorts, and with better executive function in one cohort. These gray matter covariance patterns linked to gait speed were not associated with episodic memory in any of the cohorts. These findings suggest that gait speed, processing speed (and to some extent executive functions) rely on shared neural systems that are subject to age-related and dementia-related change. The implications of these findings are discussed within the context of the development of interventions to compensate for age-related gait and cognitive decline.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA.
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA.
| | - Lucy L Brown
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Gilles Allali
- Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Emmeline Ayers
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - Olivier Beauchet
- Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Michele Callisaya
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania (M.L.C.), Hobart, TAS, Australia
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - P S Mathuranath
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Thanh G Phan
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - V G Pradeep Kumar
- Department of Neurology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Velandai Srikanth
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania (M.L.C.), Hobart, TAS, Australia
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
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Intzandt B, Beck EN, Silveira CR. The effects of exercise on cognition and gait in Parkinson’s disease: A scoping review. Neurosci Biobehav Rev 2018; 95:136-169. [DOI: 10.1016/j.neubiorev.2018.09.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
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Beauchet O, Launay CP, Sekhon H, Montembeault M, Allali G. Association of hippocampal volume with gait variability in pre-dementia and dementia stages of Alzheimer disease: Results from a cross-sectional study. Exp Gerontol 2018; 115:55-61. [PMID: 30447261 DOI: 10.1016/j.exger.2018.11.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/10/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Decreased hippocampal volume is a biomarker of Alzheimer disease (AD). The association of hippocampal volume with gait variability across the spectrum of AD, especially in early stages, has been few studied. The study aims to examine the association of hippocampal volume with the coefficient of variation (CoV) of stride time in individuals with mild and moderate to severe subjective cognitive impairment (SCI), non-amnestic mild cognitive impairment (na-MCI), amnestic mild cognitive impairment (a-MCI), and mild to moderate AD dementia. METHODS 271 individuals (79 mild SCI, 68 moderate to severe SCI, 47 na-MCI, 42 a-MCI and 35 mild to moderate AD dementia) were included in this cross-sectional study. Hippocampal volume was quantified from a three-dimensional T1-weighted MRI. CoV of stride time was recorded at self-selected pace with an electronic walkway. Age, sex, body mass index, number of drugs daily taken, history of falls, walking speed, type of MRI scanner, total intracranial volume, and white matter volume abnormality were used as covariates. RESULTS Participants with moderate to severe SCI had a higher CoV of stride time compared to those with mild SCI and na-MCI (P < 0.010), and a higher hippocampal volume compared to other groups (P ≤ 0.001). Participants with moderate to severe SCI had increased hippocampal volume associated with increased CoV of stride time (coefficient of regression β = 0.750 with P = 0.041), while the other groups did not show any significant association. CONCLUSIONS A positive association between greater hippocampal volume (i.e., better brain morphological structure) and an increased stride time variability (i.e., worse gait performance) in individuals with moderate to severe SCI is reported. This association confirms the key role of the hippocampus in gait control and suggests an inefficient compensatory mechanism in early stages of pathological aging like AD.
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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 University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill Integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - Cyrille P Launay
- Division of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Switzerland
| | - Harmehr Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Maxime Montembeault
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital, University of Geneva, Switzerland
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Higueras-Fresnillo S, de la Cámara MA, Esteban-Cornejo I, Rodríguez-Artalejo F, Martinez-Gomez D. Concurrent Criterion Validity of a Test of Usual Gait Speed in Older Adults. Percept Mot Skills 2018; 125:908-922. [PMID: 30089427 DOI: 10.1177/0031512518780594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Usual gait speed has been shown to have very good reliability and convincing predictive validity for evaluating older adults' gait skills, but its criterion validity is unknown. We examined the criterion validity of the 8-feet (i.e., 2.44 meters) test in a laboratory environment to assess usual gait speed by comparing its results with the Intelligent Device for Energy Expenditure and Activity (IDEEA) monitor. Participants were 200 well-functioning community-dwelling adults aged 65 and older (113 women; 87 men; mean [M] age = 71.8, standard deviation [ SD] = 5.6 years). Participants wore the IDEEA monitor for 48 consecutive hours, and we used the participants' average usual gait speed for the analysis. The Spearman correlation of usual gait speed using both the 8-feet test and IDEEA monitor was moderate and statistically significant (ρ = .364, p < .001). The mean difference between both methods was 0.20 ( SD = 0.27) meters/second, and the corresponding limits of agreement were 0.73 and -0.33 meters/second. There was a small systematic bias when the difference between the two methods was correlated with usual gait speed as measured by the IDEEA (ρ = -.20, p = .011). The perfect agreement (weighted kappa) of both instruments for classifying usual gait speed into tertiles, quartiles, and quintiles was 48.3% ( k = 0.17), 30.9% ( k = 0.23), and 25.4% ( k = 0.29), respectively. Our results indicate that the 8-feet test showed moderate criterion-related validity for evaluating and assessing usual gait speed test in older adults.
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Affiliation(s)
- S Higueras-Fresnillo
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - M A de la Cámara
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - I Esteban-Cornejo
- 2 PROFITH Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - F Rodríguez-Artalejo
- 3 Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Spain.,4 IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - D Martinez-Gomez
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
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Rajtar-Zembaty A, Sałakowski A, Rajtar-Zembaty J, Starowicz-Filip A, Skalska A. Slow gait as a motor marker of mild cognitive impairment? the relationships between functional mobility and mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2018; 26:521-530. [PMID: 29985737 DOI: 10.1080/13825585.2018.1495690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to evaluate the association between functional mobility and mild cognitive impairment in older adults. A total of 800 older adults were recruited (653 controls and 147 subjects with MCI [88 subjects with aMCI and 59 subjects with naMCI]). Motor performance was measured with the Timed Up and Go test (TUG). The demographic factors associated with MCI were: age (OR = 1.05; 95% CI: 1.01-1.09) and the level of education (OR = 0.73; 95% CI: 0.68-0.79). An independent clinical factor associated with MCI was the TUG (OR = 1.14; 95% CI: 1.03-1.27). In the aMCI group, the relation between the TUG and cognitive status occurred (OR = 1.15; 95% CI: 1.02-1.31), whereas in the naMCI group this relationship was not observed. There is an association between cognitive dysfunction and impaired motor performance in older adults with MCI.
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Affiliation(s)
- Anna Rajtar-Zembaty
- a The Department of Psychiatry , Jagiellonian University Medical College , Krakow , Poland
| | - Andrzej Sałakowski
- b Nowa Rehabilitacja - Medical-Rehabilitation Center Kraków-Południe , Kraków , Poland
| | - Jakub Rajtar-Zembaty
- c The Department of Internal Medicine and Gerontology , Jagiellonian University Medical College , Krakow , Poland
| | - Anna Starowicz-Filip
- a The Department of Psychiatry , Jagiellonian University Medical College , Krakow , Poland
| | - Anna Skalska
- c The Department of Internal Medicine and Gerontology , Jagiellonian University Medical College , Krakow , Poland
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Umegaki H, Makino T, Yanagawa M, Nakashima H, Kuzuya M, Sakurai T, Toba K. Maximum gait speed is associated with a wide range of cognitive functions in Japanese older adults with a Clinical Dementia Rating of 0.5. Geriatr Gerontol Int 2018; 18:1323-1329. [PMID: 29978592 DOI: 10.1111/ggi.13464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/07/2018] [Accepted: 05/27/2018] [Indexed: 01/11/2023]
Abstract
AIM Physical and cognitive functions are mutually associated. However, it is unknown which markers of physical functions or body composition are most strongly associated with cognition. Here, we explored the association between body composition/physical performance and comprehensive neuropsychological assessments in an effort to identify reliable markers of cognition among factors in body composition/physical performance, including both usual and maximum gait speeds. METHODS We examined a total of 161 Japanese individuals (71 men, 90 women; aged 76.3 ± 7.2 years) with a Clinical Dementia Rating of 0.5 and a Mini-Mental State Examination score >24. A battery of neuropsychological assessments, physical functional assessments and measurements of body composition was carried out. We conducted a multiple regression analysis to investigate the associations between cognitive performance and the factors in body composition and physical performance with adjustments for age, sex, and number of school years. RESULTS Maximum gait speed was the factor most widely associated with cognitive performance among the factors of body composition and physical performance. CONCLUSION Maximum gait speed might be the best marker for cognition in this population of older individuals. Geriatr Gerontol Int 2018; 18: 1323-1329.
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Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Taeko Makino
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Madoka Yanagawa
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
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A Gray Matter Volume Covariance Network Associated with the Motoric Cognitive Risk Syndrome: A Multicohort MRI Study. J Gerontol A Biol Sci Med Sci 2018; 74:884-889. [DOI: 10.1093/gerona/gly158] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Indexed: 11/14/2022] Open
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Beauchet O, Sekhon H, Barden J, Liu-Ambrose T, Chester VL, Szturm T, Grenier S, Léonard G, Bherer L, Allali G. Association of Motoric Cognitive Risk Syndrome with Cardiovascular Disease and Risk Factors: Results from an Original Study and Meta-Analysis. J Alzheimers Dis 2018; 64:875-887. [DOI: 10.3233/jad-180203] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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 University, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada
| | - Harmehr Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - John Barden
- Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria L. Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sébastien Grenier
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Guillaume Léonard
- Research Center on Aging, Sherbrooke university, Sherbrooke, Québec, Canada
| | - Louis Bherer
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
- Montreal Heart Institute Research Center and Departement of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland
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Byrom B, McCarthy M, Schueler P, Muehlhausen W. Brain Monitoring Devices in Neuroscience Clinical Research: The Potential of Remote Monitoring Using Sensors, Wearables, and Mobile Devices. Clin Pharmacol Ther 2018; 104:59-71. [PMID: 29574776 PMCID: PMC6032823 DOI: 10.1002/cpt.1077] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/26/2018] [Accepted: 03/18/2018] [Indexed: 12/19/2022]
Abstract
The increasing miniaturization and affordability of sensors and circuitry has led to the current level of innovation in the area of wearable and microsensor solutions for health monitoring. This facilitates the development of solutions that can be used to measure complex health outcomes in nonspecialist and remote settings. In this article, we review a number of innovations related to brain monitoring including portable and wearable solutions to directly measure brain electrical activity, and solutions measuring aspects related to brain function such as sleep patterns, gait, cognition, voice acoustics, and gaze analysis. Despite the need for more scientific validation work, we conclude that there is enough understanding of how to implement these approaches as exploratory tools that may provide additional valuable insights due to the rich and frequent data they produce, to justify their inclusion in clinical study protocols.
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Rüdiger S, Stuckenschneider T, Vogt T, Abeln V, Lawlor B, Olde Rikkert M, Schneider S. Cognitive Impairment Is Reflected by an Increased Difference between Real and Imagined Timed Up and Go Test Performance. Dement Geriatr Cogn Disord 2018; 44:55-62. [PMID: 28738338 DOI: 10.1159/000477760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Recent research suggests using an imaginary version of the Timed Up and Go test (TUG) for a first assessment of cognitive impairment. By using the time difference between a real (TUGr) and an imagined (TUGi) TUG task, the objective of this study was to examine the effect of cognitive impairment on motor imagery ability. METHODS Fifty-two participants (mean age 69.3 ± 4.0 years) with mild cognitive impairment or subjective cognitive impairment were included in this study. The time difference between the TUGr and the TUGi was used as the main outcome. The Trail Making Test part B (TMT B), the ratio between TMT A and TMT B, and the Montreal Cognitive Assessment (MoCA) battery were the main independent variables. RESULTS The difference between TUGr and TUGi performance time and the TMT B performance time increased with decreasing cognitive function (p < 0.01). There was no relationship between TUGr and TUGi performance time and TMT B/A ratio. There were significant correlations between TUG time differences and the MoCA score (r = -0.489, p < 0.01), the TMT B (r = 0.364, p < 0.01), and the TMT B/A ratio (r = 0.377, p < 0.01). CONCLUSION The combination of TUGr and TUGi may have added value in assessing cognitive impairment, which is a possible pre-stage of dementia.
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Affiliation(s)
- Stefanie Rüdiger
- Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
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Schwenk M, Sabbagh M, Lin I, Morgan P, Grewal GS, Mohler J, Coon DW, Najafi B. Sensor-based balance training with motion feedback in people with mild cognitive impairment. ACTA ACUST UNITED AC 2018; 53:945-958. [PMID: 28475201 DOI: 10.1682/jrrd.2015.05.0089] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 02/03/2016] [Indexed: 11/05/2022]
Abstract
Some individuals with mild cognitive impairment (MCI) experience not only cognitive deficits but also a decline in motor function, including postural balance. This pilot study sought to estimate the feasibility, user experience, and effects of a novel sensor-based balance training program. Patients with amnestic MCI (mean age 78.2 yr) were randomized to an intervention group (IG, n = 12) or control group (CG, n = 10). The IG underwent balance training (4 wk, twice a week) that included weight shifting and virtual obstacle crossing. Real-time visual/audio lower-limb motion feedback was provided from wearable sensors. The CG received no training. User experience was measured by a questionnaire. Postintervention effects on balance (center of mass sway during standing with eyes open [EO] and eyes closed), gait (speed, variability), cognition, and fear of falling were measured. Eleven participants (92%) completed the training and expressed fun, safety, and helpfulness of sensor feedback. Sway (EO, p = 0.04) and fear of falling (p = 0.02) were reduced in the IG compared to the CG. Changes in other measures were nonsignificant. Results suggest that the sensor-based training paradigm is well accepted in the target population and beneficial for improving postural control. Future studies should evaluate the added value of the sensor-based training compared to traditional training.
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Affiliation(s)
- Michael Schwenk
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ.,Arizona Center on Aging, University of Arizona, Tucson, AZ.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Marwan Sabbagh
- Cleo Roberts Memory and Movement Disorders Center, Banner Sun Health Research Institute, Sun City, AZ
| | - Ivy Lin
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ
| | - Pharah Morgan
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ
| | - Gurtej S Grewal
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ
| | - Jane Mohler
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ.,Arizona Center on Aging, University of Arizona, Tucson, AZ
| | - David W Coon
- College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance-Arizona (iCAMP-A), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ.,Arizona Center on Aging, University of Arizona, Tucson, AZ.,Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX
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Baillieul S, Wuyam B, Pépin JL, Marillier M, Tamisier R, Pérennou D, Verges S. Continuous positive airway pressure improves gait control in severe obstructive sleep apnoea: A prospective study. PLoS One 2018; 13:e0192442. [PMID: 29474363 PMCID: PMC5825012 DOI: 10.1371/journal.pone.0192442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/11/2018] [Indexed: 01/10/2023] Open
Abstract
Study aim Severe obstructive sleep apnoea (OSA) can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP) on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients. Material and methods In this prospective controlled study, twelve severe OSA patients (age = 57.2±8.9 years, body mass index = 27.4±3.1 kg·m-2, apnoea-hypopnoea index = 46.3±11.7 events·h-1) and 10 healthy matched subjects were included. Overground gait parameters were recorded at spontaneous speed and stride time variability, a clinical marker of gait control, was calculated. To assess the role of executive functions in gait and postural control, a dual-task paradigm was applied using a Stroop test as secondary cognitive task. All assessments were performed before and after 8 weeks of CPAP treatment. Results Before CPAP treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5%) and lower cognitive performances under dual task compared to controls. After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls. Cognitive performance under dual task also improved after CPAP treatment. Conclusion Eight weeks of CPAP treatment improves gait control of severe OSA patients, suggesting morphological and functional cerebral improvements. Our data provide a rationale for further mechanistic studies and the use of gait as a biomarker of OSA brain consequences.
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Affiliation(s)
- Sébastien Baillieul
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France
- * E-mail:
| | - Bernard Wuyam
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Louis Pépin
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France
| | - Mathieu Marillier
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
| | - Renaud Tamisier
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France
| | - Dominic Pérennou
- LPNC laboratory (UMPR CNRS 5105), Grenoble Alpes University, Grenoble, France
- MPR Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Samuel Verges
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
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