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Nikoumanesh N, Chase CJ, Nagarajan R, Potter K, Martini DN. Frontal cortex neurometabolites and mobility in older adults: a preliminary study. Exp Brain Res 2024; 242:2013-2022. [PMID: 38949687 DOI: 10.1007/s00221-024-06881-0] [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] [Received: 02/22/2024] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The frontal cortex, relevant to global cognition and motor function, is recruited to compensate for mobility dysfunction in older adults. However, the in vivo neurophysiological (e.g., neurometabolites) underpinnings of the frontal cortex compensation for mobility dysfunction remain poorly understood. The purpose of this study was to investigate the relationships among frontal cortex neurophysiology, mobility, and cognition in healthy older adults. METHODS Magnetic Resonance Spectroscopy (MRS) quantified N-acetylasparate (tNAA) and total choline (tCho) concentrations and ratios in the frontal cortex in 21 older adults. Four inertial sensors recorded the Timed Up & Go (TUG) test. Cognition was assessed using the Flanker Inhibitory Control and Attention Test which requires conflict resolution because of response interference from flanking distractors during incongruent trials. Congruent trials require no conflict resolution. RESULTS tNAA concentration significantly related to the standing (p = 0.04) and sitting (p = 0.03) lean angles. tCho concentration (p = 0.04) and tCho ratio (p = 0.02) significantly related to TUG duration. tCho concentration significantly related to incongruent response time (p = 0.01). tCho ratio significantly related to both congruent (p = 0.009) and incongruent (p < 0.001) response times. Congruent (p = 0.02) and incongruent (p = 0.02) Flanker response times significantly related to TUG duration. CONCLUSIONS Altered levels of frontal cortex neurometabolites are associated with both mobility and cognitive abilities in healthy older adults. Identifying neurometabolites associated with frontal cortex compensation of mobility dysfunction could improve targeted therapies aimed at improving mobility in older adults.
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Affiliation(s)
- Nikou Nikoumanesh
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
| | - Colleen J Chase
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
| | - Rajakumar Nagarajan
- Human Magnetic Resonance Center, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katie Potter
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA
- Center for Personalized Health Monitoring, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Douglas N Martini
- Department of Kinesiology, University of Massachusetts Amherst, Totman Building 30 Eastman Lane Amherst, Amherst, MA, 01003, USA.
- Center for Personalized Health Monitoring, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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Morrison L, Dyer AH, Dolphin H, Killane I, Bourke NM, Widdowson M, Woods CP, Gibney J, Reilly RB, Kennelly SP. Discrete Relationships between Spatiotemporal Gait Characteristics and Domain-Specific Neuropsychological Performance in Midlife. SENSORS (BASEL, SWITZERLAND) 2024; 24:3903. [PMID: 38931687 PMCID: PMC11207228 DOI: 10.3390/s24123903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Midlife risk factors such as type 2 diabetes mellitus (T2DM) confer a significantly increased risk of cognitive impairment in later life with executive function, memory, and attention domains often affected first. Spatiotemporal gait characteristics are emerging as important integrative biomarkers of neurocognitive function and of later dementia risk. We examined 24 spatiotemporal gait parameters across five domains of gait previously linked to cognitive function on usual-pace, maximal-pace, and cognitive dual-task gait conditions in 102 middle-aged adults with (57.5 ± 8.0 years; 40% female) and without (57.0 ± 8.3 years; 62.1% female) T2DM. Neurocognitive function was measured using a neuropsychological assessment battery. T2DM was associated with significant changes in gait phases and rhythm domains at usual pace, and greater gait variability observed during maximal pace and dual tasks. In the overall cohort, both the gait pace and rhythm domains were associated with memory and executive function during usual pace. At maximal pace, gait pace parameters were associated with reaction time and delayed memory. During the cognitive dual task, associations between gait variability and both delayed memory/executive function were observed. Associations persisted following covariate adjustment and did not differ by T2DM status. Principal components analysis identified a consistent association of slower gait pace (step/stride length) and increased gait variability during maximal-pace walking with poorer memory and executive function performance. These data support the use of spatiotemporal gait as an integrative biomarker of neurocognitive function in otherwise healthy middle-aged individuals and reveal discrete associations between both differing gait tasks and gait domains with domain-specific neuropsychological performance. Employing both maximal-pace and dual-task paradigms may be important in cognitively unimpaired populations with risk factors for later cognitive decline-with the aim of identifying individuals who may benefit from potential preventative interventions.
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Affiliation(s)
- Laura Morrison
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Adam H. Dyer
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Helena Dolphin
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Isabelle Killane
- Department of Engineering, Technological University Dublin, D07 EWV4 Dublin, Ireland
| | - Nollaig M. Bourke
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Matthew Widdowson
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Conor P. Woods
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - James Gibney
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Richard B. Reilly
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Sean P. Kennelly
- Tallaght Institute of Memory and Cognition, Tallaght University Hospital, D24 NR0A Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
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3
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Brundage K, Holtzer R. Presence and Persistence of Perceived Subjective Cognitive Complaints and Incident Mild Cognitive Impairments Among Community-Residing Older Adults. Am J Geriatr Psychiatry 2023; 31:1140-1148. [PMID: 37516657 DOI: 10.1016/j.jagp.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES To examine whether Subjective Cognitive Complaints (SCCs) predicted incident mild cognitive impairment (MCI). DESIGN Prospective Study. SETTING Central Control of Mobility and Aging (CCMA), a cohort study of community-residing older adults. PARTICIPANTS Participants were dementia-free community-residing older adults. MEASUREMENTS SCCs were assessed at the baseline and via bi-monthly structured phone interviews during the first year using the Ascertain Dementia 8 (AD8). Nonpersistent status required one or two SCCs endorsements and Persistent status required three or more SCCs endorsements. Outcome, presence of mild cognitive impairments (MCI) was determined by established case conference diagnostic procedures. Participants were followed annually. Generalized estimating equations (GEE), logistic model type, were used to determine the odds of developing MCI during follow-up. SCCs served as the three-level predictor (no/nonpersistent/persistent) and cognitive status (MCI versus normal) as the binary outcome. Analyses were adjusted for age, sex, education, race, health status, depressive symptoms, and global cognition. RESULTS The sample (n=454; mean age=75.67 ± 6.43; %female=55.3) included 245 participants who reported no SCCs, 156 who reported 1-2 SCCs, and 53 who reported 3 or more SCCs. Sixty-eight participants developed MCI during follow-up. Results showed that compared to no SCCs, persistent SCCs, and nonpersistent SCCs were significantly associated with increased odds of developing MCI during follow-up. CONCLUSIONS The presence of SCCs regardless of their persistence was associated with increased odds of developing MCI even when adjusting for objectively-assessed cognitive performance.
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Affiliation(s)
- Katie Brundage
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
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4
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Mahoney JR, Blumen HM, De Sanctis P, Fleysher R, Frankini C, Hoang A, Hoptman MJ, Jin R, Lipton M, Nunez V, Twizer L, Uy N, Valdivia A, Verghese T, Wang C, Weiss EF, Zwerling J, Verghese J. Visual-somatosensory integration (VSI) as a novel marker of Alzheimer’s disease: A comprehensive overview of the VSI study. Front Aging Neurosci 2023; 15:1125114. [PMID: 37065459 PMCID: PMC10098130 DOI: 10.3389/fnagi.2023.1125114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/03/2023] [Indexed: 03/31/2023] Open
Abstract
Identification of novel, non-invasive, non-cognitive based markers of Alzheimer’s disease (AD) and related dementias are a global priority. Growing evidence suggests that Alzheimer’s pathology manifests in sensory association areas well before appearing in neural regions involved in higher-order cognitive functions, such as memory. Previous investigations have not comprehensively examined the interplay of sensory, cognitive, and motor dysfunction with relation to AD progression. The ability to successfully integrate multisensory information across multiple sensory modalities is a vital aspect of everyday functioning and mobility. Our research suggests that multisensory integration, specifically visual-somatosensory integration (VSI), could be used as a novel marker for preclinical AD given previously reported associations with important motor (balance, gait, and falls) and cognitive (attention) outcomes in aging. While the adverse effect of dementia and cognitive impairment on the relationship between multisensory functioning and motor outcomes has been highlighted, the underlying functional and neuroanatomical networks are still unknown. In what follows we detail the protocol for our study, named The VSI Study, which is strategically designed to determine whether preclinical AD is associated with neural disruptions in subcortical and cortical areas that concurrently modulate multisensory, cognitive, and motor functions resulting in mobility decline. In this longitudinal observational study, a total of 208 community-dwelling older adults with and without preclinical AD will be recruited and monitored yearly. Our experimental design affords assessment of multisensory integration as a new behavioral marker for preclinical AD; identification of functional neural networks involved in the intersection of sensory, motor, and cognitive functioning; and determination of the impact of early AD on future mobility declines, including incident falls. Results of The VSI Study will guide future development of innovative multisensory-based interventions aimed at preventing disability and optimizing independence in pathological aging.
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Affiliation(s)
- Jeannette R. Mahoney
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- *Correspondence: Jeannette R. Mahoney,
| | - Helena M. Blumen
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Pierfilippo De Sanctis
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Roman Fleysher
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Carolina Frankini
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Alexandria Hoang
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Matthew J. Hoptman
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Runqiu Jin
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Michael Lipton
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
- The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Valerie Nunez
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Lital Twizer
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Naomi Uy
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Ana Valdivia
- Department of Radiology, Division of Nuclear Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Tanya Verghese
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Cuiling Wang
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Erica F. Weiss
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Center of Aging Brain, Montefiore Medical Center, Yonkers, NY, United States
| | - Jessica Zwerling
- Center of Aging Brain, Montefiore Medical Center, Yonkers, NY, United States
| | - Joe Verghese
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Center of Aging Brain, Montefiore Medical Center, Yonkers, NY, United States
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S, Richardson TK, Savatteri N, Wang Y, Tkachyk C. Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures. Psychogeriatrics 2022; 22:553-573. [PMID: 35535013 DOI: 10.1111/psyg.12848] [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: 02/08/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Yimo Wang
- Myodetox Markham, Markham, Ontario, Canada
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Guharajan D, Holtzer R. Association of Affect and Performance in Dual-Task Walking in Non-demented Older Adults. J Aging Health 2022; 34:1062-1070. [PMID: 35477303 DOI: 10.1177/08982643221087836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We examined whether individual differences in positive and negative affective states predicted dual-task costs using an established Dual-Task Walking protocol in non-demented older adults. We hypothesized that positive and negative affect would be associated with smaller and larger dual-task costs, respectively. Methods: Participants (N = 403; mean age = 76.22 ± 6.55; females = 56%) completed the Positive and Negative Affect Schedule and the walking protocol involving three conditions: Single-Task-Alpha, Single-Task-Walk (STW), and Dual-Task-Walk (DTW). Gait velocity was assessed via an instrumented walkway. Results: Negative affect was associated with greater decline in gait velocity from STW to DTW (95% confidence interval [-0.73 to -0.03]) but not the decline of the rate of correct letter generation. There was no significant relationship between positive affect and DTW performance. Discussion: Findings suggest negative affect is adversely associated with allocation of attentional resources, leading to worse mobility outcomes in older adults.
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Affiliation(s)
- Deepan Guharajan
- Ferkauf Graduate School of Psychology, 184694Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, 184694Yeshiva University, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine184694, Bronx, NY, USA
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7
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Dillenseger A, Weidemann ML, Trentzsch K, Inojosa H, Haase R, Schriefer D, Voigt I, Scholz M, Akgün K, Ziemssen T. Digital Biomarkers in Multiple Sclerosis. Brain Sci 2021; 11:brainsci11111519. [PMID: 34827518 PMCID: PMC8615428 DOI: 10.3390/brainsci11111519] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
For incurable diseases, such as multiple sclerosis (MS), the prevention of progression and the preservation of quality of life play a crucial role over the entire therapy period. In MS, patients tend to become ill at a younger age and are so variable in terms of their disease course that there is no standard therapy. Therefore, it is necessary to enable a therapy that is as personalized as possible and to respond promptly to any changes, whether with noticeable symptoms or symptomless. Here, measurable parameters of biological processes can be used, which provide good information with regard to prognostic and diagnostic aspects, disease activity and response to therapy, so-called biomarkers Increasing digitalization and the availability of easy-to-use devices and technology also enable healthcare professionals to use a new class of digital biomarkers-digital health technologies-to explain, influence and/or predict health-related outcomes. The technology and devices from which these digital biomarkers stem are quite broad, and range from wearables that collect patients' activity during digitalized functional tests (e.g., the Multiple Sclerosis Performance Test, dual-tasking performance and speech) to digitalized diagnostic procedures (e.g., optical coherence tomography) and software-supported magnetic resonance imaging evaluation. These technologies offer a timesaving way to collect valuable data on a regular basis over a long period of time, not only once or twice a year during patients' routine visit at the clinic. Therefore, they lead to real-life data acquisition, closer patient monitoring and thus a patient dataset useful for precision medicine. Despite the great benefit of such increasing digitalization, for now, the path to implementing digital biomarkers is widely unknown or inconsistent. Challenges around validation, infrastructure, evidence generation, consistent data collection and analysis still persist. In this narrative review, we explore existing and future opportunities to capture clinical digital biomarkers in the care of people with MS, which may lead to a digital twin of the patient. To do this, we searched published papers for existing opportunities to capture clinical digital biomarkers for different functional systems in the context of MS, and also gathered perspectives on digital biomarkers under development or already existing as a research approach.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tjalf Ziemssen
- Correspondence: ; Tel.: +49-351-458-5934; Fax: +49-351-458-5717
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8
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Heaw YC, Singh DKA, Tan MP, Kumar S. Bidirectional association between executive and physical functions among older adults: A systematic review. Australas J Ageing 2021; 41:20-41. [PMID: 34724301 DOI: 10.1111/ajag.13008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We aimed to examine the bidirectional associations between specific executive function (EF) and physical function (PF) subdomains among older adults. METHODS A systematic literature search (MEDLINE, EMBASE, PsycINFO, EBSCOHOST, Scopus and EmCare) was undertaken from February 2018 to May 2020. Observational studies measuring associations between EF and PF subdomains among older adults were included. RESULTS Twenty-nine studies met the inclusion criteria. Twenty-seven studies reported associations between EF and PF. There were bidirectional associations between slower processing speed and slower gait speed; slower processing speed and lower muscle strength; and lower verbal fluency and slower gait speed. Lower muscle strength was unilaterally associated with lower working memory. CONCLUSIONS We found consistent bidirectional associations between processing speed with gait speed and muscle strength, and verbal fluency and gait speed. There was a unidirectional association between muscle strength and working memory. Common causal mechanisms for EF and PF require further studies.
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Affiliation(s)
- Yu Chi Heaw
- Physiotherapy Programme and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Physiotherapy Programme, Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance Unit, City East Campus, University of South Australia, Adelaide, South Australia, Australia
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9
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Higginson CI, Valenti M, Ibrahim K, Knarr BA, Ryan R, Higginson JS. Neuroticism and Extraversion Are Related to Changes in Postural Stability During Anatomically-Related Cognitive Tasks. J Mot Behav 2021; 54:401-409. [PMID: 34657579 DOI: 10.1080/00222895.2021.1988504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The relationship between personality and postural stability has received little attention. This study addressed whether neuroticism and extraversion correlate with changes in postural stability while performing cognitive tasks related to brain regions selectively associated with neuroticism and extraversion. Thirty-two adults stood on a foam mat in tandem stance and completed a 2-back task and a weather prediction task (WPT). As predicted, higher neuroticism was related to increased dual task sway during the 2-back task, r = 0.40, p = 0.023, and lower extraversion was related to increased dual task sway during the WPT, r = -0.43, p = 0.013, suggesting that personality is related to postural stability in healthy young adults and that personality could be considered in the prediction and treatment of individuals with balance difficulties.
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Affiliation(s)
| | - Marisa Valenti
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
| | - Karlie Ibrahim
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
| | - Brian A Knarr
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA
| | - Rob Ryan
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
| | - Jill S Higginson
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
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10
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Holtzer R, Ross D, O'Brien C, Izzetoglu M, Wagshul ME. Cognitive Reserve Moderates the Efficiency of Prefrontal Cortex Activation Patterns of Gait in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:1836-1844. [PMID: 34606598 DOI: 10.1093/gerona/glab288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cognitive Reserve (CR) protects against cognitive decline, but whether CR influences the efficiency of cortical control of gait has not been reported. The current study addressed this important gap in the literature. Specifically, we determined the role of CR in moderating the efficiency of functional Near-Infrared-Spectroscopy (fNIRS)-derived HbO2 in the prefrontal cortex (PFC) assessed during active walking. We hypothesized that higher CR would be associated with more efficient brain activation patterns. METHODS Participants were 55 (mean age=74.84; %female=49.1) older adults who underwent the combined walking/fNIRS protocol and had MRI data. We used an established dual-task walking paradigm that consisted of three task conditions: Single-Task-Walk (STW), Single-Task-Alpha (STA, cognitive task) and Dual-Task-Walk (DTW). Using the residuals approach, CR was derived from a word-reading test score by removing variance accounted for by socio-demographic variables, tests of current cognitive functions and a measure of structural brain integrity. RESULTS CR moderated the change in fNIRS-derived HbO2 in the PFC across tasks. Higher CR was associated with smaller increases in fNIRS-derived HbO2 from the single tasks to dual task walking (CR x DTW compared to STW: estimate = .183; p < .001; CR x DTW compared to STA: estimate =.257; p < .001). The moderation effect of CR remained significant when adjusting for multiple covariates and concurrent moderation effects of measures of gait performance, current cognitive functions and structural integrity of the brain. CONCLUSION The current study provided first evidence that higher CR was associated with better neural efficiency of walking in older adults.
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University.,Department of Neurology, Albert Einstein College of Medicine
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | | | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
| | - Mark E Wagshul
- Department of Radiology, Albert Einstein College of Medicine
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Bauer LO. Temporal instability in brain activation: a novel paradigm for evaluating the maintenance of attention among substance dependent patients. Psychopharmacology (Berl) 2021; 238:2937-2946. [PMID: 34196741 PMCID: PMC10127227 DOI: 10.1007/s00213-021-05909-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Prior studies have demonstrated statistically significant but subtle differences in brain function between patients with a history of substance dependence (SD) and control groups. OBJECTIVES The goal of the present study was to show that variability in brain activation over the trials of a cognitive task is more useful for revealing the putative impact of SD than analyses focusing on the amplitude of activation averaged over trials. The study also tested the additional contribution of antisocial personality disorder (ASPD)-a prevalent comorbidity that promotes both an early onset and more severe course of SD. METHODS Two hundred eleven adults performed two selective attention tasks while P300 event-related electroencephalographic potentials were recorded. They were assigned to one of 3 mutually exclusive groups: no lifetime history of SD or ASPD (n = 67), a SD history but no ASPD (n = 68), or both SD and ASPD (n = 76). RESULTS The major finding was a statistically significant elevation of P300 amplitude inter-trial variability (ITV) in the SD plus ASPD group in comparison to the group with neither attribute. The elevation was detected during both selective attention tasks and most prominent at electrodes sites located over the frontal brain. There were no group differences in P300 amplitude averaged over trials. CONCLUSIONS We conclude from these findings that the ITV of P300 amplitude is an efficient and sensitive biomarker of the maintenance of attention. It is valuable for revealing group differences associated with substance dependence and ASPD. It may ultimately be valuable for detecting improvements resulting from psychostimulant treatment or other interventions, including cognitive remediation.
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Affiliation(s)
- Lance O Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA.
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12
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Mercuri G, Holtzer R. Engagement in Cognitively Stimulating Activities Mediates the Relationship between Openness and Attention/Executive Functions, but Not Memory in Older Adults. Arch Clin Neuropsychol 2021; 36:485-497. [PMID: 32853359 DOI: 10.1093/arclin/acaa066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/02/2020] [Accepted: 07/29/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Openness has a positive association with cognitive functioning and engagement in cognitively stimulating activities (CSA). Older adults who engage in more CSA tend to show greater preservation of their cognitive skills; thus, we examined whether: higher Openness would be associated with higher attention/executive functions (AEF) and verbal memory; and CSA would mediate the relationship between Openness and AEF, as well as verbal memory. METHOD 477 community-dwelling older adults (65+ years) were included in the current cross-sectional study. Composite variables of AEF (TMT-A&B, COWAT, and DSST) and verbal memory (RBANS immediate and delayed verbal memory subtasks) were included. Openness was assessed via the Big-5 Inventory and CSA with the Leisure Activity Questionnaire. METHOD 477 community-dwelling older adults (65+ years) were included in the current cross-sectional study. Composite variables of AEF (TMT-A&B, COWAT, and DSST) and verbal memory (RBANS verbal memory subtasks) were included. Openness was assessed via the Big-5 Inventory and CSA with the Leisure Activity Questionnaire. RESULTS Linear regressions indicated a significant positive association between Openness and AEF (β = .09, p < .01), but not verbal memory (β = .06, p = .06). A significant partial mediation was demonstrated between Openness, CSA, and AEF (c: β = .08, p < .05, 95%CI = .02-.14; c': β = .02, 95%CI = .01-.03). The mediation of Openness, CSA, and verbal memory was not significant (c: β = .06, p > .05, 95%CI = .01-.11; c': β = .00, 95%CI = -.01-.01). CONCLUSIONS The association between Openness and AEF, but not verbal memory, was partially mediated by CSA in healthy older adults. The findings suggest that those who are more open to and highly engaged in CSA may have a later in life advantage in preserving their AEF abilities.
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Affiliation(s)
- Giulia Mercuri
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, 10461
| | - Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, 10461
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Pakray H, Seng E, Izzetoglu M, Holtzer R. The Effects of Perceived Pain in the Past Month on Prefrontal Cortex Activation Patterns Assessed During Cognitive and Motor Performances in Older Adults. PAIN MEDICINE 2021; 22:303-314. [PMID: 33621331 DOI: 10.1093/pm/pnaa404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pain is prevalent and functionally impactful in older adults. The prefrontal cortex is involved in pain perception, attentional control, and cortical control of locomotion. Although pain is a known moderator of attentional capacity, its moderating effect on cortical control of locomotion has not been assessed. This study aimed to examine the effects of subjective pain on changes in functional near-infrared spectroscopy-derived measurements of oxygenated hemoglobin (HbO2), gait velocity, and cognitive accuracy from single- to dual-task walking conditions among older adults. SUBJECTS The sample consisted of 383 healthy older adults (55% female). METHODS Participants completed two single tasks (Single-Task-Walk [STW] and Cognitive Interference [Alpha]) and the Dual-Task-Walk (DTW), during which participants performed the two single tasks simultaneously. The Medical Outcomes Study Pain Severity Scale and Pain Effects Scale were used to assess pain severity and interference. ProtoKinetics Movement Analysis Software was used to assess gait velocity and rate of correct letter generation to assess cognitive accuracy. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess HbO2 during active walking. RESULTS Linear mixed-effects models revealed that HbO2 increased from single- to dual-task conditions. Perceived pain presence was associated with an attenuated increase in HbO2 from Alpha to DTW. Among those with pain, worse pain severity was associated with an attenuated increase in HbO2 from STW to DTW. Pain interference did not moderate the increase in HbO2 from single to dual tasks. Pain did not have a moderating effect on behavioral outcomes. CONCLUSIONS Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
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Affiliation(s)
- Hannah Pakray
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Elizabeth Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Meltem Izzetoglu
- College of Engineering, Villanova University, Villanova, Pennsylvania, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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Brydges CR, Carlson MC, Andrews RM, Rebok GW, Bielak AAM. Using Cognitive Intraindividual Variability to Measure Intervention Effectiveness: Results from the Baltimore Experience Corps Trial. J Gerontol B Psychol Sci Soc Sci 2021; 76:661-670. [PMID: 31950167 PMCID: PMC7955985 DOI: 10.1093/geronb/gbaa009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Studies investigating the effectiveness of intervention programs on cognitive ability in older adults are inconsistent; however, these studies generally focus on traditional measures of cognition, and therefore may miss some improvements by not utilizing alternate measures. We evaluate the potential for intraindividual variability in cognitive speed (IIV), a demonstrated sensitive indicator of cognitive functioning, to be used as an index of cognitive plasticity from an intervention. The current study evaluated whether older adults in a school volunteering program showed a reduction in IIV, compared to a low-activity control group over 2 years of exposure. METHOD Nondemented older adults (n = 336) participated in the Baltimore Experience Corps Trial, an evaluation of a volunteering program conducted at elementary schools designed to increase older adults' physical, cognitive, and social engagement. Participants completed a cognitive battery that included a Stroop task at baseline and after 12 and 24 months. RESULTS Traditional intent-to-treat analyses did not report significant improvements. Participants who complied at the 80th percentile or above showed a significant reduction in IIV at 24 months, with an additional trend of improved IIV with increased compliance to the treatment protocol, both at 12 months, and at 24 months. Men also showed dose-dependent improvements after 12 months. DISCUSSION The Experience Corps program resulted in an improvement in cognitive performance as measured by IIV. Analyzing previously collected data with nontraditional measures of cognition, such as IIV, may be a potentially fruitful and cost-effective method for understanding how interventions impact cognition in aging populations.
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Affiliation(s)
- Christopher R Brydges
- Department of Human Development and Family Studies, Colorado State University, Fort Collins
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ryan M Andrews
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Allison A M Bielak
- Department of Human Development and Family Studies, Colorado State University, Fort Collins
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The Influence of Diabetes on Multisensory Integration and Mobility in Aging. Brain Sci 2021; 11:brainsci11030285. [PMID: 33668979 PMCID: PMC7996615 DOI: 10.3390/brainsci11030285] [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: 12/21/2020] [Revised: 02/08/2021] [Accepted: 02/20/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: one out of every four adults over the age of 65 are living with diabetes, and this alarming rate continues to increase with age. Diabetes in older adults is associated with many adverse health outcomes, including sensory and motor impairments. The objective of this exploratory study was to determine whether diabetes influences the interplay between multisensory integration processes and mobility in aging. (2) Methods: in this cross-sectional observational study, we recruited 339 non-demented older adults (76.59 ± 6.21 years; 52% female, 18% with diabetes). Participants completed a simple reaction time test in response to visual, somatosensory, and combined visual-somatosensory stimulation. Magnitude of visual-somatosensory integration was computed and served as the independent variable. (3) Results: logistic regression revealed that presence of diabetes was inversely associated with the magnitude of visual-somatosensory integration (β = −3.21; p < 0.01). Further, mediation models revealed that presence of diabetes negatively influenced the relationship of visual–somatosensory integration magnitude with balance (95% CI −0.16, −0.01) and gait (95% CI −0.09, −0.01). Participants with diabetes and taking insulin (n = 14) failed to integrate sensory information entirely; (4) conclusions: taken together, results from this exploration provide compelling evidence to support the adverse effect of diabetes on both multisensory and motor functioning in older adults.
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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 PMCID: PMC8768501 DOI: 10.3233/jad-201576] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Holtzer R, Ross D, Izzetoglu M. Intraindividual variability in neural activity in the prefrontal cortex during active walking in older adults. Psychol Aging 2020; 35:1201-1214. [PMID: 33180518 DOI: 10.1037/pag0000583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intraindividual variability in gait and cognitive performance is distinct from central-tendency measures and associated with clinical outcomes in aging. Knowledge concerning intraindividual variability in neural activity, however, has been relatively scarce, and no research to date has reported on such variability during active walking. The current study addressed this major gap in knowledge. Participants were community-residing older adults (n = 394; mean age = 76.29 ± 6.65 years; %female = 55). Functional near-infrared spectroscopy (fNIRS) was used to measure oxygenated hemoglobin (HbO2) in the prefrontal cortex under three experimental conditions: single-task-walk, single-task-alpha (cognitive task), and dual-task-walk, which required the participants to perform the two single tasks simultaneously. Intraindividual variability in neural activity was operationalized using the standard deviation of fNIRS-derived HbO2 observations assessed during a 30-s interval in each experimental condition. The increase in intraindividual variability in neural activity in the dual-task-walk condition compared to both single-task conditions was associated with the presence of cognitive impairments and being a male. Furthermore, measures of intraindividual variability in neural activity and gait performance were positively correlated only under the dual-task-walk condition. Intraindividual variability in the neural activity of gait may be a novel marker for age-related impairments in mobility and cognitive function. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
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18
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On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis. J Clin Med 2020; 9:jcm9113423. [PMID: 33113872 PMCID: PMC7692140 DOI: 10.3390/jcm9113423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/27/2022] Open
Abstract
The assessment of neuropsychological functions and especially dual-tasking abilities is considered to be increasingly relevant in the assessment of neurological disease, and Multiple Sclerosis (MS) in particular. However, the assessment of dual-tasking abilities is hindered by specific software requirements and extensive testing times. We designed a novel e-health (progressive web application-based) device for the assessment of dual-tasking abilities usable in “bedside” and outpatient clinic settings and examined its reliability in a sample of N = 184 MS patients in an outpatient setting. Moreover, we examined the relevance of dual-tasking assessment using this device with respect to clinically relevant parameters in MS. We show that a meaningful assessment of dual-tasking is possible within 6 min and that the behavioral readouts overall show good reliability depending on dual-tasking difficulty. We show that dual-tasking readouts were correlated with clinically relevant parameters (e.g., EDSS, disease duration, processing speed) and were not affected by fatigue levels. We consider the tested dual-tasking assessment device suitable for routine clinical neuropsychological assessments of dual-tasking abilities. Future studies may further evaluate this test regarding its suitability in the long-term follow up assessments and to assess dual-tasking abilities in other neurological and psychiatric disorders.
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Reinhardt J, Rus-Oswald OG, Bürki CN, Bridenbaugh SA, Krumm S, Michels L, Stippich C, Kressig RW, Blatow M. Neural Correlates of Stepping in Healthy Elderly: Parietal and Prefrontal Cortex Activation Reflects Cognitive-Motor Interference Effects. Front Hum Neurosci 2020; 14:566735. [PMID: 33132879 PMCID: PMC7550687 DOI: 10.3389/fnhum.2020.566735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/19/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Julia Reinhardt
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, University of Basel, Basel, Switzerland
- *Correspondence: Julia Reinhardt,
| | - Oana G. Rus-Oswald
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Céline N. Bürki
- Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital of Basel, University of Basel, Basel, Switzerland
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | | | - Sabine Krumm
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christoph Stippich
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reto W. Kressig
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Maria Blatow
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Jacobs S, Mercuri G, Holtzer R. Assessing within-task verbal fluency performance: the utility of individual time intervals in predicting incident mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:733-747. [PMID: 32901518 DOI: 10.1080/13825585.2020.1817306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The current study aimed to determine whether word generation performance on individual within-task 20-second time intervals predicted conversion to Mild Cognitive Impairment (MCI) status. Longitudinal data (Mean follow-up=2.95±1.64 years) was collected from cognitively-healthy community-dwelling older adults (N=344; %female=56.1). Performance on letter and semantic fluency tasks was divided into three consecutive within-task 20-second intervals. Incident MCI status (n=50) was determined via established diagnostic case conference. Fully adjusted Cox proportional-hazards regression models revealed that greater word production on semantic fluency across all time intervals significantly predicted a reduced risk of incident MCI [0-20 seconds (HR=0.906, p=0.002), 21-40 seconds (HR=0.904, p=0.02), and 41-60 seconds (HR=0.892, p=0.017)]. Conversely, on letter fluency, greater word production within the 41-60 second time interval only was significantly associated with reduced risk of incident MCI (HR=0.886, p=0.002). Overall, the clinical use of within-interval performance is supported given evidence of predictive sensitivity and ease of administration.
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Affiliation(s)
- Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Giulia Mercuri
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Mild Cognitive Impairments Attenuate Prefrontal Cortex Activations during Walking in Older Adults. Brain Sci 2020; 10:brainsci10070415. [PMID: 32630216 PMCID: PMC7407944 DOI: 10.3390/brainsci10070415] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 01/15/2023] Open
Abstract
The presence of Mild Cognitive Impairments (MCI) is associated with worse gait performance. However, the effect of MCI on cortical control of gait, as assessed during active walking, is unknown. We hypothesized that MCI would be associated with attenuated activations and limited improvement in efficiency in the Prefrontal cortex (PFC) under cognitively-demanding walking conditions. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess Oxygenated Hemoglobin (HbO2) in the PFC during Single-Task-Walk (STW), cognitive interference (Alpha) and Dual-Task-Walk (DTW) conditions. Three repeated trials in each experimental condition were administered. Healthy control (n = 71; mean age = 76.82 ± 6.21 years; %female = 50.7) and MCI (n = 11; mean age = 78.27 ± 4.31 years; %female = 45.5) participants were included. The increase in HbO2 from STW to DTW was attenuated among MCI participants compared to controls (estimate = 0.505; p = 0.001). Whereas, among controls, HbO2 increased from Alpha to DTW, the opposite was observed among MCI participants (estimate = 0.903; p < 0.001). In DTW, the decline in HbO2 from trial 1 to 2 was attenuated in MCI participants compared to controls (estimate = 0.397; p = 0.008). Moreover, whereas HbO2 declined from trial 1 to 3 among controls, MCI participants showed the opposite trend (estimate = 0.946; p < 0.001). MCI was associated with attenuated brain activation patterns and compromised ability to improve PFC efficiency during dual-task walking.
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22
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Mahoney JR, Cotton K, Verghese J. Multisensory Integration Predicts Balance and Falls in Older Adults. J Gerontol A Biol Sci Med Sci 2020; 74:1429-1435. [PMID: 30357320 DOI: 10.1093/gerona/gly245] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Effective integration of concurrent sensory information is crucial for successful locomotion. This study aimed to determine the association of multisensory integration with mobility outcomes in aging. METHODS A total of 289 healthy older adults (mean age 76.67 ± 6.37 years; 53% female participants) participated in a visual-somatosensory simple reaction time task. Magnitude of multisensory effects was assessed using probability models, and then categorized into four multisensory integration classifications (superior, good, poor, or deficient). Associations of multisensory integration with falls and balance (unipedal stance) were tested at cross-section and longitudinally using Cox proportional hazards models. RESULTS At baseline, the prevalence of falls in the previous year was 24%, and 52% reported an incident fall over a mean follow-up period of 24 ± 17 months. Mean unipedal stance time was 15 ± 11 seconds. Magnitude of multisensory integration was a strong predictor of balance performance at cross-section (β = 0.11; p < .05). Of the cohort, 31% had superior, 26% had good, 28% had poor, and 15% had deficient multisensory effects. Older adults with superior multisensory integration abilities were significantly less likely to report a fall in the past year (17%), compared to the rest of the cohort (28%; χ2 = 4.01; p = .04). Magnitude of multisensory integration was an incremental predictor of incident falls (adjusted hazard ratio = 0.24; p = .01), over and above balance and other known fall risk factors. CONCLUSIONS Our study highlights the clinical relevance of multisensory integration in aging; worse visual-somatosensory integration is associated with worse balance and increased risk of incident falls.
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Affiliation(s)
- Jeannette R Mahoney
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, New York
| | - Kelly Cotton
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, New York
| | - Joe Verghese
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, New York.,Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, New York
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Brydges CR, Liu-Ambrose T, Bielak AAM. Using intraindividual variability as an indicator of cognitive improvement in a physical exercise intervention of older women with mild cognitive impairment. Neuropsychology 2020; 34:825-834. [PMID: 32338944 DOI: 10.1037/neu0000638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Intervention programs designed to improve cognitive ability in older adults with mild cognitive impairment (MCI) have often focused on physical exercise as a means to improve traditional measures of cognition, with mixed success. Individuals with MCI show high levels of intraindividual variability (IIV) in response speed, and IIV may be sensitive to intervention-related changes. The current study evaluated if participants who participated in a physical activity intervention (aerobic or resistance training) showed a reduction in IIV, compared to a balance and tone control group. METHOD This study was a secondary analysis of the EXercise for Cognition and Everyday Living (EXCEL) Study. Women Aged 70-80 years with probable MCI (n = 86) participated in a 6-month randomized controlled trial designed to investigate the effects of different physical exercises on cognitive ability. Participants completed 1-back, task switching, and spatial working memory tasks at baseline, 13 weeks (midpoint) and upon completion of the program. RESULTS Analyses were conducted following both the intent-to-treat principle and complier average casual effect (CACE) modeling. Participants in the intervention group who complied with the program showed reduced IIV on task switching in the CACE models. The intent-to-treat analyses were all nonsignificant. CONCLUSIONS Physical exercise resulted in improved IIV in older adults with probable MCI, showing that IIV is modifiable by lifestyle engagement. IIV may be a useful complementary index of cognitive plasticity particularly among those with cognitive impairment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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van der Leeuw G, Ayers E, Blankenstein AH, van der Horst HE, Verghese J. The association between pain and prevalent and incident motoric cognitive risk syndrome in older adults. Arch Gerontol Geriatr 2020; 87:103991. [DOI: 10.1016/j.archger.2019.103991] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/11/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022]
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Holtzer R, Jacobs S, Demetriou E. Intraindividual variability in verbal fluency performance is moderated by and predictive of mild cognitive impairments. Neuropsychology 2020; 34:31-42. [PMID: 31192656 PMCID: PMC6908771 DOI: 10.1037/neu0000576] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The current study was designed to achieve 2 primary objectives: (a) determine the moderating effect of mild cognitive impairments (MCI) on intraindividual variability in semantic and letter fluency performance taking into account longitudinal annual assessments; and (b) establish predictive utility for intraindividual variability in semantic and letter fluency performance as a risk factor of incident MCI. METHODS Participants were community-residing older adults (n = 514; M age = 75.89 ± 6.45; 55.1% female). Sixty participants were diagnosed with MCI at baseline and 50 developed incident MCI during the follow-up. We operationalized intraindividual variability as word generation slopes derived from 3 consecutive time intervals during the standard 1-min administration of both letter and semantic fluency tasks (i.e., 0-20 s, 21-40 s, and 41-60 s). RESULTS Linear mixed effects models revealed significant within task slope effects for semantic (estimate = -8.350; p < .0001; 95% confidence interval [CI] = -8.604, -8.095) and letter (estimate = -5.068; p < .0001; 95% CI [-5.268, -4.869]) fluency indicating that word generation declined over the course of both tasks. The two-way interactions of MCI × Slope were significant for semantic (estimate = 1.34; p = .001; 95% CI [0.551, 2.126]) and letter (estimate = 0.733; p = .020; 95% CI [0.116, 1.350]) fluency indicating attenuated slopes among MCI participants compared to controls taking into account repeated annual assessments. Cox proportional-hazards models revealed that attenuated word generation slope, at baseline, in semantic (hazard ratio [HR] = 2.063; p = .015; 95% = 1.149 to 3.702) but not letter (HR = 0.704; p = .243; 95% CI [0.391, 1.269]) fluency was associated with increased risk of incident MCI. CONCLUSION Intraindividual variability in verbal fluency performance has clinical and predictive utility; it can be easily incorporated into testing batteries in clinical and research settings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Yeshiva University
| | - Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University
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McKinney TL, Euler MJ, Butner JE. It’s about time: The role of temporal variability in improving assessment of executive functioning. Clin Neuropsychol 2019; 34:619-642. [DOI: 10.1080/13854046.2019.1704434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Ty L. McKinney
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Matthew J. Euler
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Niermeyer MA, Suchy Y. Walking, talking, and suppressing: Executive functioning mediates the relationship between higher expressive suppression and slower dual-task walking among older adults. Clin Neuropsychol 2019; 34:775-796. [DOI: 10.1080/13854046.2019.1704436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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de Oliveira Silva F, Ferreira JV, Plácido J, Chagas D, Praxedes J, Guimarães C, Batista LA, Laks J, Deslandes AC. Gait analysis with videogrammetry can differentiate healthy elderly, mild cognitive impairment, and Alzheimer's disease: A cross-sectional study. Exp Gerontol 2019; 131:110816. [PMID: 31862421 DOI: 10.1016/j.exger.2019.110816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/29/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Gait parameters have been investigated as an additional tool for differential diagnosis in neurocognitive disorders, especially among healthy elderly (HE), those with mild cognitive impairment (MCI), and Alzheimer's disease (AD) patients. A videogrammetry system could be used as a low-cost and clinically practical equipment to capture and analyze gait in older adults. The aim of this study was to select the better gait parameter to differentiate these groups among different motor test conditions with videogrammetry analyses. Different motor conditions were used in three specific assessments: 10-meter walk test (10mWT), timed up and go test (TUGT), and treadmill walk test (TWT). These tasks were compared among HE (n=17), MCI (n=23), and AD (n=23) groups. One-way ANOVA, Kruskal-Wallis, and Bonferroni post-hoc tests were used to compare variables among groups. Then, an effect size (ES) and a linear regression analysis were calculated. The gait parameters showed significant differences among groups in all conditions, but not in TWT. Controlled by confounding variables, the gait velocity in 10mWT at usual speed, and TUGT in dual-task condition, predicts 39% and 53% of the difference among diagnoses, respectively. Finally, these results suggest that a low-cost and practical video analysis could be able to differentiate HE, those with MCI, and AD patients in clinical assessments.
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Affiliation(s)
| | | | - Jéssica Plácido
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Chagas
- Physical Education and Sports Institute, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jomilto Praxedes
- Physical Education and Sports Institute, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luiz Alberto Batista
- Physical Education and Sports Institute, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jerson Laks
- Postgraduate Program in Translacional Biomedicine, Universidade do Grande Rio, Rio de Janeiro, Brazil
| | - Andrea Camaz Deslandes
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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29
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Niermeyer MA, Suchy Y. The vulnerability of executive functioning: The additive effects of recent non-restorative sleep, pain interference, and use of expressive suppression on test performance. Clin Neuropsychol 2019; 34:700-719. [DOI: 10.1080/13854046.2019.1696892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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30
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The Two Minute Walk Test Overground and on a Self-Paced Treadmill Detects Dual Task Deficits in Individuals With Parkinson's Disease. J Aging Phys Act 2019; 27:843-847. [PMID: 31034314 DOI: 10.1123/japa.2018-0264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this project was to 1) evaluate the potential of the Two Minute Walk Test (2MWT) to detect declines in gait velocity under dual task conditions, and 2) compare gait velocity overground and on a self-paced treadmill in Parkinson's disease (PD). Twenty-three individuals with PD completed the 2MWT under single and dual task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single to dual task conditions overground (1.32±.22 m/sec to 1.10±.25 m/sec, p <.001) and on the self-paced treadmill (1.24±.21 m/sec to 1.05±.25 m/sec, p <.001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2MWT coupled with a cognitive task provides an effective model of identifying dual task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.
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31
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Pillemer S, Ayers E, Holtzer R. Gender-stratified analyses reveal longitudinal associations between social support and cognitive decline in older men. Aging Ment Health 2019; 23:1326-1332. [PMID: 30328696 PMCID: PMC6470062 DOI: 10.1080/13607863.2018.1495178] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 10/28/2022]
Abstract
Objectives: Research has extensively examined the relationship between social support and health outcomes in older adults. Little is known, however, about the longitudinal associations between distinct dimensions of perceived social support and incident cognitive decline. The current longitudinal study examined whether dimensions of perceived social support were associated with increased risk of cognitive decline, and if the relationship differed by gender. Methods: 493 community-residing non-demented older adults were assessed for baseline social support via the Medical Outcomes Study-Social Support Survey (MOS-SSS). Incident cognitive impairment was determined using a 1 standard deviation below age and education adjusted total score on the Repeatable Battery for the Assessment of Neuropsychological Status Cox proportional-hazard models were used to analyze incident risk of cognitive impairment. Results: Higher perceived support, overall and in specific domains, at baseline was associated with increased risk of incident cognitive impairment. Further gender-stratified analyses revealed that higher perceived support at baseline was associated with increased risk of incident cognitive impairment only among males. Conclusion: Contrary to previous research, results from this longitudinal study suggest that perceived support might be an important risk factor for cognitive decline, notably in males, and should be integrated into multifactorial risk assessment and intervention procedures.
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Affiliation(s)
- Sarah Pillemer
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Emmeline Ayers
- Albert Einstein College of Medicine, Bronx New York, USA
| | - Roee Holtzer
- Albert Einstein College of Medicine, Bronx New York, USA
- Yeshiva University, New York, New York, USA
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32
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Brydges CR, Bielak AAM. The Impact of a Sustained Cognitive Engagement Intervention on Cognitive Variability: The Synapse Project. JOURNAL OF COGNITIVE ENHANCEMENT 2019; 3:365-375. [PMID: 32775959 DOI: 10.1007/s41465-019-00140-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Interest in maintaining one's cognitive ability and quality of life through older adulthood has greatly increased in recent years. However, research examining the effectiveness of cognitive engagement interventions on older adults is mixed and the mechanisms behind improving cognition in older age are unknown. It is possible that traditional measures of cognitive outcomes, such as average reaction time, may overlook potential benefits due to a lack of sensitivity in these measures. One alternative metric is intraindividual variability (IIV) in response speed (short-term variations in performance on reaction time tasks), which reflects fluctuations in attention and is a sensitive behavioral measure of neurological integrity that is predictive of future cognitive decline and impairment. Objective The current study aimed to investigate whether IIV was improved in older adults through productive cognitive engagement (i.e., acquisition of new skills) in comparison to receptive engagement (activities that rely upon existing knowledge). Methods Participants were 173 typically aging adults aged 60-90 years who were recruited to the Synapse Project and randomly allocated to a productive engagement activity (learning to quilt and/or conduct digital photography) or receptive engagement activity (socializing, or placebo cognitive tasks such as completing crosswords). Participants completed three flanker tasks at baseline and after completing the 14-week intervention program. IIV was calculated as the trial-to-trial variability in responding to congruent and incongruent trials in each task. Results Neither traditional intent-to-treat nor complier average causal effect modeling analyses showed any significant improvements in IIV for either intervention group. Further, Bayesian analyses showed that there was moderate evidence in favor of the null hypothesis. Conclusion An intensive cognitive activity intervention did not result in a reduction in IIV. We suggest that intervention programs may need to specifically engage cognitive domains associated with IIV (i.e., attention, executive control) for improvements to be observed. Additionally, other design factors such as using a longer duration and/or applying the intervention to atypically aging groups, such as those with mild cognitive impairment, may increase the likelihood of significantly reducing IIV via an intervention.
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Affiliation(s)
| | - Allison A M Bielak
- Department of Human Development and Family Studies, Colorado State University, USA
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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: 35] [Impact Index Per Article: 7.0] [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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34
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Ghanavati T, Smitt MS, Lord SR, Sachdev P, Wen W, Kochan NA, Brodaty H, Delbaere K. Deep white matter hyperintensities, microstructural integrity and dual task walking in older people. Brain Imaging Behav 2019; 12:1488-1496. [PMID: 29297156 DOI: 10.1007/s11682-017-9787-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To examine neural, physiological and cognitive influences on gait speed under single and dual-task conditions. Sixty-two community-dwelling older people (aged 80.0 ± 4.2 years) participated in our study. Gait speed was assessed with a timed 20-meter walk under single and dual-task (reciting alternate letters of the alphabet) conditions. Participants also underwent tests to estimate physiological fall risk based on five measures of sensorimotor function, cognitive function across five domains, brain white matter (WM) hyperintensities and WM microstructural integrity by measuring fractional anisotropy (FA). Univariate linear regression analyses showed that global physiological and cognitive measures were associated with single (β = 0.594 and β=-0.297, respectively) and dual-task gait speed (β = 0.306 and β=-0.362, respectively). Deep WMHs were associated with dual-task gait speed only (β = 0.257). Multivariate mediational analyses showed that global and executive cognition reduced the strength of the association between deep WMHs and dual-task gait speed by 27% (β = 0.188) and 44% (β = 0.145) respectively. There was a significant linear association between single-task gait speed and mean FA values of the genu (β=-0.295) and splenium (β=-0.326) of the corpus callosum, and between dual-task gait speed and mean FA values of Superior Cerebellar Peduncle (β=-0.284), splenium of the Corpus Callosum (β=-0.286) and Cingulum (β=-0.351). Greater deep WMH volumes are associated with slower walking speed under dual-task conditions, and this relationship is mediated in part by global cognition and executive abilities specifically. Furthermore, both cerebellum and cingulum are related to dual-task walking due to their role in motor skill performance and attention, respectively.
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Affiliation(s)
- Tabassom Ghanavati
- Department of Physiotherapy Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Myriam Sillevis Smitt
- Neuroscience Research Australia, University of New South Wales, NeuRA, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales, NeuRA, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA) School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA) School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA) School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA) School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia.,Dementia Collaborative Research Centre UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, University of New South Wales, NeuRA, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia.
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35
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Costello MC, Sizemore SJ, O’Brien KE, Manning LK. Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults. GEROPSYCH 2019. [DOI: 10.1024/1662-9647/a000202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.
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Affiliation(s)
| | - Shane J. Sizemore
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Kimberly E. O’Brien
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Lydia K. Manning
- Division of Human Services/Gerontology, Concordia University, River Forest, IL, USA
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36
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Holtzer R, Kraut R, Izzetoglu M, Ye K. The effect of fear of falling on prefrontal cortex activation and efficiency during walking in older adults. GeroScience 2019; 41:89-100. [PMID: 30737727 DOI: 10.1007/s11357-019-00056-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/24/2019] [Indexed: 11/25/2022] Open
Abstract
Neural inefficiency is inferred when higher brain activations are associated with similar or worse performance. Improved neural efficiency is achieved when task-related brain activations are reduced after practice. No information is available on the effect of fear-of-falling (FOF) on brain activation during walking. We hypothesized that the presence of FOF would be associated with neural inefficiency and with a delay in improving neural efficiency during dual-task walking. Task conditions included single-task walk (STW), Alpha (cognitive interference), and dual-task walk (DTW). Functional near-infrared spectroscopy (fNIRS)-derived HbO2 in the prefrontal cortex (PFC) was used to quantify task-related changes in brain activation. Practice included three repeated counterbalanced trials for each task. Participants with FOF (n = 19; mean age = 79.84 ± 6.01 years; %female = 68.42) and without FOF (n = 56; mean age = 76.73 ± 6.39 years; %female = 44.64) were included. The presence of FOF was associated with slower stride velocity (estimate = - 12.354; p = 0.0154) and with greater increases in PFC HbO2 from STW to DTW (estimate = 0.303, p = 0.0009) and from Alpha to DTW (estimate = 0.387, p < 0.0001). Compared to controls, participants reporting FOF demonstrated an attenuated decline in PFC HbO2 from the first to the second DTW trials (estimate = 0.264; p = 0.0173). In contrast, compared to controls, participants with FOF demonstrated greater decline in Alpha PFC HbO2 from trial 1 to trial 2 (estimate = - 0.419, p < 0.0001) and from trial 1 to 3 (estimate = - 0.281, p = 0.0006). The change in PFC HbO2 over repeated STW trials was not significant and was not moderated by FOF status. The presence of FOF was associated with higher and inefficient PFC activation during DTW in older adults.
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Affiliation(s)
- Roee Holtzer
- Albert Einstein College of Medicine Bronx, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA.
- Yeshiva University Bronx, New York, NY, USA.
| | | | - Meltem Izzetoglu
- Villanova University Electrical and Computer Engineering, Villanova, PA, USA
| | - Kenny Ye
- Albert Einstein College of Medicine Bronx, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY, 10461, USA
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37
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Wagshul ME, Lucas M, Ye K, Izzetoglu M, Holtzer R. Multi-modal neuroimaging of dual-task walking: Structural MRI and fNIRS analysis reveals prefrontal grey matter volume moderation of brain activation in older adults. Neuroimage 2019; 189:745-754. [PMID: 30710680 DOI: 10.1016/j.neuroimage.2019.01.045] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 11/28/2022] Open
Abstract
It has been well established over the last two decades that walking is not merely an automatic, motoric activity; it also utilizes executive function circuits, which play an increasingly important role in walking for older people and those with mobility and cognitive deficits. Dual-task walking, such as walking while performing a cognitive task, is a necessary skill for everyday functioning, and has been shown to activate prefrontal lobe areas in healthy older people. Another well-established point in healthy aging is the loss of grey matter, and in particular loss of frontal lobe grey matter volume. However, the relationship between increased frontal lobe activity during dual-task walking and loss of frontal grey matter in healthy aging remains unknown. In the current study, we combined oxygenated hemoglobin (HbO2) data from functional near-infrared spectroscopy (fNIRS), taken during dual-task walking, with structural MRI volumetrics in a cohort of healthy older subjects to identify this relationship. We studied fifty-five relatively healthy, older participants (≥65 years) during two separate sessions: fNIRS to measure HbO2 changes between single-task (i.e., normal walking) and dual-task walking-while-talking, and high-resolution, structural MRI to measure frontal lobe grey matter volumes. Linear mixed effects modeling was utilized to determine the moderation effect of grey matter volume on the change in prefrontal oxygenated hemoglobin between the two walking tasks, while controlling for covariates including task performance. We found a highly significant interaction effect between frontal grey matter volume and task on HbO2 levels (p < 0.0001). Specifically, increased HbO2 levels during dual-task compared to single-task walking were associated with reduced frontal grey matter volume. Regional analysis identified bilateral superior and rostral middle gyri as the primary areas driving these results. The findings provide support for the concept of neural inefficiency: in the absence of behavioral gains, grey matter loss in relatively healthy, older individuals leads to over-activation of frontal lobe during a cognitively demanding walking task with established clinical and predictive utility.
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Affiliation(s)
- Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA; Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Melanie Lucas
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Kenny Ye
- Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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38
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Tripathi S, Verghese J, Blumen HM. Gray matter volume covariance networks associated with dual-task cost during walking-while-talking. Hum Brain Mapp 2019; 40:2229-2240. [PMID: 30664283 PMCID: PMC6445705 DOI: 10.1002/hbm.24520] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/27/2018] [Accepted: 01/06/2019] [Indexed: 01/01/2023] Open
Abstract
We studied gray matter volume covariance networks associated with normal pace walking (NPW) speed and dual-task costs (DTCs) during walking-while-talking (WWT)-a mobility stress test that involves walking while reciting alternate letters of the alphabet. Using a multivariate covariance-based analytic approach, we identified gray matter networks associated with NPW speed (mean 102.1 cm/s ±22.5 cm/s) and DTC (percent difference in gait speed between NPW and WWT, mean 25.9% ± 18.8%) in 139 older adults without dementia (M = 75.3 ± 6.1 years). The gray matter network associated with NPW was primarily composed of supplementary motor area, precuneus cortex, and the middle frontal gyrus. Greater expression of this NPW network was associated with better processing speed (trail-making test A [r = -0.30, p = 0.005]) and executive function (trail-making test B - A [r = -0.43, p < 0.0001]). The gray matter network associated with DTC was primarily composed of medial prefrontal, cingulate, and thalamic regions. Greater expression of this DTC network was associated with better episodic memory performance on the free and cued selective reminding test (r = 0.30, p = 0.007). These results suggest that NPW speed and DTC are supported by different networks, and are associated with different cognitive domains.
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Affiliation(s)
- Susmit Tripathi
- Departments of MedicineAlbert Einstein College of MedicineBronxNew York
| | - Joe Verghese
- Departments of MedicineAlbert Einstein College of MedicineBronxNew York,Departments of NeurologyAlbert Einstein College of MedicineBronxNew York
| | - Helena M. Blumen
- Departments of MedicineAlbert Einstein College of MedicineBronxNew York,Departments of NeurologyAlbert Einstein College of MedicineBronxNew York
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39
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Saleh S, Sandroff BM, Vitiello T, Owoeye O, Hoxha A, Hake P, Goverover Y, Wylie G, Yue G, DeLuca J. The Role of Premotor Areas in Dual Tasking in Healthy Controls and Persons With Multiple Sclerosis: An fNIRS Imaging Study. Front Behav Neurosci 2018; 12:296. [PMID: 30618658 PMCID: PMC6297844 DOI: 10.3389/fnbeh.2018.00296] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/16/2018] [Indexed: 11/16/2022] Open
Abstract
Persons with multiple sclerosis (pwMS) experience declines in physical and cognitive abilities and are challenged by dual-tasks. Dual-tasking causes a drop in performance, or what is known as dual-task cost (DTC). This study examined DTC of walking speed (WS) and cognitive performance (CP) in pwMS and healthy controls (HCs) and the effect of dual-tasking on cortical activation of bilateral premotor cortices (PMC) and bilateral supplementary motor area (SMA). Fourteen pwMS and 14 HCs performed three experimental tasks: (1) single cognitive task while standing (SingCog); (2) single walking task (SingWalk); and (3) dual-task (DualT) that included concurrent performance of the SingCog and SingWalk. Six trials were collected for each condition and included measures of cortical activation, WS and CP. WS of pwMS was significantly lower than HC, but neuropsychological (NP) measures were not significantly different. pwMS and HC groups had similar DTC of WS, while DTC of CP was only significant in the MS group; processing speed and visual memory predicted 55% of this DTC. DualT vs. SingWalk recruited more right-PMC activation only in HCs and was associated with better processing speed. DualT vs. SingCog recruited more right-PMC activation and bilateral-SMA activation in both HC and pwMS. Lower baseline WS and worse processing speed measures in pwMS predicted higher recruitment of right-SMA (rSMA) activation suggesting maladaptive recruitment. Lack of significant difference in NP measures between groups does not rule out the influence of cognitive factors on dual-tasking performance and cortical activations in pwMS, which might have a negative impact on quality of life.
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Affiliation(s)
- Soha Saleh
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, United States.,Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tyler Vitiello
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Oyindamola Owoeye
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Armand Hoxha
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Patrick Hake
- Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
| | - Yael Goverover
- Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States.,Department of Occupational Therapy, New York University, New York, NY, United States
| | - Glenn Wylie
- Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States
| | - Guang Yue
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, United States.,Rutgers New Jersey Medical School, Newark, NJ, United States
| | - John DeLuca
- Rutgers New Jersey Medical School, Newark, NJ, United States.,Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
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40
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The Effect of Pain on Major Cognitive Impairment in Older Adults. THE JOURNAL OF PAIN 2018; 19:1435-1444. [DOI: 10.1016/j.jpain.2018.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/31/2018] [Accepted: 06/27/2018] [Indexed: 01/26/2023]
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41
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Mahoney JR, Verghese J. Visual-Somatosensory Integration and Quantitative Gait Performance in Aging. Front Aging Neurosci 2018; 10:377. [PMID: 30538628 PMCID: PMC6277592 DOI: 10.3389/fnagi.2018.00377] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background: The ability to integrate information across sensory modalities is an integral aspect of mobility. Yet, the association between visual-somatosensory (VS) integration and gait performance has not been well-established in aging. Methods: A total of 333 healthy older adults (mean age 76.53 ± 6.22; 53% female) participated in a visual-somatosensory simple reaction time task and underwent quantitative gait assessment using an instrumented walkway. Magnitude of VS integration was assessed using probability models, and then categorized into four integration classifications (superior, good, poor, or deficient). Associations of VS integration with three independent gait factors (Pace, Rhythm, and Variability derived by factor analysis method) were tested at cross-section using linear regression analyses. Given overlaps in neural circuitry necessary for both multisensory integration and goal-directed locomotion, we hypothesized that VS integration would be significantly associated with pace but not rhythm which is a more automatic process controlled mainly through brainstem and spinal networks. Results: In keeping with our hypothesis, magnitude of VS integration was a strong predictor of pace (β = 0.12, p < 0.05) but not rhythm (β = −0.01, p = 0.83) in fully-adjusted models. While there was a trend for the association of magnitude of VS integration with variability (β = −0.11, p = 0.051), post-hoc testing of individual gait variables that loaded highest on the variability factor revealed that stride length variability (β = −0.13, p = 0.03) and not swing time variability (β = −0.08, p = 0.15) was significantly associated with magnitude of VS integration. Of the cohort, 29% had superior, 26% had good, 29% had poor, and 16% had deficient VS integration effects. Conclusions: Worse VS integration in aging is associated with worse spatial but not temporal aspects of gait performance.
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Affiliation(s)
- Jeannette R Mahoney
- Division of Cognitive and Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.,Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
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Bauer LO. HIV/AIDS and an overweight body mass are associated with excessive intra-individual variability in response preparation. J Neurovirol 2018; 24:577-586. [PMID: 29777461 PMCID: PMC6202127 DOI: 10.1007/s13365-018-0644-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/03/2018] [Accepted: 04/26/2018] [Indexed: 12/24/2022]
Abstract
Factors other than HIV/AIDS may influence the cognitive function of patients living with this disease. The present study tested the influence of a common comorbid problem-an overweight body mass. It also examined intra-task variabilities in performance and brain activation as potentially more sensitive indicators of dysfunction than their mean levels. One-hundred seventy-eight participants were recruited and categorized by HIV-1 serostatus (-/+) and body mass (BMI < 26/≥ 26 kg/m2). They performed a simple time estimation task during which response time accuracy and electroencephalographic readiness potentials were recorded. A few hours later, they completed a battery of tests measuring balance and gait. The analyses revealed an advantage of variability over the mean in differentiating groups: the presence of HIV-1 and an overweight body mass were independently and additively associated with greater variability across trials in readiness potential amplitude and response accuracy. The analysis also showed that intra-task variability in the readiness potential, but not in response accuracy, was predictive of decrements in single and tandem leg balance and gait velocity. The present findings suggest that an elevated body mass is associated with, and may contribute to, problems in brain function and motor behavior experienced by patients in the current era. The findings recommend a careful consideration of the manner in which these problems are measured. When the problems are episodic and subtle, measures of central tendency may be less than ideal.
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Affiliation(s)
- Lance O Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, 06030-1403, USA.
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Inter-trial variability in brain activity as an indicator of synergistic effects of HIV-1 and drug abuse. Drug Alcohol Depend 2018; 191:300-308. [PMID: 30170301 PMCID: PMC10127228 DOI: 10.1016/j.drugalcdep.2018.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND The objective of this investigation was to detect evidence of the synergism in the effects of HIV-1 and drug abuse on brain function that has been hypothesized but rarely shown. The investigation incorporated several noteworthy improvements in the approach. It used urine toxicology tests to exclude participants complicated by recent methadone use and illicit drug use. Also, it defined drug abuse on a scale that considered symptom severity. Most importantly, it examined inter-trial variability in brain activity as a potentially more sensitive indicator of group differences and functional impairment than the across-trial average. METHODS 173 participants were assigned to groups defined by their HIV-1 serostatus and Drug Abuse Screening Test score (DAST < vs. > = 6). They completed a simple letter discrimination task including rare target and rare nontarget stimuli. Event-related electroencephalographic responses and key press responses were measured on each trial. During a separate assessment, posturographic measures were recorded. RESULTS The inter-trial standard deviation of P300-like activity was superior to the mean amplitude of this activity in differentiating the groups. Unlike the mean, it revealed synergistic statistical effects of HIV and drug abuse. It also correlated significantly with static ataxia. CONCLUSIONS Inter-trial variability in P300-like activity is a useful marker for detecting subtle and episodic disruptions in brain function. It demonstrates greater sensitivity than the mean amplitude for detecting differences across groups. Also, as a putative indicator of a disruption in the attentional monitoring of behavior, it predicts subtle impairments in gross motor function.
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44
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Knight MJ, Air T, Baune BT. The role of cognitive impairment in psychosocial functioning in remitted depression. J Affect Disord 2018; 235:129-134. [PMID: 29655074 DOI: 10.1016/j.jad.2018.04.051] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive dysfunction is a prevalent and disabling symptom of Major Depressive Disorder (MDD), and is often retained in the remitted stage of illness. Emerging evidence suggests that cognitive impairment may be associated with dysfunction in a number of psychosocial domains (e.g., workplace productivity, social relationships). The current study explored the relationship between cognition and psychosocial functioning in remitted MDD and in healthy controls. METHODS Data were obtained from 182 participants of the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of cognition, mood, and social cognition in mood disorders. Participants' (Remitted MDD n = 72, Healthy n = 110) cognition was assessed with a battery of cognitive tests including the Repeatable Battery for the Assessment of Neuropsychological Function (RBANS) and other standard measures of cognition (e.g., The Tower of London task). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST). RESULTS The results indicated that executive functioning was the strongest independent predictor of functioning in remitted MDD patients, whereas various cognitive domains predicted psychosocial functioning in healthy individuals. LIMITATIONS Psychosocial functioning was measured with a clinical interview, and was therefore reliant on clinicians' judgement of impairment, as opposed to more objective measures of functioning. CONCLUSIONS These findings suggest that executive cognition plays an important role in functional recovery in remitted depression, and may be a crucial target in adjunctive treatment.
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Affiliation(s)
- Mattew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
| | - Tracy Air
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
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45
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Masina F, Di Rosa E, Mapelli D. Intra-Individual Variability of Error Awareness and Post-error Slowing in Three Different Age-Groups. Front Psychol 2018; 9:902. [PMID: 29922207 PMCID: PMC5996170 DOI: 10.3389/fpsyg.2018.00902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/17/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Error awareness (EA) and post-error slowing (PES) are two crucial components of an adequate performance monitoring because, respectively, they allow being aware of an error and triggering performance adjustments following unexpected events. Objective: The purpose of the present study was to investigate the ontogenetic trajectories of EA and PES, as well as to examine how EA and PES interact with each other. Methods: The performance of three groups of participants (children, younger, and older adults) in a modified version of the Error Awareness task (EAT; Hester et al., 2005) was compared. In particular, in this study not only variations of the average performance were examined, but also intra-individual variability (IIV), considered in terms of variations of SD and ex-Gaussian parameters (mu, sigma, and tau). Results: Two distinct ontogenetic trajectories of EA and PES were observed. Regarding EA, we observe a U-shaped curve that describes an increase of the process from childhood to early adulthood and a progressive reduction advancing age in late adulthood. Furthermore, a greater IIV in older adults indicated a susceptibility of EA to the aging process. The ontogenetic trajectory of PES seems substantially different from the trajectory that describes EA since in PES we do not observe age-related differences. Conclusion: These results suggest that EA and PES are two independent processes. Furthermore, it appears that EA and PES are differently prone to short-term fluctuations in performance across the lifespan. While EA presents an increase in IIV in aging, PES seems to be immune to these changes.
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Affiliation(s)
- Fabio Masina
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padova, Padova, Italy.,Department of Neuroscience, University of Padova, Padova, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padova, Padova, Italy.,Human Inspired Technologies Research Center, University of Padova, Padova, Italy
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Holtzer R, George CJ, Izzetoglu M, Wang C. The effect of diabetes on prefrontal cortex activation patterns during active walking in older adults. Brain Cogn 2018; 125:14-22. [PMID: 29807266 DOI: 10.1016/j.bandc.2018.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/05/2018] [Accepted: 03/06/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Gait alterations were documented in diabetic patients. However, the effect of diabetes on cortical control of gait has not been reported. We evaluated the effect of diabetes on prefrontal cortex (PFC) Oxygenated Hemoglobin (HbO2) levels during active walking in older adults. METHODS Of the total sample (n = 315; mean age = 76.84 ± 6.71ys; % female = 56.5) 43 participants (13.7%) had diabetes. The experimental paradigm consisted of two single tasks: Normal-Walk (NW); and Cognitive Interference (Alpha); and one dual-task condition consisting of the two single tasks, Walk-While-Talk (WWT). Functional Near-Infrared-Spectroscopy (fNIRS) was used to quantify PFC HbO2 levels. RESULTS Older adults without diabetes showed higher PFC HbO2 levels in WWT compared to both NW and Alpha. HbO2 levels during NW were not different between the two groups. Consistent with Neural Inefficiency, older adults with diabetes exhibited higher HbO2 levels during Alpha while performing significantly worse than those without diabetes. Moreover, the presence of diabetes was associated with attenuated HbO2 levels during WWT. This pattern is consistent with Capacity Limitations suggesting a failure to recruit brain resources vis-à-vis the more cognitively challenging WWT condition. CONCLUSIONS A distinct functional neural signature of diabetes was established during active and attention demanding walking among older adults without overt neurological disease.
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Affiliation(s)
- Roee Holtzer
- Albert Einstein College of Medicine Bronx, New York, USA; Yeshiva University Bronx, New York, USA.
| | | | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, USA
| | - Cuiling Wang
- Albert Einstein College of Medicine Bronx, New York, USA
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Dumas K, Holtzer R, Mahoney JR. Visual-Somatosensory Integration in Older Adults: Links to Sensory Functioning. Multisens Res 2018; 29:397-420. [PMID: 29384609 DOI: 10.1163/22134808-00002521] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Research investigating multisensory integration (MSI) processes in aging is scarce, but converging evidence for larger behavioral MSI effects in older compared to younger adults exists. The current study employed a three-prong approach to determine whether inherent age-related sensory processing declines were associated with larger (i.e., worse) visual-somatosensory (VS) reaction time (RT) facilitation effects. Non-demented older adults ( n = 156 ; mean age = 77 years; 55% female) without any medical or psychiatric conditions were included. Participants were instructed to make speeded foot-pedal responses as soon as they detected visual, somatosensory, or VS stimulation. Visual acuity was assessed using the Snellen test while somatosensory sensitivity was determined using vibration thresholds. The aims of the current study were to: (1) replicate a reliable MSI effect; (2) investigate the effect of unisensory functioning on VS RT facilitation; and (3) determine whether sensory functioning combination groups manifested differential MSI effects. Results revealed a significant VS RT facilitation effect that was influenced by somatosensory sensitivity but not visual acuity. That is, older adults with poor somatosensory sensitivity demonstrated significantly larger MSI effects than those with intact somatosensory sensitivity. Additionally, a significant interaction between stimulus condition and sensory functioning group suggested that the group with poor visual acuity and poor somatosensory functioning demonstrated the largest MSI effect compared to the other groups. In summary, the current study reveals that worse somatosensory functioning is associated with larger MSI effects in older adults. To our knowledge, this is first study to identify potential mechanisms behind increased RT facilitation in aging.
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48
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Beste C, Mückschel M, Paucke M, Ziemssen T. Dual-Tasking in Multiple Sclerosis - Implications for a Cognitive Screening Instrument. Front Hum Neurosci 2018; 12:24. [PMID: 29445335 PMCID: PMC5797790 DOI: 10.3389/fnhum.2018.00024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/16/2018] [Indexed: 01/22/2023] Open
Abstract
The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.
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Affiliation(s)
- Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Madlen Paucke
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Mahoney JR, Oh-Park M, Ayers E, Verghese J. Quantitative trunk sway and prediction of incident falls in older adults. Gait Posture 2017; 58:183-187. [PMID: 28797962 PMCID: PMC5645228 DOI: 10.1016/j.gaitpost.2017.07.115] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/17/2017] [Accepted: 07/27/2017] [Indexed: 02/02/2023]
Abstract
Poor balance and balance impairments are major predictors of falls. The purpose of the current study was to determine the clinical validity of baseline quantitative static trunk sway measurements in predicting incident falls in a cohort of 287 community-dwelling non-demented older Americans (mean age 76.14±6.82years; 54% female). Trunk sway was measured using the SwayStar™ device, and quantified as angular displacement in degrees in anterior-posterior (pitch) and medio-lateral (roll) planes. Over a one-year follow-up period, 66 elders (23%) reported incident falls. Anterior-posterior angular displacement was a strong predictor of incident falls in older adults in Cox proportional hazards models (hazard ratio adjusted for age, gender, education, RBANS total score, medical comorbidities, geriatric depression scale score, sensory impairments, gait speed, and history of fall in the past 1year ((aHR)=1.59; p=0.033) whereas, angular displacement in the medio-lateral plane was not predictive of falls (aHR=1.35; p=0.276). Our results reveal the significance of quantitative trunk sway, specifically anterior-posterior angular displacement, in predicting incident falls in older adults.
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Affiliation(s)
- Jeannette R. Mahoney
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA,Corresponding Author: Jeannette R. Mahoney, Ph.D., Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 316G, Bronx, New York 10461, T#: +1-718-430-3809, F#: +1-718-430-3829,
| | - Mooyeon Oh-Park
- Kessler Institute for Rehabilitation, Rutgers New Jersey Medical School, Department of Physical Medicine & Rehabilitation, West Orange, NJ, USA
| | - Emmeline Ayers
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA,Division of Geriatrics, Albert Einstein College of Medicine, The Department of Medicine, Bronx, NY, USA
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50
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Neural correlates of obstacle negotiation in older adults: An fNIRS study. Gait Posture 2017; 58:130-135. [PMID: 28778021 PMCID: PMC5645241 DOI: 10.1016/j.gaitpost.2017.07.043] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/02/2017] [Accepted: 07/15/2017] [Indexed: 02/02/2023]
Abstract
Older adults are less efficient at avoiding obstacles compared to young adults, especially under attention-demanding conditions. Using functional near-infrared-spectroscopy (fNIRS), recent studies implicated the prefrontal cortex (PFC) in cognitive control of locomotion, notably under dual-task walking conditions. The neural substrates underlying Obstacle Negotiation (ON), however, have not been established. The current study determined the role of the PFC in ON during walking in seniors. Non-demented older adults (n=90; mean age=78.1±5.5years; %female=51) underwent fNIRS acquisition to assess changes in hemodynamic activity in the PFC during normal-walk [NW] and walk-while-talk [WWT] conditions with and without obstacles. Obstacles were presented as red elliptical shapes using advanced laser technology, which resemble potholes. Linear mixed effects models were used to determine differences in oxygenated hemoglobin (HbO2) levels among the four task conditions. The presence of slow gait, a risk factor for dementia and falls, served as a predictor hypothesized to moderate the effect of obstacles on PFC HbO2 levels. PFC HbO2 levels were significantly higher in WWT compared to NW (p<0.001) irrespective of ON. Slow gait moderated the effect of obstacles on HbO2 levels across task conditions. Specifically, compared to participants with normal gait, PFC HbO2 levels were significantly increased in ON-NW relative to NW (p=0.017) and ON-WWT relative to WWT (p<0.001) among individuals with slow gait. Consistent with Compensatory Reallocation, ON required greater PFC involvement among individuals with mobility limitations.
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