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Marino FR, Deal JA, Dougherty RJ, Bilgel M, Tian Q, An Y, Simonsick EM, Resnick SM, Ferrucci L, Spira AP, Wanigatunga AA, Schrack JA. Differences in Daily Physical Activity by Alzheimer's Risk Markers Among Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae119. [PMID: 38742659 PMCID: PMC11157965 DOI: 10.1093/gerona/glae119] [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: 01/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Daily physical activity patterns differ by Alzheimer's disease (AD) status and might signal cognitive risk. It is critical to understand whether patterns are disrupted early in the AD pathological process. Yet, whether established AD risk markers (β-amyloid [Aβ] or apolipoprotein E-ε4 [APOE-ε4]) are associated with differences in objectively measured activity patterns among cognitively unimpaired older adults is unclear. METHODS Wrist accelerometry, brain Aβ (+/-), and APOE-ε4 genotype were collected in 106 (Aβ) and 472 (APOE-ε4) participants (mean age 76 [standard deviation{SD}: 8.5) or 75 [SD: 9.2] years, 60% or 58% women) in the Baltimore Longitudinal Study of Aging. Adjusted linear and function-on-scalar regression models examined whether Aβ or APOE-ε4 status was cross-sectionally associated with activity patterns (amount, variability, or fragmentation) overall and by time of day, respectively. Differences in activity patterns by combinations of Aβ and APOE-ε4 status were descriptively examined (n = 105). RESULTS There were no differences in any activity pattern by Aβ or APOE-ε4 status overall. Aβ+ was associated with lower total amount and lower within-day variability of physical activity overnight and early evening, and APOE-ε4 carriers had higher total amount of activity in the evening and lower within-day variability of activity in the morning. Diurnal curves of activity were blunted among those with Aβ+ regardless of APOE-ε4 status, but only when including older adults with mild cognitive impairment/dementia. CONCLUSIONS Aβ+ in cognitively unimpaired older adults might manifest as lower amount and variability of daily physical activity, particularly during overnight/evening hours. Future research is needed to examine changes in activity patterns in larger samples and by other AD biomarkers.
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Affiliation(s)
- Francesca R Marino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Murat Bilgel
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Yang An
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Adam P Spira
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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2
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Čepukaitytė G, Newton C, Chan D. Early detection of diseases causing dementia using digital navigation and gait measures: A systematic review of evidence. Alzheimers Dement 2024; 20:3054-3073. [PMID: 38425234 PMCID: PMC11032572 DOI: 10.1002/alz.13716] [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: 08/14/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024]
Abstract
Wearable digital technologies capable of measuring everyday behaviors could improve the early detection of dementia-causing diseases. We conducted two systematic reviews following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to establish the evidence base for measuring navigation and gait, two everyday behaviors affected early in AD and non-AD disorders and not adequately measured in current practice. PubMed and Web of Science databases were searched for studies on asymptomatic and early-stage symptomatic individuals at risk of dementia, with the Newcastle-Ottawa Scale used to assess bias and evaluate methodological quality. Of 316 navigation and 2086 gait records identified, 27 and 83, respectively, were included in the final sample. We highlight several measures that may identify at-risk individuals, whose quantifiability with different devices mitigates the risk of future technological obsolescence. Beyond navigation and gait, this review also provides the framework for evaluating the evidence base for future digital measures of behaviors considered for early disease detection.
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3
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Chen PH, Lin SI, Liao YY, Hsu WL, Cheng FY. Associations between blood-based biomarkers of Alzheimer's disease with cognition in motoric cognitive risk syndrome: A pilot study using plasma Aβ42 and total tau. Front Aging Neurosci 2022; 14:981632. [PMID: 36268195 PMCID: PMC9577229 DOI: 10.3389/fnagi.2022.981632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023] Open
Abstract
Background Motoric cognitive risk (MCR) syndrome is a conceptual construct that combines slow gait speed with subjective cognitive complaints and has been shown to be associated with an increased risk of developing dementia. However, the relationships between the pathology of Alzheimer's disease (AD) and MCR syndrome remain uncertain. Therefore, the purpose of this study was to determine the levels of plasma AD biomarkers (Aβ42 and total tau) and their relationships with cognition in individuals with MCR. Materials and methods This was a cross-sectional pilot study that enrolled 25 individuals with normal cognition (NC), 27 with MCR, and 16 with AD. Plasma Aβ42 and total tau (t-tau) levels were measured using immunomagnetic reduction (IMR) assays. A comprehensive neuropsychological assessment was also performed. Results The levels of plasma t-tau proteins did not differ significantly between the MCR and AD groups, but that of plasma t-tau was significantly increased in the MCR and AD groups, compared to the NC group. Visuospatial performance was significantly lower in the MCR group than in the NC group. The levels of plasma t-tau correlated significantly with the Montreal Cognitive Assessment (MoCA) and Boston naming test scores in the MCR group. Conclusion In this pilot study, we found significantly increased plasma t-tau proteins in the MCR and AD groups, compared with the NC group. The plasma t-tau levels were also significantly correlated with the cognitive function of older adults with MCR. These results implied that MCR and AD may share similar pathology. However, these findings need further confirmation in longitudinal studies.
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Affiliation(s)
- Pei-Hao Chen
- Department of Neurology, MacKay Memorial Hospital, Taipei, Taiwan,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan,Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Sang-I Lin
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Ling Hsu
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan,Center of Dementia Care, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan,*Correspondence: Fang-Yu Cheng,
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4
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Doan DNT, Ku B, Kim K, Jun M, Choi KY, Lee KH, Kim JU. Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment. Front Nutr 2022; 9:873623. [PMID: 35719147 PMCID: PMC9201435 DOI: 10.3389/fnut.2022.873623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To examine the changes in body composition, water compartment, and bioimpedance in mild cognitive impairment (MCI) individuals. Methods We obtained seven whole-body composition variables and seven pairs of segmental body composition, water compartment, and impedance variables for the upper and lower extremities from the segmental multi-frequency bioelectrical impedance analysis (BIA) of 939 elderly participants, including 673 cognitively normal (CN) people and 266 individuals with MCI. Participants’ characteristics, anthropometric information, and the selected BIA variables were described and statistically compared between the CN participants and those with MCI. The correlations between the selected BIA variables and neuropsychological tests such as the Korean version of the Mini-Mental State Examination and Seoul Neuropsychological Screening Battery – Second Edition were also examined before and after controlling for age and sex. Univariate and multivariate logistic regression analyses with estimated odds ratios (ORs) were conducted to investigate the associations between these BIA variables and MCI prevalence for different sexes. Results Participants with MCI were slightly older, more depressive, and had significantly poorer cognitive abilities when compared with the CN individuals. The partial correlations between the selected BIA variables and neuropsychological tests upon controlling for age and sex were not greatly significant. However, after accounting for age, sex, and the significant comorbidities, segmental lean mass, water volume, resistance, and reactance in the lower extremities were positively associated with MCI, with ORs [95% confidence interval (CI)] of 1.33 (1.02–1.71), 1.33 (1.03–1.72), 0.76 (0.62–0.92), and 0.79 (0.67–0.93), respectively; with presumably a shift of water from the intracellular area to extracellular space. After stratifying by sex, resistance and reactance in lower extremities remained significant only in the women group. Conclusion An increase in segmental water along with segmental lean mass and a decrease in body cell strength due to an abnormal cellular water distribution demonstrated by reductions in resistance and reactance are associated with MCI prevalence, which are more pronounced in the lower extremities and in women. These characteristic changes in BIA variables may be considered as an early sign of cognitive impairment in the elderly population.
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Affiliation(s)
- Dieu Ni Thi Doan
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
| | - Boncho Ku
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kahye Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Minho Jun
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Jaeuk U. Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
- *Correspondence: Jaeuk U. Kim,
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5
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Metabolites Associated with Memory and Gait: A Systematic Review. Metabolites 2022; 12:metabo12040356. [PMID: 35448544 PMCID: PMC9024701 DOI: 10.3390/metabo12040356] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 01/19/2023] Open
Abstract
We recently found that dual decline in memory and gait speed was consistently associated with an increased risk of dementia compared to decline in memory or gait only or no decline across six aging cohorts. The mechanisms underlying this relationship are unknown. We hypothesize that individuals who experience dual decline may have specific pathophysiological pathways to dementia which can be indicated by specific metabolomic signatures. Here, we summarize blood-based metabolites that are associated with memory and gait from existing literature and discuss their relevant pathways. A total of 39 eligible studies were included in this systematic review. Metabolites that were associated with memory and gait belonged to five shared classes: sphingolipids, fatty acids, phosphatidylcholines, amino acids, and biogenic amines. The sphingolipid metabolism pathway was found to be enriched in both memory and gait impairments. Existing data may suggest that metabolites from sphingolipids and the sphingolipid metabolism pathway are important for both memory and gait impairments. Future studies using empirical data across multiple cohorts are warranted to identify metabolomic signatures of dual decline in memory and gait and to further understand its relationship with future dementia risk.
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6
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Nakamura M, Imaoka M, Hashizume H, Tazaki F, Hida M, Nakao H, Omizu T, Kanemoto H, Takeda M. The beneficial effect of physical activity on cognitive function in community-dwelling older persons with locomotive syndrome. PeerJ 2021; 9:e12292. [PMID: 34721979 PMCID: PMC8522643 DOI: 10.7717/peerj.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 09/21/2021] [Indexed: 11/29/2022] Open
Abstract
Background Cognitive decline is closely related to motor decline. Locomotive syndrome (LS) is defined as a state associated with a high risk of requiring support because of locomotive organ disorders, and can be evaluated using a questionnaire. This study aimed to clarify the effectiveness of daily goal-targeted exercise on cognitive function in two different populations classified by scores on the Locomo 25 questionnaire. Methods Seventy community-dwelling older people who participated in a 13-week health class were divided into two populations based on Locomo 25 scores: <7 (non-LS) and ≥7 (LS). Participants were presented with a daily target steps and worked towards that goal. Cognitive function was evaluated using the Japanese version of Addenbrooke’s Cognitive Examination-Revised (ACE-R). Average daily physical activity (exercise [Ex]) for 13 weeks was measured using a portable activity meter. Depression status was assessed using the Geriatric Depression Scale (GDS-15). Results No significant differences were observed in age, years of education, body mass index, smooth muscle mass index, GDS-15 scores, or ACE-R scores between the non-LS and LS populations. Multiple logistic regression analysis showed that Ex (odds ratio = 5.01, p = 0.002) for 13 weeks was significantly associated with increased cognitive function in the LS population. The Ex threshold for the increase in cognitive function based on receiver operating curve analysis was 2.29 metabolic equivalents of task (METs) × h (METs · h/day) (p = 0.047) in the LS population. After 13 weeks, ACE-R scores were significantly higher in the Ex ≥ 2.29 than in the Ex < 2.29 METs · h/day group (p = 0.024, ηp2 = 0.241) in the LS population based on two-way analysis of covariance. Furthermore, a significant increase in the ACE-R memory domain was seen in the Ex ≥ 2.29 group (p = 0.035, ηp2 = 0.213). Conclusions These results suggest that Ex ≥ 2.29 METs · h/day is important for improving cognitive function in LS populations.
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Affiliation(s)
- Misa Nakamura
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Masakazu Imaoka
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.,School of Health and Nursing Science, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Fumie Tazaki
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Mitsumasa Hida
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Hidetoshi Nakao
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Tomoko Omizu
- Department of Health and Medical Science, Kansai University of Welfare Sciences, Kashiwara, Osaka, Japan
| | - Hideki Kanemoto
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masatoshi Takeda
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
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Sullivan KJ, Ranadive R, Su D, Neyland BR, Hughes TM, Hugenschmidt CE, Lockhart SN, Wong DF, Jack CR, Gottesman RF, Mosley TH, Griswold ME, Windham BG. Imaging-based indices of Neuropathology and gait speed decline in older adults: the atherosclerosis risk in communities study. Brain Imaging Behav 2021; 15:2387-2396. [PMID: 33439369 PMCID: PMC9189901 DOI: 10.1007/s11682-020-00435-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 02/01/2023]
Abstract
Imaging markers of cerebrovascular disease and Alzheimer's disease (AD) are implicated in mobility impairment in older adults, but few studies have examined these relationships longitudinally in a racially-diverse population-based sample. At Visit 5 (2011-13) of the ARIC Study, 1859 participants had usual pace gait speed (cm/s) assessed and brain MRI (mean age = 76.3, 28.5% Black) and PET (n = 343; mean age = 75.9, 42.6% Black) measures including total/regional brain volume (cm3), white matter hyperintensities (WMH; cm3), infarcts (present/absent), microbleeds (count) and global beta-amyloid (Aβ). Participants returned at Visit 6 (n = 1264, 2016-17) and Visit 7 (n = 1108, 2018-19) for follow-up gait speed assessments. We used linear regression to estimate effects of baseline infarct presence, higher microbleed count, and a one interquartile range (IQR) poorer measures of continuous predictors (-1 IQR total brain volume, temporal-parietal lobe meta region of interest(ROI); +1 IQR WMH volume, global Aβ SUVR) on cross-sectional gait speed and change in gait speed adjusting for age, sex, education, study site, APOE e4, estimated intracranial volume, BMI, and cardiovascular risk factors. Cross-sectionally, slower gait speed outcome was associated with higher WMH volume, -3.38 cm/s (95%CI:-4.71, -2.04), infarct presence, -5.60 cm/s (-7.69, -3.51), microbleed count, -2.20 cm/s (-3.20, -0.91), smaller total brain volume, -9.26 cm/s (-12.1, -6.43), and smaller temporal-parietal lobe ROI -6.28 cm/s (-8.28, -4.28). Longitudinally, faster gait speed outcome decline was associated with higher WMH volume, -0.27 cm/s/year, (-0.51, -0.03) and higher global Aβ SUVR, -0.62 cm/s/year (-1.20, -0.03). Both cerebrovascular and AD pathology may contribute to mobility decline commonly seen with aging.
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Affiliation(s)
- Kevin J Sullivan
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Radhikesh Ranadive
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Dan Su
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Blake R Neyland
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Samuel N Lockhart
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dean F Wong
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | | | - Rebecca F Gottesman
- Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA
- Department of Epidemiology, The Johns Hopkins University, Baltimore, MD, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Michael E Griswold
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - B Gwen Windham
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
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8
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Dougherty RJ, Ramachandran J, Liu F, An Y, Wanigatunga AA, Tian Q, Bilgel M, Simonsick EM, Ferrucci L, Resnick SM, Schrack JA. Association of walking energetics with amyloid beta status: Findings from the Baltimore Longitudinal Study of Aging. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12228. [PMID: 34458552 PMCID: PMC8377776 DOI: 10.1002/dad2.12228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Higher energetic costs for mobility predict gait speed decline. Slow gait is linked to cognitive decline and Alzheimer's disease (AD). Whether the energetic cost of walking is linked to AD pathology is unknown. We investigated the cross-sectional association between the energetic cost of walking, gait speed, and amyloid beta (Aβ) status (+/-) in older adults. METHODS One hundred forty-nine cognitively normal adults (56% women, mean age 77.5 ± 8.4 years) completed customary-paced walking assessments with indirect calorimetry and 11C-Pittsburgh compound B positron emission tomography. Logistic regression models examined associations adjusted for demographics, body composition, comorbid conditions, and apolipoprotein E ε4. RESULTS Each 0.01 mL/kg/m greater energy cost was associated with 18% higher odds of being Aβ+ (odds ratio [OR] = 1.18; 95% confidence interval [CI]: 1.04 to 1.34; P = .011). These findings were not observed when investigating gait speed (OR = 0.99; 95% CI: 0.97 to 1.01; P = .321). DISCUSSION High energetic cost of walking is linked to AD pathology and may be a potential target for therapeutic intervention.
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Affiliation(s)
- Ryan J. Dougherty
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Janani Ramachandran
- Departments of Epidemiology and BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Fangyu Liu
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Yang An
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
| | - Amal A. Wanigatunga
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Qu Tian
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
| | - Murat Bilgel
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
| | - Susan M. Resnick
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
| | - Jennifer A. Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Intramural Research Program, National Institute on AgingBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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9
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Pedrero-Chamizo R, Szoeke C, Dennerstein L, Campbell S. Influence of Physical Activity Levels and Functional Capacity on Brain β-Amyloid Deposition in Older Women. Front Aging Neurosci 2021; 13:697528. [PMID: 34305574 PMCID: PMC8300898 DOI: 10.3389/fnagi.2021.697528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
Physical activity (PA) and Alzheimer's disease are associated. However, how PA influences the cerebral β-amyloid (Aβ) burden remains unclear. The aim of this study was to determine if PA levels and/or functional capacity (FC) are associated with Aβ plaque deposition, and whether these associations differed according to APOE-ε4 genotype. A total of 117 women (69.7 ± 2.6 years; 33.3% APOE-ε4-carriers) from the Women's Healthy Ageing Project cohort (WHAP) were analyzed. PA was measured using the International Physical Activity Questionnaire and, FC was evaluated using the Timed Up and Go test (TUGt). Positron emission tomography with F-18 Florbetaben was carried out to assess cerebral Aβ burden, and quantified using standardized uptake value rations. The sample was split into PA and TUGt tertiles (T1, T2 and T3), and compared according to APOE-ε4 genotype (positive/negative). There were no significant differences in Aβ accumulation according to PA tertiles and APOE-ε4 genotype. Regarding FC, APOE-ε4+ participants in the first TUGt tertile (high performance) obtained significant lower Aβ accumulations compared with the other two tertiles (p < 0.05). Comparing between genotypes, greater Aβ depositions were found between T2 and T3 in APOE-ε4+ compared with those who were APOE-ε4– (p < 0.05). Values of TUGt ≥ 6.5 s (APOE-ε4+) and 8.5 s (APOE-ε4–) were associated with an increased risk of having higher Aβ retention. In conclusion, low performance in TUGt is associated with a negative effect on brain pathology with increasing cerebral Aβ depositions in older women who are APOE-ε4+. In physically active older women (> 600 METs·min/week), higher PA levels are not associated with reduction in Aβ depositions.
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Affiliation(s)
- Raquel Pedrero-Chamizo
- Department of Health and Human Performance, ImFINE Research Group, Universidad Politécnica de Madrid, Madrid, Spain.,Exercise and Health Spanish Research Net (EXERNET), Zaragoza, Spain
| | - Cassandra Szoeke
- Department of Medicine, Faculty of Medicine Dentistry and Health Sciences, Centre for Medical Research (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.,Australian Healthy Ageing Organisation, Parkville, VIC, Australia
| | | | - Stephen Campbell
- Australian Healthy Ageing Organisation, Parkville, VIC, Australia.,Melbourne Health, Royal Melbourne Hospital, Parkville, VIC, Australia
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10
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Semba RD, Tian Q, Carlson MC, Xue QL, Ferrucci L. Motoric cognitive risk syndrome: Integration of two early harbingers of dementia in older adults. Ageing Res Rev 2020; 58:101022. [PMID: 31996326 PMCID: PMC7697173 DOI: 10.1016/j.arr.2020.101022] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
Dementia is characterized by a long preclinical phase that may last years to decades before the onset of mild cognitive impairment. Slow gait speed and subjective memory complaint commonly co-occur during this preclinical phase, and each is a strong independent predictor of cognitive decline and dementia. Motoric cognitive risk (MCR) syndrome is a pre-dementia syndrome that combines these two early harbingers of dementia. The risk of cognitive decline or dementia is stronger for MCR than for either slow gait speed or subjective memory complaint alone. Slow gait speed and subjective memory complaint have several common risk factors: cardiovascular disease, diabetes mellitus, abnormal cortisol profiles, low vitamin D levels, brain atrophy with decreased hippocampal volume, and increased deposition of beta-amyloid in the brain. The underlying pathogenesis of MCR remains poorly understood. Metabolomics and proteomics have great potential to provide new insights into biological pathways involved in MCR during the long preclinical phase preceding dementia.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Qu Tian
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qian-Li Xue
- Departments of Medicine, Biostatistics, and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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Tian Q, Osawa Y, Resnick SM, Ferrucci L, Studenski SA. Rate of Muscle Contraction Is Associated With Cognition in Women, Not in Men. J Gerontol A Biol Sci Med Sci 2020; 74:714-719. [PMID: 29741590 DOI: 10.1093/gerona/gly115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In older persons, lower hand grip strength is associated with poorer cognition. Little is known about how the rate of muscle contraction relates to cognition and upper extremity motor function, and sex differences are understudied. METHODS Linear regression, adjusting for age, race, education, body mass index, appendicular lean mass, and knee pain, assessed sex-specific cross-sectional associations of peak torque, rate of torque development (RTD), and rate of velocity development (RVD) with cognition and upper extremity motor function. RESULTS In men (n = 447), higher rate-adjusted peak torque and a greater RVD were associated with faster simple finger tapping speed, and a greater RVD was associated with higher nondominant pegboard performance. In women (n = 447), higher peak torque was not associated with any measures, but a greater RTD was associated with faster simple tapping speed and higher language performance, and a greater RVD was associated with higher executive function, attention, memory, and nondominant pegboard performance. In women with low isokinetic peak torque, RVD was associated with attention and memory. CONCLUSIONS RVD capacity may reflect neural health, especially in women with low muscle strength.
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Affiliation(s)
- Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging
| | - Yusuke Osawa
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging
| | - Stephanie A Studenski
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging
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12
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Bassil F, Brown HJ, Pattabhiraman S, Iwasyk JE, Maghames CM, Meymand ES, Cox TO, Riddle DM, Zhang B, Trojanowski JQ, Lee VMY. Amyloid-Beta (Aβ) Plaques Promote Seeding and Spreading of Alpha-Synuclein and Tau in a Mouse Model of Lewy Body Disorders with Aβ Pathology. Neuron 2020; 105:260-275.e6. [PMID: 31759806 PMCID: PMC6981053 DOI: 10.1016/j.neuron.2019.10.010] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/12/2019] [Accepted: 10/03/2019] [Indexed: 12/17/2022]
Abstract
Studies have shown an overlap of Aβ plaques, tau tangles, and α-synuclein (α-syn) pathologies in the brains of Alzheimer's disease (AD) and Parkinson's disease (PD) with dementia (PDD) patients, with increased pathological burden correlating with severity of cognitive and motor symptoms. Despite the observed co-pathology and concomitance of motor and cognitive phenotypes, the consequences of the primary amyloidogenic protein on the secondary pathologies remain poorly understood. To better define the relationship between α-syn and Aβ plaques, we injected α-syn preformed fibrils (α-syn mpffs) into mice with abundant Aβ plaques. Aβ deposits dramatically accelerated α-syn pathogenesis and spread throughout the brain. Remarkably, hyperphosphorylated tau (p-tau) was induced in α-syn mpff-injected 5xFAD mice. Finally, α-syn mpff-injected 5xFAD mice showed neuron loss that correlated with the progressive decline of cognitive and motor performance. Our findings suggest a "feed-forward" mechanism whereby Aβ plaques enhance endogenous α-syn seeding and spreading over time post-injection with mpffs.
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Affiliation(s)
- Fares Bassil
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hannah J Brown
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shankar Pattabhiraman
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Joe E Iwasyk
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Chantal M Maghames
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Emily S Meymand
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Timothy O Cox
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dawn M Riddle
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Bin Zhang
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - John Q Trojanowski
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Virginia M-Y Lee
- The Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
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13
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Brinkley TE, Berger M, Callahan KE, Fieo RA, Jennings LA, Morris JK, Wilkins HM, Kritchevsky SB. Workshop on Synergies Between Alzheimer's Research and Clinical Gerontology and Geriatrics: Current Status and Future Directions. J Gerontol A Biol Sci Med Sci 2019; 73:1229-1237. [PMID: 29982466 PMCID: PMC6454460 DOI: 10.1093/gerona/gly041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 03/13/2018] [Indexed: 12/13/2022] Open
Abstract
Age is the strongest risk factor for physical disability and Alzheimer's disease (AD) and related dementias. As such, other aging-related risk factors are also shared by these two health conditions. However, clinical geriatrics and gerontology research has included cognition and depression in models of physical disability, with less attention to the pathophysiology of neurodegenerative disease. Similarly, AD research generally incorporates limited, if any, measures of physical function and mobility, and therefore often fails to consider the relevance of functional limitations in neurodegeneration. Accumulating evidence suggests that common pathways lead to physical disability and cognitive impairment, which jointly contribute to the aging phenotype. Collaborations between researchers focusing on the brain or body will be critical to developing, refining, and testing research paradigms emerging from a better understanding of the aging process and the interacting pathways contributing to both physical and cognitive disability. The National Institute of Aging sponsored a workshop to bring together the Claude D. Pepper Older Americans Independence Center and AD Center programs to explore areas of synergies between the research concerns of the two programs. This article summarizes the proceedings of the workshop and presents key gaps and research priorities at the intersection of AD and clinical aging research identified by the workshop participants.
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Affiliation(s)
- Tina E Brinkley
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Miles Berger
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Kathryn E Callahan
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Robert A Fieo
- Department of Geriatric Research, University of Florida, Gainesville
| | - Lee A Jennings
- Department of Geriatric Medicine, University of Oklahoma Health Sciences Center
| | - Jill K Morris
- Department of Neurology, Alzheimer's Disease Center, University of Kansas
| | - Heather M Wilkins
- Department of Neurology, Alzheimer's Disease Center, University of Kansas
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
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14
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Wennberg AMV, Lesnick TG, Schwarz CG, Savica R, Hagen CE, Roberts RO, Knopman DS, Hollman JH, Vemuri P, Jack CR, Petersen RC, Mielke MM. Longitudinal Association Between Brain Amyloid-Beta and Gait in the Mayo Clinic Study of Aging. J Gerontol A Biol Sci Med Sci 2019; 73:1244-1250. [PMID: 29236984 DOI: 10.1093/gerona/glx240] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 12/06/2017] [Indexed: 01/29/2023] Open
Abstract
Background The longitudinal association between cerebral amyloid-beta (Aβ) and change in gait, and whether this association is mediated by cortical thickness, has yet to be determined. Methods We included 439 clinically normal (CN) participants, aged 50-69 years and enrolled in the Mayo Clinic Study of Aging with cerebral Aβ, cortical thickness, and gait measurements. Cerebral Aβ deposition was assessed by Pittsburgh Compound B (PiB)-PET in multiple regions of interest (ROIs) (ie, frontal, orbitofrontal, parietal, temporal, anterior cingulate, posterior cingulate/precuneus, and motor). Cortical thickness was assessed on 3T MRI in corresponding ROIs. Gait parameters (gait speed, cadence, stride length, double support time, and covariance of stance time) were measured with GAITRite. Multivariate-adjusted two level structural equation models were used to examine the longitudinal association between PiB-PET, cortical thickness, and change in gait over a median 15.6 months. Results Higher PiB-PET in all ROIs was associated with decreasing cadence and increasing double support time, and in the temporal ROI was associated with declining gait speed. In sex-stratified analyses, higher PiB-PET in all ROIs was associated with declining performance on all gait parameters among women. In contrast, among men, the only association was with higher orbitofrontal ROI PiB-PET and declining cadence. None of the associations were mediated by cortical thickness or attenuated after adjustment of baseline cognition. Conclusion Higher PiB-PET was associated with declining gait, particularly among women in this middle-aged CN cohort, independent of cortical thickness and baseline cognitive. Elevated brain Aβ may play a critical role in age-related mobility decline.
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Affiliation(s)
| | - Timothy G Lesnick
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Rodolfo Savica
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Clinton E Hagen
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Rosebud O Roberts
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - John H Hollman
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | | | | | - Ronald C Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
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15
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Wilson J, Allcock L, Mc Ardle R, Taylor JP, Rochester L. The neural correlates of discrete gait characteristics in ageing: A structured review. Neurosci Biobehav Rev 2019; 100:344-369. [PMID: 30552912 PMCID: PMC6565843 DOI: 10.1016/j.neubiorev.2018.12.017] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/01/2018] [Accepted: 12/12/2018] [Indexed: 11/03/2022]
Abstract
Gait is complex, described by diverse characteristics underpinned by widespread central nervous system networks including motor and cognitive functions. Despite this, neural substrates of discrete gait characteristics are poorly understood, limiting understanding of gait impairment in ageing and disease. This structured review aims to map gait characteristics, defined from a pre-specified model reflecting independent gait domains, to brain imaging parameters in older adults. Fifty-two studies of 38,029 yielded were reviewed. Studies showed inconsistent approaches when mapping gait assessment to neural substrates, limiting conclusions. Gait impairments typically associated with brain deterioration, specifically grey matter atrophy and white matter integrity loss. Gait velocity, a global measure of gait control, was most frequently associated with these imaging markers within frontal and basal ganglia regions, and its decline predicted from white matter volume and integrity measurements. Fewer studies assessed additional gait measures or functional imaging parameters. Future studies mapping regional neuroanatomical and functional correlates of gait are needed, including those which take a multi-process network perspective to better understand mobility in health and disease.
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Affiliation(s)
- Joanna Wilson
- Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK
| | - Liesl Allcock
- Geriatric Medicine, Northumbria Healthcare Trust, UK
| | - Ríona Mc Ardle
- Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK
| | - Lynn Rochester
- Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK; Newcastle Upon Tyne Hospital NHS Foundation Trust, UK.
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16
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Buchman AS, Yu L, Wilson RS, Lim A, Dawe RJ, Gaiteri C, Leurgans SE, Schneider JA, Bennett DA. Physical activity, common brain pathologies, and cognition in community-dwelling older adults. Neurology 2019; 92:e811-e822. [PMID: 30651386 DOI: 10.1212/wnl.0000000000006954] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/16/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the associations of physical activity, Alzheimer disease (AD), and other brain pathologies and cognition in older adults. METHODS We studied 454 brain autopsies from decedents in a clinical-pathologic cohort study. Nineteen cognitive tests were summarized in a global cognitive score. Total daily physical activity summarized continuous multiday recordings of activity during everyday living in the community setting. A global motor ability score summarized 10 supervised motor performance tests. A series of regression analyses were used to examine associations of physical activity, AD, and other brain pathologies with global cognition proximate to death controlling for age, sex, education, and motor abilities. RESULTS Higher levels of total daily activity (estimate 0.148, 95% confidence interval 0.053-0.244, SE 0.049, p = 0.003) and better motor abilities (estimate 0.283, 95% confidence interval, 0.175-0.390, SE 0.055, p < 0.001) were independently associated with better cognition. These independent associations remained significant when terms for AD and other pathologies were added as well as in sensitivity analyses excluding cases with poor cognition or dementia. Adding interaction terms, the associations of total daily activity and motor abilities with cognition did not vary in individuals with and without dementia. The associations of AD and other pathologies with cognition did not vary with the levels of total daily activity or motor abilities. CONCLUSIONS Physical activity in older adults may provide cognitive reserve to maintain function independent of the accumulation of diverse brain pathologies. Further studies are needed to identify the molecular mechanisms underlying this potential reserve and to ensure the causal effects of physical activity.
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Affiliation(s)
- Aron S Buchman
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada.
| | - Lei Yu
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Robert S Wilson
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Andrew Lim
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Robert J Dawe
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Chris Gaiteri
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Sue E Leurgans
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Julie A Schneider
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - David A Bennett
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
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Abnormal CSF amyloid-β42 and tau levels in hip fracture patients without dementia. PLoS One 2018; 13:e0204695. [PMID: 30252906 PMCID: PMC6155555 DOI: 10.1371/journal.pone.0204695] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 09/12/2018] [Indexed: 11/29/2022] Open
Abstract
Background There is strong association of Alzheimer’s disease (AD) pathology with gait disorder and falls in older adults without dementia. The goal of the study was to examine the prevalence and severity of AD pathology in older adults without dementia who fall and sustain hip fracture. Methods Cerebrospinal fluid (CSF) was obtained from 168 hip fracture patients. CSF Aβ42/40 ratio, p-tau, and t-tau measures were dichotomized into normal vs. abnormal, and categorized according to the A/T/N classification. Results Among the hip fracture patients, 88.6% of the cognitively normal (Clinical Dementia Rating-CDR 0; n = 70) and 98.8% with mild cognitive impairment (CDR 0.5; n = 81) fell in the abnormal biomarker categories by the A/T/N classification. Conclusions A large proportion of older hip fracture patients have CSF evidence of AD pathology. Preoperative determination of AD biomarkers may play a crucial role in identifying persons without dementia who have underlying AD pathology in perioperative settings.
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18
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Buchman AS, Dawe RJ, Yu L, Lim A, Wilson RS, Schneider JA, Bennett DA. Brain pathology is related to total daily physical activity in older adults. Neurology 2018; 90:e1911-e1919. [PMID: 29695600 PMCID: PMC5962918 DOI: 10.1212/wnl.0000000000005552] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/05/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that brain pathology is associated with total daily physical activity proximate to death in older adults. METHODS We studied brain autopsies from 428 decedents of the Rush Memory and Aging Project. The quantity of all physical activity was measured continuously for up to 10 days with actigraphy (Actical; Philips Healthcare, Bend, OR). Multiple regression analyses controlling for age and sex were used to examine the relation of brain indexes to total daily physical activity and other clinical covariates proximate to death. RESULTS Average total daily activity was 1.53 × 105 counts/d (SD 1.14 × 105 counts/d), and mean age at death was 90.6 (SD 6.12) years. Nigral neuronal loss (estimate -0.232, standard error [SE] = 0.070, p = 0.001) and macroinfarcts (estimate -0.266, SE 0.112, p = 0.017) were independently associated with total daily physical activity proximate to death, accounting for an additional 2.4% of the variance of total daily activity. Other postmortem indexes (Alzheimer disease, Lewy bodies, TAR DNA-binding protein 43, hippocampal sclerosis, microinfarcts, atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy) were not associated with total daily activity. In 295 cases (70%), we derived a measure of white matter tissue integrity from postmortem brain MRI. This metric accounted for an additional 5.8% of the variance of total daily physical activity when controlling for age, sex, nigral neuronal loss, and macroinfarcts. CONCLUSION Macroinfarcts, nigral neuronal loss, and white matter pathologies are related to total daily physical activity in older adults, but further studies are needed to explain its pathologic basis more fully.
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Affiliation(s)
- Aron S Buchman
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada.
| | - Robert J Dawe
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
| | - Lei Yu
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
| | - Andrew Lim
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
| | - Robert S Wilson
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
| | - Julie A Schneider
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
| | - David A Bennett
- From the Rush Alzheimer's Disease Center (A.S.B., R.J.D., L.Y., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (A.S.B., L.Y., R.S.W., J.A.S., D.A.B.), Department of Radiology (R.J.D.), Department of Psychology (R.S.W.), and Department of Pathology (Neuropathology) (J.A.S.), Rush University Medical Center Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Ontario, Canada
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Tian Q, Bair WN, Resnick SM, Bilgel M, Wong DF, Studenski SA. β-amyloid deposition is associated with gait variability in usual aging. Gait Posture 2018; 61:346-352. [PMID: 29428714 PMCID: PMC5866772 DOI: 10.1016/j.gaitpost.2018.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/25/2018] [Accepted: 02/02/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Higher amyloid burden predicts gait slowing in aging. Whether and which gait characteristics are associated with amyloid burden is less clear. Gait variability may be more sensitive to amyloid burden than mean gait characteristics. METHODS In the Baltimore Longitudinal Study of Aging, 99 older participants without neurological disease had concurrent amyloid imaging and assessment of gait characteristics. β-amyloid burden was measured using 11C-Pittsburgh compound B (PiB) positron emission tomography. PiB+/- status was based on a mean cortical distribution volume ratio (DVR) cut point. Gait characteristics were quantified by 3D motion analysis. Cross-sectional associations of PiB+/- status and DVR in motor-related regions (primary motor cortex, putamen, caudate) with gait characteristics were examined using linear regression, adjusted for age, sex, height, body mass index, gait speed and covariates (memory, executive function, visuoperceptual speed, depressive symptoms, cardiovascular risk, ApoE ε4, cerebrovascular burden, neurodegeneration, peripheral arterial disease, knee pain). RESULTS Being PiB+ and higher DVR in motor-related regions were associated with greater gait speed variability, cadence variability, and gait cycle time variability but not with mean gait characteristics. Associations remained similar after adjustment for gait speed and covariates, except for memory, which attenuated associations of PiB+/- with cadence variability and gait cycle time variability. Associations were prominent in men but were not found in women. CONCLUSIONS In usual aging, integrated temporal gait variability measures, but not mean performance, appear related to amyloid burden from cortical and motor-related cortical and subcortical regions, especially in men. Increased gait variability may be a subclinical indicator of increased amyloid burden in men.
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Affiliation(s)
- Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Woei-Nan Bair
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Dean F Wong
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephanie A Studenski
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
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Bennett DA, Buchman AS, Boyle PA, Barnes LL, Wilson RS, Schneider JA. Religious Orders Study and Rush Memory and Aging Project. J Alzheimers Dis 2018; 64:S161-S189. [PMID: 29865057 PMCID: PMC6380522 DOI: 10.3233/jad-179939] [Citation(s) in RCA: 662] [Impact Index Per Article: 110.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Religious Orders Study and Rush Memory and Aging Project are both ongoing longitudinal clinical-pathologic cohort studies of aging and Alzheimer's disease (AD). OBJECTIVES To summarize progress over the past five years and its implications for understanding neurodegenerative diseases. METHODS Participants in both studies are older adults who enroll without dementia and agree to detailed longitudinal clinical evaluations and organ donation. The last review summarized findings through the end of 2011. Here we summarize progress and study findings over the past five years and discuss new directions for how these studies can inform on aging and AD in the future. RESULTS We summarize 1) findings on the relation of neurobiology to clinical AD; 2) neurobiologic pathways linking risk factors to clinical AD; 3) non-cognitive AD phenotypes including motor function and decision making; 4) the development of a novel drug discovery platform. CONCLUSION Complexity at multiple levels needs to be understood and overcome to develop effective treatments and preventions for cognitive decline and AD dementia.
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Affiliation(s)
- David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL., USA
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Tian Q, Resnick SM, Studenski SA. Olfaction Is Related to Motor Function in Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:1067-1071. [PMID: 27811155 DOI: 10.1093/gerona/glw222] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/20/2016] [Indexed: 11/13/2022] Open
Abstract
Background Among older adults, both olfaction and motor function predict future cognitive decline and dementia, suggesting potential shared causal pathways. However, it is not known whether olfactory and motor function are independently related in late life. Methods We assessed cross-sectional associations of olfaction with motor and cognitive function, using concurrent data on olfactory function, mobility, balance, fine motor function, manual dexterity, and cognition in 163 Baltimore Longitudinal Study of Aging participants aged 60 and older without common neurological diseases (n = 114 with available cognitive data). Using multiple linear regression, we adjusted for age, sex, race, smoking history, height, and weight for mobility and balance, and education for cognition. We used multiple linear regression to test whether olfaction-motor associations were independent of cognition and depressive symptoms. Results Olfactory scores were significantly associated with mobility (usual gait speed, rapid gait speed, 400-m walk time, and Health ABC Physical Performance Battery score), balance, fine motor function, and manual dexterity (all p < .05). In those with available cognitive data, additional adjustment for depressive symptoms, verbal memory, or visuoperceptual speed demonstrated especially strong independent relationships with challenging motor tasks such as 400-m walk and nondominant hand manual dexterity (p < .005). Conclusions This study demonstrates for the first time that, in older adults, olfactory function is associated with mobility, balance, fine motor function, and manual dexterity, and independent of cognitive function, with challenging upper and lower extremity motor function tasks. Longitudinal studies are needed to determine if olfactory performance predicts future mobility and functional decline.
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Affiliation(s)
- Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland
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