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Ofori E, Delgado F, James DL, Wilken J, Hancock LM, Doniger GM, Gudesblatt M. Impact of distinct cognitive domains on gait variability in individuals with mild cognitive impairment and dementia. Exp Brain Res 2024; 242:1573-1581. [PMID: 38753043 DOI: 10.1007/s00221-024-06832-9] [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: 02/24/2024] [Accepted: 04/07/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Gait variability is a common feature in neurodegenerative diseases and has been linked to cognitive impairment. Despite this link, the influence of specific cognitive domains, such as memory, visual spatial skills, executive function, and verbal function on gait variability is not well-understood. OBJECTIVE To investigate the predictive value of these specific cognitive domains on gait variability in people with mild cognitive impairment (MCI) and dementia during preferred and dual task walking. METHOD One hundred and two participants with either MCI or dementia underwent a comprehensive cognitive assessment and completed preferred and dual-task walking trials on a pressure-sensing walkway. Gait variability was assessed using the PKMAS software. Lower extremity function was evaluated with a self-reported validated scale. RESULTS Our findings indicate that only visual spatial abilities had a moderate predictive value on gait variability [F (1, 78) = 17.30, p < 0.01, r = 0.43], both in preferred pace walking (70% direct effect) and dual-task walking (90% direct effect) (p's < 0.05). Additionally, lower extremity functional skills had a significant indirect effect (30%) on gait variability in preferred walking contexts. CONCLUSION For individuals diagnosed with MCI or dementia, increased gait variability may be driven by deficits in visual spatial processing. An increased understanding of the role of visual spatial processing in gait variability can aid in the assessment and management of individuals with MCI or dementia, potentially leading to targeted interventions to improve mobility and safety.
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Affiliation(s)
- Edward Ofori
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Ferdinand Delgado
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Dara L James
- Edson College of Nursing and Health Innovation, Arizona State, Phoenix, AZ, USA
| | - Jeffrey Wilken
- Department of Neurology, Georgetown University, Washington, DC, USA
- Washington Neuropsychology Research Group, Fairfax, VA, USA
| | - Laura M Hancock
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Naples, FL, USA
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
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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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Wilkins L. Test conditions impact measures of visual, perceptual, and cognitive performance. ERGONOMICS 2024:1-12. [PMID: 38661125 DOI: 10.1080/00140139.2024.2344694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
Traditionally, visual, perceptual, and cognitive (VPC) testing is performed in well-lit, silent rooms, whilst seated, and with little incentive. Whilst this is a well-controlled setting, it may lack key features of ecological validity and therefore generalisations to real-world environments and tasks may be erroneous. In the present study, 60 participants completed tests of processing speed, divided attention, and selective attention under varying conditions of light, auditory demands, movement demands, and incentive. The results found that processing speed was significantly better in the incentive condition compared to the non-incentive condition; and in the seated and standing conditions compared to the stepping condition. Divided attention and selective attention were significantly worse in the silent condition compared to the music conditions. No significant differences were found between light and dark conditions. These findings demonstrate that performance on the VPC tests is affected by auditory conditions, movement conditions, and incentives, but not light conditions.
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Affiliation(s)
- Luke Wilkins
- Sports, Performance, and Nutrition (SPAN) Research Group, La Trobe University, Bundoora, VIC, Australia
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DeGutis J, Aul C, Barthelemy OJ, Davis BL, Alshuaib S, Marin A, Kinger SB, Ellis TD, Cronin-Golomb A. Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease. Neuropsychologia 2023; 190:108698. [PMID: 37806442 DOI: 10.1016/j.neuropsychologia.2023.108698] [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: 03/08/2023] [Revised: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) side of motor symptom onset has been associated with distinct cognitive deficits; individuals with left-side onset (LPD) show more visuospatial impairments, whereas those with right-side onset (RPD) show more verbal impairments. Non-spatial attention is a critical cognitive ability associated with motor functioning that is right hemisphere lateralized but has not been characterized with regard to PD side of onset. We compared individuals with LPD and RPD on non-spatial attention tasks and examined differential responses to a 4-week sustained attention training program. METHOD Participants included 9 with LPD and 12 with RPD, who performed both brief and extended go/no-go continuous performance tasks and an attentional blink task. Participants also engaged in an at-home sustained attention training program, Tonic and Phasic Alertness Training (TAPAT), 5 days/week for 4 weeks. We assessed cognitive and motor symptoms before and after training, and after a 4-week no-contact period. RESULTS At baseline, participants with LPD exhibited worse performance than those with RPD on the extended continuous performance task, indicating specific deficits in sustaining attention. Poorer attention was associated with worse clinical motor scores. Notably, side of onset had a significant effect on clinical motor changes after sustained attention training, with only LPD participants improving after training, and 4/9 showing clinically meaningful improvements. CONCLUSIONS Compared to RPD, participants with LPD had poorer sustained attention pre-training and were more likely to improve on clinical motor functioning after sustained attention training. These findings support mechanistic differences between LPD and RPD and suggest potential differential treatment approaches.
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Affiliation(s)
- Joseph DeGutis
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Courtney Aul
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
| | - Olivier J Barthelemy
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Breanna L Davis
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Shaikhah Alshuaib
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Anna Marin
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Shraddha B Kinger
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Terry D Ellis
- Department of Physical Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, MA, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
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Aul C, Brau JM, Sugarman A, DeGutis JM, Germine LT, Esterman M, McGlinchey RE, Fortenbaugh FC. The functional relevance of visuospatial processing speed across the lifespan. Cogn Res Princ Implic 2023; 8:51. [PMID: 37542181 PMCID: PMC10403489 DOI: 10.1186/s41235-023-00504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/06/2023] [Indexed: 08/06/2023] Open
Abstract
Visuospatial processing speed underlies several cognitive functions critical for successful completion of everyday tasks, including driving and walking. While it is widely accepted that visuospatial processing speed peaks in early adulthood, performance across the lifespan remains incompletely characterized. Additionally, there remains a lack of paradigms available to assess visuospatial processing speed in unsupervised web-based testing environments. To address these gaps, we developed a novel visuospatial processing speed (VIPS) task adapted from two tests sensitive to visuospatial processing speed declines in older adults, the Useful Field of View paradigm and the PERformance CEntered Portable Test. The VIPS task requires participants to make a central orientation discrimination and complete a simultaneous peripheral visual search task. Data were collected from 86 in-lab volunteers (18-30 years) to compare performance to traditional neuropsychological measures. Consistent with previous literature, performance on the novel VIPS task significantly correlated with measures of selective attention, executive functioning, visual speed, and working memory. An additional 4395 volunteers (12-62 years) were recruited on TestMyBrain.org to establish lifespan trajectories of visuospatial processing speed and associations with functional disability. VIPS task performance peaked in the early 20's, and steadily decreased such that thresholds doubled in 60-year-olds relative to 20-year-olds (817 ms vs. 412 ms). VIPS task performance significantly correlated with self-reported cognitive functioning deficits broadly across the lifespan but was specifically related to mobility issues in middle-age. These findings have important implications for early detection of cognitive decline and provide insights into potential early intervention targets for younger and middle-aged adults.
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Affiliation(s)
- Courtney Aul
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Julia M Brau
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Alexander Sugarman
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Joseph M DeGutis
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Michael Esterman
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Francesca C Fortenbaugh
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Mo Y, Mao C, Yang D, Ke Z, Huang L, Yang Z, Qin R, Huang Y, Lv W, Hu Z, Xu Y. Altered neuroimaging patterns of cerebellum and cognition underlying the gait and balance dysfunction in cerebral small vessel disease. Front Aging Neurosci 2023; 15:1117973. [PMID: 36967823 PMCID: PMC10032207 DOI: 10.3389/fnagi.2023.1117973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
BackgroundThe mechanism of gait and balance dysfunction (GBD) in cerebral small vessel disease (CSVD) remains unclear. Evidence supports cognition engages in GBD of CSVD. The cerebellum is important in motor and cognition, while little is known about the influence of the cerebellum on GBD in CSVD.MethodsThis study is a retrospective cohort study. All participants of this study were enrolled from the CSVD individuals in Nanjing Drum Tower Hospital from 2017 to 2021. The GBD of CSVD patients was defined as Tinetti Test score ≤ 23. Cerebral cortical thickness, cerebellar gray matter volume, the amplitude of low-frequency fluctuation, functional connectivity, and modular interaction were calculated to determine the cortical atrophy and activity patterns of CSVD patients with GBD. The effect of cognitive domains during GBD in CSVD patients was explored by correlation analyses.ResultsA total of 25 CSVD patients were recruited in CSVD patients with GBD group (Tinetti Test score ≤ 23, mean age ± standard deviation: 70.000 ± 6.976 years), and 34 CSVD patients were recruited in CSVD patients without GBD group (Tinetti Test score > 23, mean age ± standard deviation: 64.029 ± 9.453 years). CSVD patients with GBD displayed worse cognitive performance and cortical atrophy in the right cerebellum VIIIa and bilateral superior temporal gyrus than those without GBD. The right postcentral gyrus, left inferior temporal gyrus, right angular gyrus, right supramarginal gyrus and right middle frontal gyrus were functionally overactivated and showed decreased modular interaction with the right cerebellum. Tinetti Test scores were negatively related to the volume of the right cerebellum VIIIa in CSVD patients with GBD. Notably, memory, especially visuospatial memory, was greatly associated with GBD in CSVD.ConclusionThe cortical atrophy and altered functional activity in sensorimotor area and ventral attention network in the cerebellum and cerebrum may underlying the GBD in CSVD. Memory might be critically cognitively responsible for GBD in CSVD.
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Affiliation(s)
- Yuting Mo
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Chenglu Mao
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Dan Yang
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Lili Huang
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Zhiyuan Yang
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Ruomeng Qin
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Yanan Huang
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Weiping Lv
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Zheqi Hu
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Medical School, State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Drum Tower Hospital, Institute of Brain Science, Nanjing University, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing Drum Tower Hospital, Nanjing, China
- *Correspondence: Yun Xu,
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Sensorimotor integration, cervical sensorimotor control, and cost of cognitive-motor dual tasking: Are there differences in patients with chronic whiplash-associated disorders and chronic idiopathic neck pain compared to healthy controls? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3452-3461. [PMID: 36227366 DOI: 10.1007/s00586-022-07390-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/12/2022] [Accepted: 09/12/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The current investigation aimed to compare the sensorimotor integration, sensorimotor control, and cost of cognitive-motor dual task during walking, in persons with chronic WAD as compared to matched chronic idiopathic neck pain and normal healthy controls. METHODS A cross-sectional, case control design comparing 30 participants in each of two study groups (chronic WAD and chronic idiopathic neck pain) to a matched control group was conducted. Measurements included: (1) the cranio-vertebral angle (CVA), (2) left and right rotation head repositioning accuracy (HRA), (3) frontal N30 amplitudes to assess sensorimotor integration, (4) dual cognitive gait cost (DCGC). RESULTS A statistically significant difference for the CVA was found between groups: WAD 36.8° ± 3.4, chronic pain 44.5° ± 1.5, and controls 47.1° ± 4; p < 0.05. MANOVA revealed significant group differences for the N30 amplitude (p < 0.05), where the WAD group had the greatest amplitude. Statistically significant differences among the three groups were found for HRA left and right where the WAD group had the greatest error, (p < 0.05). Post hoc tests revealed that the WAD group had the highest dual-task cost during walking, (p < 0.05). Significant linear correlations between the CVA and N30 amplitude, HRA, and DCGC were identified in all 3 groups, (p < 0.05). CONCLUSIONS Compared to both a matched control group and chronic neck pain group, whiplash-injured persons have greater forward head posture, greater error in sensorimotor control, and an altered ability to perform a motor task with a simultaneous cognitive task.
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van Wieringen A, Van Wilderode M, Van Humbeeck N, Krampe R. Coupling of sensorimotor and cognitive functions in middle- and late adulthood. Front Neurosci 2022; 16:1049639. [PMID: 36532286 PMCID: PMC9752872 DOI: 10.3389/fnins.2022.1049639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/08/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction The present study explored age effects and the coupling of sensorimotor and cognitive functions in a stratified sample of 96 middle-aged and older adults (age 45-86 years) with no indication of mild cognitive decline. In our sensorimotor tasks, we had an emphasis on listening in noise and postural control, but we also assessed functional mobility and tactile sensitivity. Methods Our cognitive measures comprised processing speed and assessments of core cognitive control processes (executive functions), notably inhibition, task switching, and working memory updating. We explored whether our measures of sensorimotor functioning mediated age differences in cognitive variables and compared their effect to processing speed. Subsequently, we examined whether individuals who had poorer (or better) than median cognitive performance for their age group also performed relatively poorer (or better) on sensorimotor tasks. Moreover, we examined whether the link between cognitive and sensorimotor functions becomes more pronounced in older age groups. Results Except for tactile sensitivity, we observed substantial age-related differences in all sensorimotor and cognitive variables from middle age onward. Processing speed and functional mobility were reliable mediators of age in task switching and inhibitory control. Regarding coupling between sensorimotor and cognition, we observed that individuals with poor cognitive control do not necessarily have poor listening in noise skills or poor postural control. Discussion As most conditions do not show an interdependency between sensorimotor and cognitive performance, other domain-specific factors that were not accounted for must also play a role. These need to be researched in order to gain a better understanding of how rehabilitation may impact cognitive functioning in aging persons.
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Affiliation(s)
- Astrid van Wieringen
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Mira Van Wilderode
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Nathan Van Humbeeck
- Research Group Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Ralf Krampe
- Research Group Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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Shapiro M, Shaki S, Gottlieb U, Springer S. Random walk: Random number generation during backward and forward walking- the role of aging. Front Aging Neurosci 2022; 14:888979. [PMID: 36247999 PMCID: PMC9554272 DOI: 10.3389/fnagi.2022.888979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Deficits in executive function, visuospatial abilities, and cognitive embodiment may impair gait performance. This study aimed to investigate the effect of age on random number generation (RNG) performance during forward and backward locomotion to assess cognitive flexibility and cognitive embodiment during walking. Another aim was to examine the effect of age on the associations of RNG performance during walking with stride time variability (STV), the percentage of double support (DS%), and visuospatial abilities as measured by a spatial orientation test (SOT). Twenty old (age 68.8 ± 5.3, 65% female) and 20 young (age 25.2 ± 2.2, 45% female) adults generated random numbers during backward walking (BW) and forward walking (FW) over-ground and over a treadmill with an internal focus of attention and visual-attentive distraction; six walking conditions in total. To assess cognitive flexibility, sample entropy was calculated for each RNG sequence. The average of the first 5 numbers in each RNG task was calculated to assess the relationship between small/large numbers and movement direction. STV and DS% were recorded using inertial measurement units, and spatial orientation was measured using a computerized test. The older subjects had less flexibility in generating random numbers in three of the six walking conditions. A negative correlation between RNG flexibility and STV was found in older adults during treadmill BW with visual-attentive distraction and forward over-ground walking, whereas no correlations were demonstrated in the young group. The spatial orientation score (a higher value means a worse outcome) correlated positively with RNG flexibility in the older group under all walking conditions, suggesting that older adults with better visuospatial orientation have lower cognitive flexibility, and vice versa. There was no correlation between small/large numbers and direction of motion in either group. The correlation between RNG flexibility and STV may indicate similar executive control of verbal and gait rhythmicity in old adults. Conversely, our results suggest that cognitive flexibility and visuospatial ability may decline differently.
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Affiliation(s)
- Maxim Shapiro
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Samuel Shaki
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Uri Gottlieb
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Shmuel Springer
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
- *Correspondence: Shmuel Springer,
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Herings PMR, Dyer AH, Kennelly SP, Reid S, Killane I, McKenna L, Bourke NM, Woods CP, O'Neill D, Gibney J, Reilly RB. Gait Characteristics and Cognitive Function in Middle-Aged Adults with and without Type 2 Diabetes Mellitus: Data from ENBIND. SENSORS (BASEL, SWITZERLAND) 2022; 22:5710. [PMID: 35957266 PMCID: PMC9370923 DOI: 10.3390/s22155710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
Type 2 Diabetes Mellitus (T2DM) in midlife is associated with a greater risk of dementia in later life. Both gait speed and spatiotemporal gait characteristics have been associated with later cognitive decline in community-dwelling older adults. Thus, the assessment of gait characteristics in uncomplicated midlife T2DM may be important in selecting-out those with T2DM at greatest risk of later cognitive decline. We assessed the relationship between Inertial Motion Unit (IMUs)-derived gait characteristics and cognitive function assessed via Montreal Cognitive Assessment (MoCA)/detailed neuropsychological assessment battery (CANTAB) in middle-aged adults with and without uncomplicated T2DM using both multivariate linear regression and a neural network approach. Gait was assessed under (i) normal walking, (ii) fast (maximal) walking and (iii) cognitive dual-task walking (reciting alternate letters of the alphabet) conditions. Overall, 138 individuals were recruited (n = 94 with T2DM; 53% female, 52.8 ± 8.3 years; n = 44 healthy controls, 43% female, 51.9 ± 8.1 years). Midlife T2DM was associated with significantly slower gait velocity on both slow and fast walks (both p < 0.01) in addition to a longer stride time and greater gait complexity during normal walk (both p < 0.05). Findings persisted following covariate adjustment. In analyzing cognitive performance, the strongest association was observed between gait velocity and global cognitive function (MoCA). Significant associations were also observed between immediate/delayed memory performance and gait velocity. Analysis using a neural network approach did not outperform multivariate linear regression in predicting cognitive function (MoCA) from gait velocity. Our study demonstrates the impact of uncomplicated T2DM on gait speed and gait characteristics in midlife, in addition to the striking relationship between gait characteristics and global cognitive function/memory performance in midlife. Further studies are needed to evaluate the longitudinal relationship between midlife gait characteristics and later cognitive decline, which may aid in selecting-out those with T2DM at greatest-risk for preventative interventions.
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Affiliation(s)
- Pieter M R Herings
- School of Engineering, Trinity College Dublin, D08 XW7X Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Adam H Dyer
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Age-Related Healthcare, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Sean P Kennelly
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Age-Related Healthcare, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Sean Reid
- School of Engineering, Trinity College Dublin, D08 XW7X Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Isabelle Killane
- Department of Engineering, Technological University Dublin, D07 EWV4 Dublin, Ireland
| | - Louise McKenna
- Department of Age-Related Healthcare, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Nollaig M Bourke
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Conor P Woods
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Desmond O'Neill
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Age-Related Healthcare, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - James Gibney
- Robert Graves Institute of Endocrinology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Richard B Reilly
- School of Engineering, Trinity College Dublin, D08 XW7X Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
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11
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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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12
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Joshi S, Weedon BD, Esser P, Liu YC, Springett DN, Meaney A, Inacio M, Delextrat A, Kemp S, Ward T, Izadi H, Dawes H, Ayaz H. Neuroergonomic assessment of developmental coordination disorder. Sci Rep 2022; 12:10239. [PMID: 35715433 PMCID: PMC9206023 DOI: 10.1038/s41598-022-13966-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 05/31/2022] [Indexed: 12/29/2022] Open
Abstract
Until recently, neural assessments of gross motor coordination could not reliably handle active tasks, particularly in realistic environments, and offered a narrow understanding of motor-cognition. By applying a comprehensive neuroergonomic approach using optical mobile neuroimaging, we probed the neural correlates of motor functioning in young people with Developmental Coordination Disorder (DCD), a motor-learning deficit affecting 5-6% of children with lifelong complications. Neural recordings using fNIRS were collected during active ambulatory behavioral task execution from 37 Typically Developed and 48 DCD Children who performed cognitive and physical tasks in both single and dual conditions. This is the first of its kind study targeting regions of prefrontal cortical dysfunction for identification of neuropathophysiology for DCD during realistic motor tasks and is one of the largest neuroimaging study (across all modalities) involving DCD. We demonstrated that DCD is a motor-cognitive disability, as gross motor /complex tasks revealed neuro-hemodynamic deficits and dysfunction within the right middle and superior frontal gyri of the prefrontal cortex through functional near infrared spectroscopy. Furthermore, by incorporating behavioral performance, decreased neural efficiency in these regions were revealed in children with DCD, specifically during motor tasks. Lastly, we provide a framework, evaluating disorder impact in ecologically valid contexts to identify when and for whom interventional approaches are most needed and open the door for precision therapies.
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Affiliation(s)
- Shawn Joshi
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA. .,College of Medicine, Drexel University, Philadelphia, PA, USA. .,Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK. .,Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK.
| | - Benjamin D Weedon
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK
| | - Yan-Ci Liu
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK.,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospita, Taipei, Taiwan
| | - Daniella N Springett
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK.,Department for Health, University of Bath, Bath, UK
| | - Andy Meaney
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Mario Inacio
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK.,Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia, Porto, Portugal
| | - Anne Delextrat
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK
| | - Steve Kemp
- Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, UK
| | - Tomás Ward
- Insight SFI Research Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Hooshang Izadi
- School of Engineering, Computing and Mathematics, School of Technology, Design and Environment, Oxford Brookes University, Oxford, UK
| | - Helen Dawes
- Nuffield Department of Clinical Neurology, University of Oxford, Oxford, UK.,Intersect@Exeter, College of Medicine and Health, University of Exeter, Exeter, UK.,Oxford Health BRC, University of Oxford, Oxford, UK
| | - Hasan Ayaz
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA.,Department of Psychological and Brain Sciences, College of Arts and Sciences, Drexel University, Philadelphia, PA, USA.,Drexel Solution Institute, Drexel University, Philadelphia, PA, USA.,Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, USA.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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13
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Tirkkonen A, Kekäläinen T, Aukee P, Kujala UM, Laakkonen EK, Kokko K, Sipilä S. Bidirectional associations between cognitive functions and walking performance among middle-aged women. Menopause 2021; 29:200-209. [PMID: 34930867 PMCID: PMC8785773 DOI: 10.1097/gme.0000000000001896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa. METHODS In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling. RESULTS We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=-0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking. CONCLUSION Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa.
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Affiliation(s)
- Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology, Central Finland Health Care District, Jyväskylä, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K. Laakkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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14
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Wang RY, Huang YC, Zhou JH, Cheng SJ, Yang YR. Effects of Exergame-Based Dual-Task Training on Executive Function and Dual-Task Performance in Community-Dwelling Older People: A Randomized-Controlled Trial. Games Health J 2021; 10:347-354. [PMID: 34491113 DOI: 10.1089/g4h.2021.0057] [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] [Indexed: 01/18/2023] Open
Abstract
Objective: Aging is associated with decline in executive function that may lead to reduced dual-task performance. Regular exercise has been recommended for promoting or maintaining mental and physical health in older adults, yet only a fraction of older adults exercise regularly. Exergame training may have the potential to enhance exercise adherence. Therefore, the aim of this study was to examine the effects of exergame-based dual-task training on executive function and dual-task performance in community-dwelling older adults. Materials and Methods: This was a single-blinded, randomized-controlled trial. Twenty community-dwelling older adults were recruited and randomly assigned to one of two groups. All participants completed 36 trainings, including three 60-minute sessions/week over 12 weeks. Participants in the experimental group received exergame-based dual-task training, while those in the control group received home-based multicomponent exercise training. Measures of executive function, dual-task performance, and community walking ability were assessed before and after the intervention. Results: Significant group × time interactions (P = 0.000-0.027) with large effects were found in all selected outcome measures. Compared with the control group, the experimental group improved significantly in measures of general executive function (P = 0.014), inhibitory control (P = 0.037), cognitive dual-task performance (P < 0.001), and community walking ability (P = 0.002). Enhanced general executive function was highly correlated with either improved motor dual-task performance (r = 0.674) or improved cognitive dual-task performance (r = -0.701). Conclusion: These results suggested that exergame-based dual-task training improved both executive function and dual-task performance in older people. These positive effects could be transferred to enhance community walking ability. Clinical Trial Registration number: ACTRN 12617000095369.
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Affiliation(s)
- Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Yuan-Chen Huang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan
| | - Jun-Hong Zhou
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jung Cheng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.,Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
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15
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Lau LK, Wee SL, Mallya JU, Yap PLK, Pang WJB, Chen KK, Abdul Jabbar K, Seah WT, Ng TP. Physiological and cognitive determinants of gait in middle-aged, older-aged and oldest-aged Asian adults – The Yishun study. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2021.100030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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16
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Park H, Aul C, DeGutis J, Lo OY, Poole VN, McGlinchey R, Bean JF, Leritz E, Esterman M. Evidence for a Specific Association Between Sustained Attention and Gait Speed in Middle-to-Older-Aged Adults. Front Aging Neurosci 2021; 13:703434. [PMID: 34290601 PMCID: PMC8289388 DOI: 10.3389/fnagi.2021.703434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023] Open
Abstract
Although cognitive decline has previously been associated with mobility limitations and frailty, the relationship between sustained attention and gait speed is incompletely characterized. To better quantify the specificity of the sustained attention and gait speed association, we examined the extent to which this relationship is unique rather than accounted for by executive functioning and physical health characteristics. 58 middle-to-older-aged community-dwelling adults without overt evidence of cognitive impairment (45-90 years old; 21 females) participated in the study. Each participant completed a 4-meter gait speed assessment and validated neuropsychological tests to examine various domains of executive functioning including working memory (i.e., Digit Span), inhibitory control (i.e., D-KEFS Color-Word Interference), and task switching (i.e., D-KEFS Number/Letter Switching). Multiple physical and vascular risk factors were also evaluated. Sustained attention was assessed using the gradual onset continuous performance task (gradCPT), a well-validated go/no-go sustained attention task. A series of linear regression models were used to examine how different aspects of cognition, including sustained attention and traditional measures of executive functioning, related to gait speed while controlling for a variety of physical and vascular risk factors. Among all predictors, gradCPT accuracy explained the most variance in gait speed (R 2 = 0.19, p < 0.001) and was the only significant predictor (β = 0.35, p = 0.01) when accounting for executive functioning and other physical and vascular risk factors. The present results indicate that sustained attention may be uniquely sensitive and mechanistically linked to mobility limitations in middle-to-older adults.
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Affiliation(s)
- Hannah Park
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychology, Brandeis University, Waltham, MA, United States
| | - Courtney Aul
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, United States
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
| | - Joseph DeGutis
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, United States
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Victoria N. Poole
- Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- New England Geriatric Research, Educational and Clinical Center (NEGRECC), VA Boston Healthcare System, Boston, MA, United States
| | - Jonathan F. Bean
- New England Geriatric Research, Educational and Clinical Center (NEGRECC), VA Boston Healthcare System, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Elizabeth Leritz
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- New England Geriatric Research, Educational and Clinical Center (NEGRECC), VA Boston Healthcare System, Boston, MA, United States
| | - Michael Esterman
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, United States
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
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17
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Davis JRC, Knight SP, Donoghue OA, Hernández B, Rizzo R, Kenny RA, Romero-Ortuno R. Comparison of Gait Speed Reserve, Usual Gait Speed, and Maximum Gait Speed of Adults Aged 50+ in Ireland Using Explainable Machine Learning. FRONTIERS IN NETWORK PHYSIOLOGY 2021; 1:754477. [PMID: 36925580 PMCID: PMC10013005 DOI: 10.3389/fnetp.2021.754477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/15/2021] [Indexed: 12/28/2022]
Abstract
Gait speed is a measure of general fitness. Changing from usual (UGS) to maximum (MGS) gait speed requires coordinated action of many body systems. Gait speed reserve (GSR) is defined as MGS-UGS. From a shortlist of 88 features across five categories including sociodemographic, cognitive, and physiological, we aimed to find and compare the sets of predictors that best describe UGS, MGS, and GSR. For this, we leveraged data from 3,925 adults aged 50+ from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA). Features were selected by a histogram gradient boosting regression-based stepwise feature selection pipeline. Each model's feature importance and input-output relationships were explored using TreeExplainer from the Shapely Additive Explanations explainable machine learning package. The mean R a d j 2 (SD) from fivefold cross-validation on training data and the R a d j 2 score on test data were 0.38 (0.04) and 0.41 for UGS, 0.45 (0.04) and 0.46 for MGS, and 0.19 (0.02) and 0.21 for GSR. Each model selected features across all categories. Features common to all models were age, grip strength, chair stands time, mean motor reaction time, and height. Exclusive to UGS and MGS were educational attainment, fear of falling, Montreal cognitive assessment errors, and orthostatic intolerance. Exclusive to MGS and GSR were body mass index (BMI), and number of medications. No features were selected exclusively for UGS and GSR. Features unique to UGS were resting-state pulse interval, Center for Epidemiologic Studies Depression Scale (CESD) depression, sit-to-stand difference in diastolic blood pressure, and left visual acuity. Unique to MGS were standard deviation in sustained attention to response task times, resting-state heart rate, smoking status, total heartbeat power during paced breathing, and visual acuity. Unique to GSR were accuracy proportion in a sound-induced flash illusion test, Mini-mental State Examination errors, and number of cardiovascular conditions. No interactions were present in the GSR model. The four features that overall gave the most impactful interactions in the UGS and MGS models were age, chair stands time, grip strength, and BMI. These findings may help provide new insights into the multisystem predictors of gait speed and gait speed reserve in older adults and support a network physiology approach to their study.
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Affiliation(s)
- James R C Davis
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Orna A Donoghue
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernández
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rossella Rizzo
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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18
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Agathos CP, Ramanoël S, Bécu M, Bernardin D, Habas C, Arleo A. Postural Control While Walking Interferes With Spatial Learning in Older Adults Navigating in a Real Environment. Front Aging Neurosci 2020; 12:588653. [PMID: 33281600 PMCID: PMC7689348 DOI: 10.3389/fnagi.2020.588653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/16/2020] [Indexed: 11/21/2022] Open
Abstract
Cognitive demands for postural control increase with aging and cognitive-motor interference (CMI) exists for a number of walking situations, especially with visuo-spatial cognitive tasks. Such interference also influences spatial learning abilities among older adults; however, this is rarely considered in research on aging in spatial navigation. We posited that visually and physically exploring an unknown environment may be subject to CMI for older adults. We investigated potential indicators of postural control interfering with spatial learning. Given known associations between age-related alterations in gait and brain structure, we also examined potential neuroanatomical correlates of this interference. Fourteen young and 14 older adults had to find an invisible goal in an unfamiliar, real, ecological environment. We measured walking speed, trajectory efficiency (direct route over taken route) and goal fixations (proportion of visual fixations toward the goal area). We calculated the change in walking speed between the first and last trials and adaptation indices for all three variables to quantify their modulation across learning trials. All participants were screened with a battery of visuo-cognitive tests. Eighteen of our participants (10 young, 8 older) also underwent a magnetic resonance imaging (MRI) examination. Older adults reduced their walking speed considerably on the first, compared to the last trial. The adaptation index of walking speed correlated positively with those of trajectory efficiency and goal fixations, indicating a reduction in resource sharing between walking and encoding the environment. The change in walking speed correlated negatively with gray matter volume in superior parietal and occipital regions and the precuneus. We interpret older adults’ change in walking speed as indicative of CMI, similar to dual task costs. This is supported by the correlations between the adaptation indices and between the change in walking speed and gray matter volume in brain regions that are important for navigation, given that they are involved in visual attention, sensory integration and encoding of space. These findings under ecological conditions in a natural spatial learning task question what constitutes dual tasking in older adults and they can lead future research to reconsider the actual cognitive burden of postural control in aging navigation research.
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Affiliation(s)
| | - Stephen Ramanoël
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.,University of Côte d'Azur, LAMHESS, Nice, France
| | - Marcia Bécu
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Delphine Bernardin
- Vision Sciences Department, Essilor International R&D, Paris, France.,Essilor Canada Ltd., Montreal, QC, Canada
| | | | - Angelo Arleo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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19
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Deblock-Bellamy A, Lamontagne A, Blanchette AK. Cognitive-Locomotor Dual-Task Interference in Stroke Survivors and the Influence of the Tasks: A Systematic Review. Front Neurol 2020; 11:882. [PMID: 33013625 PMCID: PMC7461874 DOI: 10.3389/fneur.2020.00882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Walking in the community can be challenging for stroke survivors. The fact that community walking often requires performing another task while walking further adds to this challenge and can lead to a deterioration of performance in one or both tasks. Objective: To review the existing literature about cognitive-locomotor dual-task interference (DTI) magnitude and pattern while walking in patients with stroke and to explore the influence of tasks' nature on DTI. Moreover, this review investigated the differences in DTI between stroke survivors and age-matched healthy adults. Methods: The literature search was conducted in 4 databases (MEDLINE, CINAHL, EMBASE and PEDro). Two authors independently identified relevant studies based on predetermined selection criteria. Among these criteria, studies had to include both locomotor and cognitive DTI. Methodological quality of the studies was independently assessed by two raters using a standardized checklist. Studies were categorized according to the nature of the locomotor and the cognitive tasks. Results: A total of twenty studies, with good to high methodological quality, were selected. Task combinations, outcome measures and participants characteristics varied widely from one study to another. Despite heterogeneous results across studies, mutual DTI (decrements in both locomotor and cognitive performance) was the most frequently observed pattern in participants with stroke. Interestingly, this DTI pattern was systematically obtained when participants had to avoid obstacles while walking. DTI seemed also to be influenced by the nature of the cognitive task. Compared to age-matched healthy participants, stroke survivors had greater DTI. Mutual interferences were also more frequently observed in stroke survivors than in age-matched healthy adults. Conclusions: DTI magnitude and pattern in persons with stroke varied considerably across studies. Multiple factors, including nature of the tasks, may influence dual-task abilities when assessing individuals with stroke. Consequently, dual-task assessments should be performed in similar contexts of individuals' daily lives to ensure ecological validity.
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Affiliation(s)
- Anne Deblock-Bellamy
- Faculty of Medicine, Universite Laval, Quebec City, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) - CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Jewish Rehabilitation Hospital - CISSS de Laval, Laval, QC, Canada
| | - Andréanne K Blanchette
- Faculty of Medicine, Universite Laval, Quebec City, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) - CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada.,Department of Rehabilitation, Universite Laval, Quebec City, QC, Canada
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20
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A 10-week yoga practice has no effect on cognition, but improves balance and motor learning by attenuating brain-derived neurotrophic factor levels in older adults. Exp Gerontol 2020; 138:110998. [PMID: 32544572 DOI: 10.1016/j.exger.2020.110998] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
Despite studies investigating the effect of yoga on cognitive and motor functioning in older adults, the effect on dual-task performance and motor learning and the specific mechanisms underlying the positive effect of yoga remain unclear. Thus, the aim of this study was to investigate the effects of yoga on cognition, balance under single- and dual-task conditions, and motor learning. The potential role of brain-derived neurotrophic factor (BDNF) in induced improvement was also explored. Participants aged 60-79 years were randomized to either a control group (n = 15) or a yoga group (n = 18) for a 10-week period. The yoga group received 90-min duration yoga classes two times per week. Changes in cognition, balance under single- and dual-task conditions, and learning fast and accurate reaching movements were assessed. Yoga practice decreased (P < 0.05) the velocity vector of the center of pressure under single- and dual-task conditions, whereas no changes in cognitive performance were observed. Although reaction and movement times during learning were decreased in both groups (P < 0.05), a faster reaction time (P < 0.05) and shorter movement time (P < 0.05) were observed in the yoga group than in the control group. Significant moderate relationships (P < 0.05) between changes in BDNF levels and functional improvements were observed. Thus, 10 weeks of yoga practice resulted in improved balance and learning in the speed-accuracy motor task that were mediated by increased BDNF levels, but had no impact on cognition in older adults.
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21
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Blackwood J, Gore S. Beyond balance and mobility, contributions of cognitive function to falls in older adults with cardiovascular disease. J Frailty Sarcopenia Falls 2020; 4:65-70. [PMID: 32300720 PMCID: PMC7155361 DOI: 10.22540/jfsf-04-065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives: Older adults with cardiovascular disease (CVD) are at risk for cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in CVD. The aim of this study was to examine the contributions of cognitive function on falls in older adults with CVD. Methods: A secondary analysis was performed on data from the Health and Retirement Study cohort 2010 (N=3413) of older adults with CVD. Group assignment was based on falls history (yes/no) within the two years prior to the survey. Demographic (age, education, gender, marital status), physical (strength, balance, physical activity, and mobility) and cognitive (immediate and delayed recall, orientation, semantic verbal fluency, numeracy) information was extracted to characterize the sample. Comparisons between groups were completed for all of these variables. Logistic regression was performed to examine associations between each of the cognitive variables and falls while controlling for age, gender, marital status, education, and BMI. Results: Demographic (age, gender, marital status, and education), physical (grip strength, tandem stance time, and gait speed), and cognitive (orientation, immediate and delayed recall) variables differed by falls history (p<0.05). After controlling for confounding, immediate recall was the only significant predictor of falls (OR=1.09, 95% CI=1.01-1.17) (Nagelkerke R2=0.037, χ2=35.14, p<0.05) with correctly classifying 65.9% of cases. Conclusions: In older adults with CVD, cognitive and physical functions are more impaired in those with a falls history. Screening for cognitive function, specifically immediate recall, should be a part of the management of falls in this population.
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Affiliation(s)
| | - Shweta Gore
- MGH Institute of Health Professions, Boston, MA, USA
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22
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Mertens M, Raepsaet J, Debard G, Mondelaers M, Vanrumste B, Davis J. Use of wearable technology to quantify fall risk in psychogeriatric environments: a feasability study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3187-3190. [PMID: 31946565 DOI: 10.1109/embc.2019.8856337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fall incidents with elderly suffering from psychological pathologies, in combination with a comorbidity of clinical problems are highly prevalent. In our research setting, the psychiatric hospital OPZ in Geel, Belgium, 1790 fall incidents were recorded with 283 patients since 2013. The nature of the patients' profiles makes a valid, objective fall risk assessment very difficult; for them, instructions to perform the tests are difficult to understand and execute. Therefore, the currently used instruments are not suited for this complex situation. In this study we propose an alternative system for the assessment of fall risk for patients of a psychogeriatric ward. We also study the essential precautions needed for acceptance of wearables in this complex setting.We collected individual daily mean gait speeds of 17 patients at a psychogeriatric ward over a period of five months. We show that it is possible, using wearable technology, to measure individual gait speed. We also show that it is possible to have the wearable technology accepted by the target group. The results obtained so far are promising to use automatical gait measurement to correlate to the currently used risk assessment tests and to eventually replace these tests.
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23
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Pelicioni PHS, Tijsma M, Lord SR, Menant J. Prefrontal cortical activation measured by fNIRS during walking: effects of age, disease and secondary task. PeerJ 2019; 7:e6833. [PMID: 31110922 PMCID: PMC6501770 DOI: 10.7717/peerj.6833] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background Cognitive processes are required during walking to appropriately respond to environmental and task demands. There are now many studies that have used functional Near-Infrared Spectroscopy (fNIRS) to record brain activation to investigate neural bases of cognitive contributions in gait. The aim of this systematic review was to summarize the published research regarding Prefrontal cortical (PFC) activation patterns during simple and complex walking tasks in young adults, older adults and clinical groups with balance disorders using fNIRS. Our secondary aim was to evaluate each included study based on methodological reporting criteria important for good data quality. Methods We conducted searches in June 2018 using four databases: Embase, PubMed, Scopus and PsycINFO. The strategy search used was: (((((near infrared spectroscopy) OR functional near infrared spectroscopy) OR nirs) OR fnirs) AND (((gait) OR walking) OR locomotion) AND (((((young) OR adult) OR older) OR elderly) NOT children)) AND (((Brain) OR cortex) OR cortical) for our search. The papers included met the specific review criteria: (i) used fNIRS to measure PFC activation patterns; (ii) included walking tasks (simple and complex) and; (iii) assessed young people, older people and/or clinical groups with balance disorders. Results Thirty five (describing 75 brain activation comparisons) of the 308 studies retrieved through our search met the inclusion criteria. Based on 6 methodological reporting considerations, 20 were of high quality, 10 were of medium quality and 5 were of low quality. Eleven/20 comparisons in young people, 23/37 comparisons in older people and 15/18 comparisons in clinical groups reported increased PFC activation with increased walking task complexity. The majority of comparisons that used verbal fluency, counting backwards or secondary motor tasks reported increases in PFC activation (83%, 64% and 58% of these studies, respectively). In contrast, no studies found secondary visual tasks increased PFC activation. Conclusion Increased PFC activation was most common in studies that involved walks comprising secondary verbal fluency and arithmetic tasks. Clinical groups generally showed increased PFC activation irrespective of type of secondary task performed during walking which suggests these groups require more attentional resources for safe walking. Systematic review registration number: PROSPERO 2017 - CRD42017059501.
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Affiliation(s)
- Paulo H S Pelicioni
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Sarcopenia Is Associated with Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091491. [PMID: 31035553 PMCID: PMC6539557 DOI: 10.3390/ijerph16091491] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/19/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022]
Abstract
Sarcopenia and cognitive impairment may share common risk factors and pathophysiological pathways. We examined the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in community-dwelling older adults. We analyzed 1887 patients who underwent cognitive function tests and dual-energy X-ray absorptiometry from the baseline data of adults aged 70-84 years obtained from the Korean Frailty and Aging Cohort Study. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson's disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04-2.99) and slow gait speed (OR 2.58, 95% CI 1.34-4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05-3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.
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25
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Abstract
Cognitive decline and neurodegenerative disease have been implicated in gait dysfunction via disturbance of top-down control mechanisms. Gait velocity decreases, variability increases, and ability to multitask while walking is impaired as cognition declines. Changes in gait can be used to predict incident mild cognitive impairment states as well as dementia. Slow gait velocity together with a cognitive complaint, the Motoric Cognitive Risk syndrome, can serve as a clinical biomarker for high risk of neurologic decline. While patients with Alzheimer's disease typically have quantitative gait impairment, those with other forms of dementia often manifest more overt, qualitative changes to walking. A variety of interventions may be useful to improve gait, including physical and cognitive rehabilitation, treatment of specific underlying causes of gait problems, and treatment of the dementia itself. Understanding the relationship between gait and dementia can elucidate pathology and improve patient care.
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Affiliation(s)
- Jason A Cohen
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States; Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, NY, United States.
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26
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Valkanova V, Esser P, Demnitz N, Sexton CE, Zsoldos E, Mahmood A, Griffanti L, Kivimäki M, Singh-Manoux A, Dawes H, Ebmeier KP. Association between gait and cognition in an elderly population based sample. Gait Posture 2018; 65:240-245. [PMID: 30558938 PMCID: PMC6109203 DOI: 10.1016/j.gaitpost.2018.07.178] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 06/20/2018] [Accepted: 07/27/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait is thought to have a cognitive component, but the current evidence in healthy elderly is mixed. We studied the association between multiple gait and cognitive measures in a cohort of older people. METHODS One hundred and seventy-eight cognitively healthy participants from the Whitehall II Imaging Sub-study had a detailed clinical and neuropsychological assessment, as well as an MRI scan. Spatiotemporal and variability gait measures were derived from two 10 m walks at self-selected speed. We did a linear regression analysis, entering potential confounders with backwards elimination of variables with p ≥ 0.1. The remaining variables were then entered into a second regression before doing a stepwise analysis of cognitive measures, entering variables with p < 0.05 and removing those with p ≥ 0.1. RESULTS Amongst absolute gait measures, only greater stride length was associated with better performance on the Trail Making Test A (p = 0.023) and the Boston Naming Test (p = 0.042). The stride time variability was associated with performance on the Trail Making Test A (p = 0.031). Age was associated with poorer walking speed (p = 0.014) and stride time (p = 0.011), female sex with shorter stride time (p = 0.000) and shorter double stance (p = 0.005). Length of full-time education was associated with faster walking speed (p = 0.012) and shorter stride time (p = 0.045), and a history of muscular-skeletal disease with slower walking speed (p = 0.01) and shorter stride length (p = 0.015). Interestingly, volume of white matter hyperintensities (WMH) on FLAIR MRI images did not contribute independently to any of the gait measures (p > 0.05). CONCLUSIONS No strong relationship between gait and non-motor cognition was observed in a cognitively healthy, high functioning sample of elderly. Nevertheless, we found some relationships with spatial, but not temporal gait which warrant further investigation. WMH made no independent contributionto gait.
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Affiliation(s)
- Vyara Valkanova
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom.
| | - Patrick Esser
- Movement Science Group, Oxford Brookes University, OX3 0BP, United Kingdom; FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, United Kingdom
| | - Naiara Demnitz
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom; FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, United Kingdom
| | - Claire E Sexton
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, United Kingdom
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Ludovica Griffanti
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, United Kingdom
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, United Kingdom
| | - Archana Singh-Manoux
- Centre for Research in Epidemiology and Population Health, INSERM, U1018, Villejuif, France; Department of Epidemiology and Public Health, University College London, United Kingdom
| | - Helen Dawes
- Movement Science Group, Oxford Brookes University, OX3 0BP, United Kingdom; FMRIB Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, United Kingdom
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
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27
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Compromised prefrontal structure and function are associated with slower walking in older adults. NEUROIMAGE-CLINICAL 2018; 20:620-626. [PMID: 30191124 PMCID: PMC6125763 DOI: 10.1016/j.nicl.2018.08.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/13/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
Our previous work demonstrates that reduced activation of the executive network is associated with slow walking speed in a cohort of older adults from the MOBILIZE Boston Study. However, the influence of underlying white matter integrity on the activation of this network and walking speed is unknown. Thus, we used diffusion-weighted imaging and fMRI during an n-back task to assess associations between executive network structure, function, and walking speed. Whole-brain tract-based spatial statistics (TBSS) were used to identify regions of white matter microstructural integrity that were associated with walking speed. The integrity of these regions was then entered into multiple regression models to predict task performance and executive network activation during the n-back task. Among the significant associations of FA with walking speed, we observed the anterior thalamic radiation and superior longitudinal fasciculus were further associated with both n-back response speed and executive network activation. These findings suggest that subtle damage to frontal white matter may contribute to altered executive network activation and slower walking in older adults. Older adult walking speed was not associated with white matter lesion burden. Walking speed was associated with microstructural white matter integrity. The integrity of prefrontal areas was associated with executive network activation. Low executive network activation also corresponded to slower walking. Interventions targeting the executive network may preserve older adult mobility.
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Schott N, Klotzbier TJ. Profiles of Cognitive-Motor Interference During Walking in Children: Does the Motor or the Cognitive Task Matter? Front Psychol 2018; 9:947. [PMID: 29951020 PMCID: PMC6008773 DOI: 10.3389/fpsyg.2018.00947] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/23/2018] [Indexed: 01/31/2023] Open
Abstract
The evidence supporting the effects of age on the ability to coordinate a motor and a cognitive task show inconsistent results in children and adolescents, where the Dual-Task Effects (DTE) – if computed at all – range from either being lower or comparable or higher in younger children than in older children, adolescents and adults. A feasible reason for the variability in such findings is the wide range of cognitive tasks (and to some extend of motor tasks) used to study Cognitive-Motor Interference (CMI). Our study aims at determining the differences in CMI when performing cognitive tasks targeting different cognitive functions at varying walking pathways. 69 children and adolescents (boys, n = 45; girls, n = 24; mean age, 11.5 ± 1.50 years) completed higher-level executive function tasks (2-Back, Serial Subtraction, Auditory Stroop, Clock Task, TMT-B) in comparison to non-executive distracter tasks [Motor Response Task (MRT), TMT-A] to assess relative effects on gait during straight vs. repeated Change of Direction (COD) walking. DT during COD walking was assessed using the Trail-Walking-Test (TWT). The motor and cognitive DTE were calculated for each task. There were significant differences between 5th and 8th graders on single gait speed on the straight (p = 0.016) and the COD pathway (p = 0.023), but not on any of the DT conditions. The calculation of DTEs revealed that motor DTEs were lowest for the MRT and highest for the TWT in the numbers/letters condition (p < 0.05 for all comparisons). In contrast, there were cognitive benefits for the higher-order cognitive tasks on the straight pathways, but cognitive costs for both DT conditions on the COD pathway (p < 0.01 for all comparisons). Our findings demonstrate that DT changes in walking when completing a secondary task that involve higher-level cognition are attributable to more than low-level divided attention or motor response processes. These results specifically show the direct competition for higher-level executive function resources important for walking, and are in agreement with previous studies supporting the cognitive-motor link in relation to gait in children. This might be in line with the idea that younger children may not have adequate cognitive resources.
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Affiliation(s)
- Nadja Schott
- Department of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Thomas J Klotzbier
- Department of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany
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29
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Effects of a multicomponent exercise on dual-task performance and executive function among older adults. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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30
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Executive function and life-space mobility in old age. Aging Clin Exp Res 2018; 30:145-151. [PMID: 28432560 DOI: 10.1007/s40520-017-0762-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Life-space assessment incorporates all movements in terms of the distance from home, the frequency of movement and the need of assistance for movement. Executive function (EF) is an important higher order cognitive ability that controls and guides people's goal-directed actions. We examined the cross-sectional and longitudinal associations between EF and life-space mobility, and investigated if perceived walking difficulties, lower extremity performance, and transportation difficulties explain the association. METHODS 157 community-dwelling persons aged 76-91 years participated in the study at the baseline, and 103 of them in 2-year follow-up study. Based on the distribution on the Trail Making Test participants were categorized into tertiles of EF. Life-space mobility was assessed using the Life-Space Assessment (range 0-120). Perceived walking difficulties and transportation difficulties were self-reported, and lower extremity performance was assessed with the short physical performance battery (SPPB). Adjustments were made for gender, age, number of chronic conditions, and years of education. RESULTS Average age of participants at the baseline was 82.6 (SD 4.2) years and 61% were women. Individuals with poor EF had lower life-space mobility compared to those with good EF. SPPB and transportation difficulties explained the association. Over the 2-year follow-up, those with poor EF at the baseline showed steeper decline but the difference did not quite reach statistical significance (p = 0.068). CONCLUSIONS People with better executive function had higher life-space mobility. This was explained by better lower extremity performance and absence of transportation difficulties. Cognitive decline may hinder access to community amenities, which in turn may further accelerate cognitive decline.
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Maguire FJ, Killane I, Creagh AP, Donoghue O, Kenny RA, Reilly RB. Baseline Association of Motoric Cognitive Risk Syndrome With Sustained Attention, Memory, and Global Cognition. J Am Med Dir Assoc 2018; 19:53-58. [DOI: 10.1016/j.jamda.2017.07.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 12/11/2022]
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Hooghiemstra AM, Ramakers IHGB, Sistermans N, Pijnenburg YAL, Aalten P, Hamel REG, Melis RJF, Verhey FRJ, Olde Rikkert MGM, Scheltens P, van der Flier WM. Gait Speed and Grip Strength Reflect Cognitive Impairment and Are Modestly Related to Incident Cognitive Decline in Memory Clinic Patients With Subjective Cognitive Decline and Mild Cognitive Impairment: Findings From the 4C Study. J Gerontol A Biol Sci Med Sci 2017; 72:846-854. [PMID: 28177065 DOI: 10.1093/gerona/glx003] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/03/2017] [Indexed: 11/14/2022] Open
Abstract
Background Prospective studies in the general population show that slow gait speed is associated with cognitive decline and clinical progression to dementia. However, longitudinal studies in memory clinic populations are mostly lacking. We aimed to study the association between gait speed and grip strength and cognitive functioning at baseline and cognitive decline over time in memory clinic patients with subjective cognitive decline and mild cognitive impairment. Methods We included 309 patients (age 70 ± 9 years, 108 [35%] women, Mini-Mental State Examination 27 ± 3 points). Baseline gait speed was assessed over 15 feet, grip strength with a hydraulic hand dynamometer. Cognitive functioning was assessed annually with a comprehensive test battery during 3 years. Results Age- and gender-adjusted linear mixed models showed that slower gait speed was related to worse baseline attention, memory, information processing speed, and verbal fluency. Longitudinally, gait speed was related to decline in information processing speed and executive functioning. Weaker grip strength was related to worse baseline information processing speed and executive functioning but there were no longitudinal associations. Cox proportional hazards models revealed no significant associations with clinical progression. Conclusions Our findings suggest that markers of physical performance are related to current cognitive status and modestly related to cognitive decline but are seemingly not useful as an early marker of incident clinical progression.
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Affiliation(s)
- Astrid M Hooghiemstra
- Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.,Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Inez H G B Ramakers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
| | - Nicole Sistermans
- Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands
| | - Pauline Aalten
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
| | - Renske E G Hamel
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
| | - René J F Melis
- Department of Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, VU University Medical Center, The Netherlands
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Hobert MA, Meyer SI, Hasmann SE, Metzger FG, Suenkel U, Eschweiler GW, Berg D, Maetzler W. Gait Is Associated with Cognitive Flexibility: A Dual-Tasking Study in Healthy Older People. Front Aging Neurosci 2017; 9:154. [PMID: 28596731 PMCID: PMC5442228 DOI: 10.3389/fnagi.2017.00154] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 05/04/2017] [Indexed: 01/06/2023] Open
Abstract
Objectives: To analyze which gait parameters are primarily influenced by cognitive flexibility, and whether such an effect depends on the walking condition used. Design: Cross-sectional analysis. Setting: Tübingen evaluation of Risk factors for Early detection of Neurodegenerative Disorders. Participants: A total of 661 non-demented individuals (49–80 years). Measurements: A gait assessment with four conditions was performed: a 20 m walk at convenient speed (C), at fast speed (F), at fast speed while checking boxes (FB), and while subtracting serial 7s (FS). Seven gait parameters from a wearable sensor-unit (McRoberts, Netherlands) were compared with delta Trail-Making-Test (dTMT) values, which is a measure of cognitive flexibility. Walking strategies of good and poor dTMT performers were compared by evaluating the patterns of gait parameters across conditions. Results: Five parameters correlated significantly with the dTMT in the FS condition, two parameters in the F and FB condition, and none in the C condition. Overall correlations were relatively weak. Gait speed was the gait parameter that most strongly correlated with the dTMT (r2 = 7.4%). In good, but not poor, dTMT performers differences between FB and FS were significantly different in variability-associated gait parameters. Conclusion: Older individuals need cognitive flexibility to perform difficult walking conditions. This association is best seen in gait speed. New and particularly relevant for recognition and training of deficits is that older individuals with poor cognitive flexibility have obviously fewer resources to adapt to challenging walking conditions. Our findings partially explain gait deficits in older adults with poor cognitive flexibility.
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Affiliation(s)
- Markus A Hobert
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany.,Department of Neurology, University of KielKiel, Germany
| | - Sinja I Meyer
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany
| | - Sandra E Hasmann
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany
| | - Florian G Metzger
- Department of Psychiatry and PsychotherapyUniversity Hospital Tübingen, Tübingen, Germany.,Geriatric Center, University of TübingenTübingen, Germany
| | - Ulrike Suenkel
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and PsychotherapyUniversity Hospital Tübingen, Tübingen, Germany.,Geriatric Center, University of TübingenTübingen, Germany
| | - Daniela Berg
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany.,Department of Neurology, University of KielKiel, Germany
| | - Walter Maetzler
- Center for Neurology and Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TübingenTübingen, Germany.,DZNE, German Center for Neurodegenerative DiseasesTübingen, Germany.,Department of Neurology, University of KielKiel, Germany.,Geriatric Center, University of TübingenTübingen, Germany
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Gonzales JU, James CR, Yang HS, Jensen D, Atkins L, Al-Khalil K, O'Boyle M. Carotid flow pulsatility is higher in women with greater decrement in gait speed during multi-tasking. Gait Posture 2017; 54:271-276. [PMID: 28371741 DOI: 10.1016/j.gaitpost.2017.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/07/2017] [Accepted: 03/23/2017] [Indexed: 02/02/2023]
Abstract
AIM Central arterial hemodynamics is associated with cognitive impairment. Reductions in gait speed during walking while performing concurrent tasks known as dual-tasking (DT) or multi-tasking (MT) is thought to reflect the cognitive cost that exceeds neural capacity to share resources. We hypothesized that central vascular function would associate with decrements in gait speed during DT or MT. METHODS Gait speed was measured using a motion capture system in 56 women (30-80y) without mild-cognitive impairment. Dual-tasking was considered walking at a fast-pace while balancing a tray. Multi-tasking was the DT condition plus subtracting by serial 7's. Applanation tonometry was used for measurement of aortic stiffness and central pulse pressure. Doppler-ultrasound was used to measure blood flow velocity and β-stiffness index in the common carotid artery. RESULTS The percent change in gait speed was larger for MT than DT (14.1±11.2 vs. 8.7±9.6%, p <0.01). Tertiles were formed based on the percent change in gait speed for each condition. No vascular parameters differed across tertiles for DT. In contrast, carotid flow pulsatility (1.85±0.43 vs. 1.47±0.42, p=0.02) and resistance (0.75±0.07 vs. 0.68±0.07, p=0.01) indices were higher in women with more decrement (third tertile) as compared to women with less decrement (first tertile) in gait speed during MT after adjusting for age, gait speed, and task error. Carotid pulse pressure and β-stiffness did not contribute to these tertile differences. CONCLUSION Elevated carotid flow pulsatility and resistance are characteristics found in healthy women that show lower cognitive capacity to walk and perform multiple concurrent tasks.
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Affiliation(s)
- Joaquin U Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
| | - C Roger James
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Hyung Suk Yang
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Daniel Jensen
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Lee Atkins
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kareem Al-Khalil
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
| | - Michael O'Boyle
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
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Salkovic D, Hobert MA, Bellut C, Funer F, Renno S, Haertner L, Hasmann SE, Staebler J, Geritz J, Suenkel U, Fallgatter AJ, Eschweiler GW, Berg D, Maetzler W. Evidence for a Selectively Regulated Prioritization Shift Depending on Walking Situations in Older Adults. Front Aging Neurosci 2017; 9:75. [PMID: 28420979 PMCID: PMC5378715 DOI: 10.3389/fnagi.2017.00075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 03/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Older adults have increased risks of balance issues and falls when walking and performing turns in daily situations. Changes of prioritization during different walking situations associated with dual tasking may contribute to these deficits. The objective of this study was therefore to investigate whether older adults demonstrate changes of prioritization during different walking paths. Methods: In total, 1,054 subjects with an age range from 50 to 83 years were selected from the first follow-up visit of the TREND (Tuebinger evaluation of Risk factors for Early detection of Neurodegenerative Disorders) study. They were classified according to their performance on the Trail Making Test (TMT) into good and poor TMT performers (based on recent results showing that cognitive flexibility affects prioritization strategies during straight walking). Absolute dual-task performance and relative dual-task costs (DTC, relative performance under dual-task conditions compared with single-task conditions) were assessed in two paradigms: walking while subtracting serial 7 s and walking while checking boxes on a clipboard. Both tasks were performed on straight and curved paths. Results: Overall, the poor TMT performers group performed worse in all single and dual tasks. Interestingly, the relative change in performance measured by dual-task costs differed in the groups between the two walking paths. On straight paths, poor TMT performers had a similar DTC of walking to that of good performers (p = 0.10) but had a significantly lower DTC of subtracting (p = 0.02). On curved paths, poor performers had a similar DTC of subtracting (p = 0.10), but their DTC of walking was significantly higher (p < 0.0001). Conclusion: Given that walking on curved paths is considered more difficult than that on straight paths and that the serial subtracting dual task is more difficult than the box checking dual task, this study in older adults provides evidence for the existence of a (walking) situation-dependent change of prioritization. If confirmed in other studies, situation-dependent change of prioritization should be included as a potential factor contributing to gait and balance impairments, and increased fall risk in older adults.
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Affiliation(s)
- Dina Salkovic
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Markus A Hobert
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany.,Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Carolin Bellut
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Florian Funer
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Sarah Renno
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Linda Haertner
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Sandra E Hasmann
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Jana Staebler
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Johanna Geritz
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Ulrike Suenkel
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany
| | | | - Gerhard W Eschweiler
- Department of Psychiatry, University of TuebingenTuebingen, Germany.,Geriatric Center, University of TuebingenTuebingen, Germany
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany.,Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany.,German Center for Neurodegenerative DiseasesTuebingen, Germany.,Department of Neurology, Christian-Albrechts-UniversityKiel, Germany.,Geriatric Center, University of TuebingenTuebingen, Germany
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MacDonald SWS, Hundza S, Love JA, DeCarlo CA, Halliday DWR, Brewster PWH, Lukyn TV, Camicioli R, Dixon RA. Concurrent Indicators of Gait Velocity and Variability Are Associated with 25-Year Cognitive Change: A Retrospective Longitudinal Investigation. Front Aging Neurosci 2017; 9:17. [PMID: 28243199 PMCID: PMC5303746 DOI: 10.3389/fnagi.2017.00017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/20/2017] [Indexed: 11/28/2022] Open
Abstract
Background/Objectives: Physical function indicators, including gait velocity, stride time and step length, are linked to neural and cognitive function, morbidity and mortality. Whereas cross-sectional associations are well documented, far less is known about long-term patterns of cognitive change as related to objective indicators of mobility-related physical function. Methods: Using data from the Victoria Longitudinal Study, a long-term investigation of biological and health aspects of aging and cognition, we examined three aspects of cognition-physical function linkages in 121 older adults. First, we examined a simple marker of physical function (3 m timed-walk) as a predictor of cross-sectional differences and up to 25-year change for four indicators of cognitive function. Second, we tested associations between two markers of gait function derived from the GAITRite system (velocity and stride-time variability) and differences and change in cognition. Finally, we evaluated how increasing cognitive load during GAITRite assessment influenced the associations between gait and cognition. Results: The simple timed-walk measure, commonly used in clinical and research settings, was a minor predictor of change in cognitive function. In contrast, the objectively measured indicator of walking speed significantly moderated long-term cognitive change. Under increasing cognitive load, the moderating influence of velocity on cognitive change increased, with increasing variability in stride time also emerging as a predictor of age-related cognitive decline. Conclusion: These findings: (a) underscore the utility of gait as a proxy for biological vitality and for indexing long-term cognitive change; and (b) inform potential mechanisms underlying age-related linkages in physical and cognitive function.
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Affiliation(s)
- Stuart W S MacDonald
- Department of Psychology, University of VictoriaVictoria, BC, Canada; Institute of Aging and Lifelong Health, University of VictoriaVictoria, BC, Canada
| | - Sandra Hundza
- School of Exercise Science, University of Victoria Victoria, BC, Canada
| | - Janet A Love
- Department of Psychology, University of Victoria Victoria, BC, Canada
| | - Correne A DeCarlo
- Department of Psychology, University of VictoriaVictoria, BC, Canada; Institute of Aging and Lifelong Health, University of VictoriaVictoria, BC, Canada
| | - Drew W R Halliday
- Department of Psychology, University of VictoriaVictoria, BC, Canada; Institute of Aging and Lifelong Health, University of VictoriaVictoria, BC, Canada
| | - Paul W H Brewster
- Department of Psychology, University of VictoriaVictoria, BC, Canada; Institute of Aging and Lifelong Health, University of VictoriaVictoria, BC, Canada
| | - Timothy V Lukyn
- Department of Psychology, University of Victoria Victoria, BC, Canada
| | - Richard Camicioli
- Department of Medicine (Neurology), University of AlbertaEdmonton, AB, Canada; Neuroscience and Mental Health Institute, University of AlbertaEdmonton, AB, Canada
| | - Roger A Dixon
- Neuroscience and Mental Health Institute, University of AlbertaEdmonton, AB, Canada; Department of Psychology, University of AlbertaEdmonton, AB, Canada
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Auvinet B, Touzard C, Montestruc F, Delafond A, Goeb V. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. J Neuroeng Rehabil 2017; 14:7. [PMID: 28143497 PMCID: PMC5282774 DOI: 10.1186/s12984-017-0218-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 01/14/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach. METHODS An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi2 tests). RESULTS Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity allowed the identification of 3 motor phenotypes (p < 0.01), without any difference for white matter hyperintensities, but with an increased Scheltens score from the first to the third motor phenotype (p = 0.05). CONCLUSIONS Gait analysis under dual-task conditions in elderly people suffering from gait disorders or memory impairment is of great value in assessing the severity of gait disorders, differentiating between peripheral pathologies and central nervous system pathologies, and identifying motor phenotypes. Correlations between motor phenotypes and brain imaging require further studies.
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Affiliation(s)
- Bernard Auvinet
- Rheumalogy Unit, Polyclinique du Maine, 4 Avenue des Français Libres, F 53010 Laval, France
| | - Claude Touzard
- Geontology Unit, Centre Hospitalier de LAVAL, Rue du haut rocher, F 53000 Laval, France
| | | | - Arnaud Delafond
- Radiology Unit, Polyclinique du Maine, 4 Avenue des Français Libres, F 53000 Laval, France
| | - Vincent Goeb
- Rheumatology Department, University Hospital, F 80054 Amiens, France
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Wang N, Allali G, Kesavadas C, Noone ML, Pradeep VG, Blumen HM, Verghese J. Cerebral Small Vessel Disease and Motoric Cognitive Risk Syndrome: Results from the Kerala-Einstein Study. J Alzheimers Dis 2016; 50:699-707. [PMID: 26757037 DOI: 10.3233/jad-150523] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The contribution of cerebral small vessel disease to cognitive decline, especially in non-Caucasian populations, is not well established. OBJECTIVE We examined the relationship between cerebral small vessel disease and motoric cognitive risk syndrome (MCR), a recently described pre-dementia syndrome, in Indian seniors. METHODS 139 participants (mean age 66.6 ± 5.4 y, 33.1% female) participating in the Kerala-Einstein study in Southern India were examined in a cross-sectional study. The presence of cerebral small vessel disease (lacunar infarcts and cerebral microbleeds (CMB)) and white matter hyperintensities on MRI was ascertained by raters blinded to clinical information. MCR was defined by the presence of cognitive complaints and slow gait in older adults without dementia or mobility disability. RESULTS Thirty-eight (27.3%) participants met MCR criteria. The overall prevalence of lacunar infarcts and CMB was 49.6% and 9.4% , respectively. Lacunar infarcts in the frontal lobe, but no other brain regions, were associated with MCR even after adjusting for vascular risk factors and presence of white matter hyperintensities (adjusted Odds Ratio (aOR): 4.67, 95% CI: 1.69-12.94). Frontal lacunar infarcts were associated with slow gait (aOR: 3.98, 95% CI: 1.46-10.79) and poor performance on memory test (β: -1.24, 95% CI: -2.42 to -0.05), but not with cognitive complaints or non-memory tests. No association of CMB was found with MCR, individual MCR criterion or cognitive tests. CONCLUSIONS Frontal lacunar infarcts are associated with MCR in Indian seniors, perhaps, by contributing to slow gait and poor memory function.
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Affiliation(s)
- Nan Wang
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gilles Allali
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Chandrasekharan Kesavadas
- Department of Imaging Science and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Mohan L Noone
- Department of Neurology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Vayyattu G Pradeep
- Department of Neurology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Helena M Blumen
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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A systematic review and meta-analysis of cross-sectional studies examining the relationship between mobility and cognition in healthy older adults. Gait Posture 2016; 50:164-174. [PMID: 27621086 PMCID: PMC5081060 DOI: 10.1016/j.gaitpost.2016.08.028] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/15/2016] [Accepted: 08/25/2016] [Indexed: 02/02/2023]
Abstract
Ageing is associated with declines in cognitive function and mobility. The extent to which this relationship encompasses the subdomains of cognition and mobility remains unclear, however. We searched MEDLINE and EMBASE databases for cross-sectional studies examining the association between objective mobility measures (gait, lower-extremity function, balance) and cognitive function (global, executive function, memory, processing speed) in healthy older adults. Of the 642 studies identified, 26 studies met the inclusion criteria, with a total of 26,355 participants. For each feature of physical mobility, the relation to each aspect of cognition was reviewed. In the context of each association, we summarised the results to date and performed random-effects meta-analyses of published data. Reviewed findings suggest that individuals with better mobility perform better on assessments of global cognition, executive function, memory and processing speed. Not all measures of mobility were equally associated with cognitive function, however. Although there was a larger number of gait and lower-extremity function studies, and this may have driven findings, most studies examining balance and cognition measures reported no significant results. Meta-analyses on reported associations supported results by revealing significant, albeit small, effect sizes in favour of a positive association between performance on mobility measures and cognitive assessments. Future research should aim to establish the mechanisms driving this relationship, as this may identify predictors of age-related impairments.
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40
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Gonzales JU, James CR, Yang HS, Jensen D, Atkins L, Thompson BJ, Al-Khalil K, O'Boyle M. Different cognitive functions discriminate gait performance in younger and older women: A pilot study. Gait Posture 2016; 50:89-95. [PMID: 27585184 DOI: 10.1016/j.gaitpost.2016.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/28/2016] [Accepted: 08/22/2016] [Indexed: 02/02/2023]
Abstract
AIM Cognitive dysfunction is associated with slower gait speed in older women, but whether cognitive function affects gait performance earlier in life has yet to be investigated. Thus, the objective of this study was to test the hypothesis that cognitive function will discriminate gait performance in healthy younger women. METHODS Fast-pace and dual-task gait speed were measured in 30 young to middle-aged (30-45y) and 26 older (61-80y) women without mild cognitive impairment. Visuoperceptual ability, working memory, executive function, and learning ability were assessed using neuropsychological tests. Within each age group, women were divided by the median into lower and higher cognitive function groups to compare gait performance. RESULTS Younger women with higher visuoperceptual ability had faster fast-pace (2.25±0.30 vs. 1.98±0.18m/s, p≤0.01) and dual-task gait speed (2.02±0.27 vs. 1.69±0.25m/s, p≤0.01) than women with lower visuoperceptual ability. The difference in dual-task gait speed remained significant (p=0.02) after adjusting for age, years of education, and other covariates. Dividing younger women based on other cognitive domains showed no difference in gait performance. In contrast, working memory and executive function discriminated dual-task gait speed (p<0.05) in older women after adjusting for age and education. CONCLUSION To our knowledge, this is the first study to show that poorer cognitive function even at a relatively young age can negatively impact mobility. Different cognitive functions discriminated gait performance based on age, highlighting a possible influence of aging in the relationship between cognitive function and mobility in women.
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Affiliation(s)
- Joaquin U Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, P.O. Box 43011, Lubbock, TX, 79409-3011, USA.
| | - C Roger James
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Hyung Suk Yang
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Daniel Jensen
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Lee Atkins
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Brennan J Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA
| | - Kareem Al-Khalil
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
| | - Michael O'Boyle
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA
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Gross AL, Xue QL, Bandeen-Roche K, Fried LP, Varadhan R, McAdams-DeMarco MA, Walston J, Carlson MC. Declines and Impairment in Executive Function Predict Onset of Physical Frailty. J Gerontol A Biol Sci Med Sci 2016; 71:1624-1630. [PMID: 27084314 DOI: 10.1093/gerona/glw067] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 03/20/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Clinical cognitive impairment and physical frailty often co-occur. However, it is unclear whether preclinical impairment or decline in cognitive domains are associated with onset of physical frailty. We tested this hypothesis and further hypothesized that preclinical impairment and decline in executive functioning are more strongly associated with frailty onset than memory or general cognitive performance. METHODS We used 9 years of data from the Women's Health and Aging Study II (six visits) that longitudinally measured psychomotor speed and executive functioning using the Trail Making Test, parts A and B, respectively, and immediate and delayed word-list recall from the Hopkins Verbal Learning Test. We used Cox proportional hazards models to regress time to frailty on indicators for impairment on these cognitive tests and on rates of change of the tests. Models adjusted for depressive symptoms, age, years of education, and race. RESULTS Of the 331 women initially free of dementia and frailty, 44 (13%) developed frailty. A binary indicator of impaired executive functioning (Trail Making Test, part B [TMT-B]) was most strongly associated with hazard, or risk, of frailty onset (hazard ratio [HR] = 3.3, 95% confidence interval [CI] = 1.4, 7.6) after adjustment for covariates and other tests. Adjusting for baseline cognitive performance, faster deterioration on TMT-B (HR = 0.6, 95% CI = 0.4, 1.0) was additionally associated with hazard of frailty onset. CONCLUSIONS Findings inform the association of executive functioning with transitions to frailty, suggesting both impairments in and declines in executive functioning are associated with risk of frailty onset. It remains to be determined whether these associations are causal or whether shared aging related or other mechanisms are involved.
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Affiliation(s)
- Alden L Gross
- Department of Epidemiology, .,Department of Mental Health
| | - Qian-Li Xue
- Department of Epidemiology.,Division of Geriatric Medicine and Gerontology, Department of Medicine, and.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Karen Bandeen-Roche
- Division of Geriatric Medicine and Gerontology, Department of Medicine, and.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Linda P Fried
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York
| | - Ravi Varadhan
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Care Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Jeremy Walston
- Division of Geriatric Medicine and Gerontology, Department of Medicine, and
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42
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Zettel-Watson L, Suen M, Wehbe L, Rutledge DN, Cherry BJ. Aging well: Processing speed inhibition and working memory related to balance and aerobic endurance. Geriatr Gerontol Int 2015; 17:108-115. [DOI: 10.1111/ggi.12682] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Laura Zettel-Watson
- Department of Psychology; California State University; Fullerton California USA
- Gerontology Academic Program; California State University; Fullerton California USA
| | - Meagan Suen
- Department of Psychology; California State University; Fullerton California USA
| | - Lara Wehbe
- Department of Psychology; California State University; Fullerton California USA
| | - Dana N Rutledge
- School of Nursing; California State University; Fullerton California USA
| | - Barbara J Cherry
- Department of Psychology; California State University; Fullerton California USA
- Gerontology Academic Program; California State University; Fullerton California USA
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43
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The aging brain shows less flexible reallocation of cognitive resources during dual-task walking: A mobile brain/body imaging (MoBI) study. Neuroimage 2015; 117:230-42. [PMID: 25988225 DOI: 10.1016/j.neuroimage.2015.05.028] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/11/2015] [Accepted: 05/11/2015] [Indexed: 11/23/2022] Open
Abstract
Aging is associated with reduced abilities to selectively allocate attention across multiple domains. This may be particularly problematic during everyday multitasking situations when cognitively demanding tasks are performed while walking. Due to previous limitations in neuroimaging technology, much remains unknown about the cortical mechanisms underlying resource allocation during locomotion. Here, we utilized an EEG-based mobile brain/body imaging (MoBI) technique that integrates high-density event-related potential (ERP) recordings with simultaneously acquired foot-force sensor data to monitor gait patterns and brain activity concurrently. To assess effects of motor load on cognition we evaluated young (N=17; mean age=27.2) and older adults (N=16; mean age=63.9) and compared behavioral and ERP measures associated with performing a Go/No-Go response inhibition task as participants sat stationary or walked on a treadmill. Stride time and variability were also measured during task performance and compared to stride parameters obtained without task performance, thereby assessing effects of cognitive load on gait. Results showed that older, but not young adults' accuracy dropped significantly when performing the inhibitory task while walking. Young adults revealed ERP modulations at relatively early (N2 amplitude reduction) and later (earlier P3 latency) stages within the processing stream as motor load increased while walking. In contrast, older adults' ERP modulations were limited to later processing stages (increased P3 amplitude) of the inhibitory network. The relative delay and attenuation of ERP modulations accompanied by behavioral costs in older participants might indicate an age-associated loss in flexible resource allocation across multiple tasks. Better understanding of the neural underpinnings of these age-related changes may lead to improved strategies to reduce fall risk and enhance mobility in aging.
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44
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Walshe EA, Patterson MR, Commins S, Roche RAP. Dual-task and electrophysiological markers of executive cognitive processing in older adult gait and fall-risk. Front Hum Neurosci 2015; 9:200. [PMID: 25941481 PMCID: PMC4400911 DOI: 10.3389/fnhum.2015.00200] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/26/2015] [Indexed: 11/13/2022] Open
Abstract
The role of cognition is becoming increasingly central to our understanding of the complexity of walking gait. In particular, higher-level executive functions are suggested to play a key role in gait and fall-risk, but the specific underlying neurocognitive processes remain unclear. Here, we report two experiments which investigated the cognitive and neural processes underlying older adult gait and falls. Experiment 1 employed a dual-task (DT) paradigm in young and older adults, to assess the relative effects of higher-level executive function tasks (n-Back, Serial Subtraction and visuo-spatial Clock task) in comparison to non-executive distracter tasks (motor response task and alphabet recitation) on gait. All DTs elicited changes in gait for both young and older adults, relative to baseline walking. Significantly greater DT costs were observed for the executive tasks in the older adult group. Experiment 2 compared normal walking gait, seated cognitive performances and concurrent event-related brain potentials (ERPs) in healthy young and older adults, to older adult fallers. No significant differences in cognitive performances were found between fallers and non-fallers. However, an initial late-positivity, considered a potential early P3a, was evident on the Stroop task for older non-fallers, which was notably absent in older fallers. We argue that executive control functions play a prominent role in walking and gait, but the use of neurocognitive processes as a predictor of fall-risk needs further investigation.
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Affiliation(s)
- Elizabeth A Walshe
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
| | - Matthew R Patterson
- Insight Center for Data Analytics, University College Dublin Dublin, Ireland
| | - Seán Commins
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
| | - Richard A P Roche
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
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45
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García-Mesa Y, Colie S, Corpas R, Cristòfol R, Comellas F, Nebreda AR, Giménez-Llort L, Sanfeliu C. Oxidative Stress Is a Central Target for Physical Exercise Neuroprotection Against Pathological Brain Aging. J Gerontol A Biol Sci Med Sci 2015; 71:40-9. [PMID: 25720862 DOI: 10.1093/gerona/glv005] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 01/08/2015] [Indexed: 01/09/2023] Open
Abstract
Physical exercise is suggested for preventing or delaying senescence and Alzheimer's disease (AD). We have examined its therapeutic value in the advanced stage of AD-like pathology in 3xTg-AD female mice through voluntary wheel running from 12 to 15 months of age. Mice submitted to exercise showed improved body fitness, immunorejuvenation, improvement of behavior and cognition, and reduced amyloid and tau pathology. Brain tissue analysis of aged 3xTg-AD mice showed high levels of oxidative damage. However, this damage was decreased by physical exercise through regulation of redox homeostasis. Network analyses showed that oxidative stress was a central event, which correlated with AD-like pathology and the AD-related behaviors of anxiety, apathy, and cognitive loss. This study corroborates the importance of redox mechanisms in the neuroprotective effect of physical exercise, and supports the theory of the crucial role of oxidative stress in the switch from normal brain aging to pathological aging and AD.
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Affiliation(s)
- Yoelvis García-Mesa
- Institut d'Investigacions Biomèdiques de Barcelona - CSIC, Spain. Present address: Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sandra Colie
- Signalling and Cell Cycle Laboratory, Institute for Research in Biomedicine, Barcelona, Spain
| | - Rubén Corpas
- Institut d'Investigacions Biomèdiques de Barcelona - CSIC, Spain
| | - Rosa Cristòfol
- Institut d'Investigacions Biomèdiques de Barcelona - CSIC, Spain
| | - Francesc Comellas
- Department of Applied Mathematics IV, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Angel R Nebreda
- Signalling and Cell Cycle Laboratory, Institute for Research in Biomedicine, Barcelona, Spain. Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Lydia Giménez-Llort
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neuroscience, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Coral Sanfeliu
- Institut d'Investigacions Biomèdiques de Barcelona - CSIC, Spain. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
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