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Xu H, Gong X, Cui K, Li X, Chen L, Lu Y, Liao Y, Liu J. Association of peak expiratory flow with motoric cognitive risk syndrome among older adults. Front Aging Neurosci 2024; 16:1412542. [PMID: 39170900 PMCID: PMC11335682 DOI: 10.3389/fnagi.2024.1412542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024] Open
Abstract
Background The association between lung function and motoric cognitive risk syndrome (MCR) is unclear. We aimed to explore the association of peak expiratory flow (PEF) with MCR using cross-sectional and longitudinal analyses. Methods Within the CHARLS, 5095 participants were included in the cross-sectional analysis, and 4340 MCR-free participants were included in the longitudinal analysis. The PEF was assessed with a lung peak flow meter. MCR was characterized by cognitive complaints and a slow walking speed with normal mobility and without dementia. Logistic regression, Cox regression, and Laplace regression models were employed for data analysis. Results In this cross-sectional study, logistic regression analyses revealed that continuous PEF was associated with MCR (odds ratio [OR], 0.998; 95% confidence interval [CI], 0.998, 0.999), and the ORs (95% CIs) of MCR prevalence were 0.857 (0.693, 1.061) for the middle tertile and 0.665 (0.524, 0.845) for the highest tertile compared to the lowest tertile. In a longitudinal cohort study, continuous PEF was dose-dependently associated with the risk of MCR. Compared with those in the lowest tertile of PEF, the hazard ratios (95% CIs) of incident MCR were 0.827 (0.661, 1,036) for the middle tertile and 0.576 (0.432, 0.767) for the highest tertile. Furthermore, compared with the lowest tertile, the highest tertile was associated with a delayed onset time of MCR of 0.484 (95% CI: 0.151, 0.817) years. Conclusion A higher PEF was related to a lower prevalence of MCR and a lower risk for MCR, and a higher PEF also prolonged the onset time of MCR.
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Affiliation(s)
- Hui Xu
- Big Data Center, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Xiangwen Gong
- Department of Respiratory and Critical Care Medicine, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute of Respiratory Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Kaiwang Cui
- Department of Respiratory and Critical Care Medicine, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute of Respiratory Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Xuerui Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China
| | - Long Chen
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yiyi Lu
- Department of Respiratory and Critical Care Medicine, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute of Respiratory Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Yangfang Liao
- Department of Respiratory and Critical Care Medicine, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute of Respiratory Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Jianping Liu
- Department of Respiratory and Critical Care Medicine, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute of Respiratory Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
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De Sanctis P, Mahoney JR, Wagner J, Blumen HM, Mowrey W, Ayers E, Schneider C, Orellana N, Molholm S, Verghese J. Linking Dementia Pathology and Alteration in Brain Activation to Complex Daily Functional Decline During the Preclinical Dementia Stages: Protocol for a Prospective Observational Cohort Study. JMIR Res Protoc 2024; 13:e56726. [PMID: 38842914 PMCID: PMC11190628 DOI: 10.2196/56726] [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: 01/30/2024] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Progressive difficulty in performing everyday functional activities is a key diagnostic feature of dementia syndromes. However, not much is known about the neural signature of functional decline, particularly during the very early stages of dementia. Early intervention before overt impairment is observed offers the best hope of reducing the burdens of Alzheimer disease (AD) and other dementias. However, to justify early intervention, those at risk need to be detected earlier and more accurately. The decline in complex daily function (CdF) such as managing medications has been reported to precede impairment in basic activities of daily living (eg, eating and dressing). OBJECTIVE Our goal is to establish the neural signature of decline in CdF during the preclinical dementia period. METHODS Gait is central to many CdF and community-based activities. Hence, to elucidate the neural signature of CdF, we validated a novel electroencephalographic approach to measuring gait-related brain activation while participants perform complex gait-based functional tasks. We hypothesize that dementia-related pathology during the preclinical period activates a unique gait-related electroencephalographic (grEEG) pattern that predicts a subsequent decline in CdF. RESULTS We provide preliminary findings showing that older adults reporting CdF limitations can be characterized by a unique gait-related neural signature: weaker sensorimotor and stronger motor control activation. This subsample also had smaller brain volume and white matter hyperintensities in regions affected early by dementia and engaged in less physical exercise. We propose a prospective observational cohort study in cognitively unimpaired older adults with and without subclinical AD (plasma amyloid-β) and vascular (white matter hyperintensities) pathologies. We aim to (1) establish the unique grEEG activation as the neural signature and predictor of decline in CdF during the preclinical dementia period; (2) determine associations between dementia-related pathologies and incidence of the neural signature of CdF; and (3) establish associations between a dementia risk factor, physical inactivity, and the neural signature of CdF. CONCLUSIONS By establishing the clinical relevance and biological basis of the neural signature of CdF decline, we aim to improve prediction during the preclinical stages of ADs and other dementias. Our approach has important research and translational implications because grEEG protocols are relatively inexpensive and portable, and predicting CdF decline may have real-world benefits. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56726.
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Affiliation(s)
- Pierfilippo De Sanctis
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Cognitive Neurophysiology Laboratory, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jeannette R Mahoney
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Johanna Wagner
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California, San Diego, La Jolla, CA, United States
| | - Helena M Blumen
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine (Geriatrics), Albert Einstein College of Medicine, Bronx, NY, United States
| | - Wenzhu Mowrey
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Emmeline Ayers
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Claudia Schneider
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Natasha Orellana
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Sophie Molholm
- Department of Pediatrics, Cognitive Neurophysiology Laboratory, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joe Verghese
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine (Geriatrics), Albert Einstein College of Medicine, Bronx, NY, United States
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Tanpure S, Phadnis A, Nagda T, Rathod C, Kothurkar R, Chavan A. Gait variability and biomechanical distinctions in knee osteoarthritis: Insights from a 3D analysis in an adult elderly cohort. J Orthop 2024; 49:172-179. [PMID: 38234966 PMCID: PMC10789935 DOI: 10.1016/j.jor.2023.12.011] [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: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Background This study employs 3D gait analysis to investigate normal gait patterns in individuals afflicted with knee Osteoarthritis (OA). Focusing on the adult osteoarthritic population, the research aims to establish reference values for joint angles, temporospatial parameters, Gait Profile Score (GPS), and Movement Analysis Profile (MAP) collected concurrently along a standardized walking path. Furthermore, the study delves into potential variations linked to gender and OA severity, comparing gait parameters between male and female participants and among individuals with grade 3 and grade 4 OA. Method The study involved 34 adults with a mean age of 68.6 ± 5.75 years, all experiencing OA knees and awaiting Total Knee Arthroplasty (TKA). Utilizing Qualisys Motion capture system, 3D gait analysis was conducted. Data were processed through Visual 3D C-Motion Software. Results Gait analysis revealed noteworthy differences between genders for various parameters, including stance time, GPS, MAP of the hip, and joint angle for the sagittal plane (ankle), coronal plane (knee), and transverse plane (hip and knee). Moreover, significant differences were observed between grade 3 and grade 4 OA knees in MAP and for the transverse plane joint angle (ankle). Conclusion This gait analysis study sheds light on distinctive gait patterns in the adult osteoarthritic population. The identified variations in temporospatial parameters, joint angles, GPS, and MAP provide valuable reference values for individuals suffering from knee OA. The observed differences between genders and across different OA severity grades emphasize the need for personalized approaches in managing knee OA and planning interventions like TKA.
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Affiliation(s)
- Sanket Tanpure
- Department of Orthopaedics, Jupiter Lifeline Hospital, Thane, India
| | - Ashish Phadnis
- Department of Orthopaedics, Jupiter Lifeline Hospital, Thane, India
| | - Taral Nagda
- Department of Orthopaedics, Jupiter Lifeline Hospital, Thane, India
| | - Chasanal Rathod
- Department of Orthopaedics, Jupiter Lifeline Hospital, Thane, India
| | - Rohan Kothurkar
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India
| | - Ajay Chavan
- Jupiter Gait Lab, Jupiter Lifeline Hospital, Thane, India
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Kamasaki T, Otao H, Hachiya M, Tanaka S, Ochishi K, Shimokihara S, Maruta M, Han G, Akasaki Y, Hidaka Y, Tabira T. Association between Toe Pressure Strength in the Standing Position and Maximum Walking Speed in Older Adults. Ann Geriatr Med Res 2023; 27:338-345. [PMID: 37743683 PMCID: PMC10772338 DOI: 10.4235/agmr.23.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Considering concerns about conventional toe grip strength, we devised a method to measure toe pressure strength in the standing position, which is close to the actual motion. This study examined the association between toe pressure strength in the standing position and walking speed among older adults. METHODS This cross-sectional study included 150 community-dwelling older adults (81±8 years, 73% female) who participated in the physical fitness test. We analyzed the correlation between the participants' maximum walking speed and physical function. Furthermore, we performed regression analysis with the maximum walking speed as the dependent variable to examine the association with toe pressure strength in the standing position. We also examined the association between maximum walking speed and toe pressure strength in the standing position by introducing a covariate. RESULTS Correlation analysis revealed a significant positive correlation between maximum walking speed and toe pressure strength in the standing position, with a moderate effect size (r=0.48, p<0.001). Moreover, multiple regression analysis with covariates showed an association between maximum walking speed and toe pressure strength in the standing position (standardization factor=0.13, p<0.026). CONCLUSION Toe pressure strength in the standing position was associated with maximum walking speed. This finding clarifies the significance of assessing toe pressure strength in the standing position and suggests that enhanced toe pressure strength in the standing position may increase maximum walking speed.
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Affiliation(s)
- Taishiro Kamasaki
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Nishikyushu University, Kanzaki, Japan
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiroshi Otao
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Nishikyushu University, Kanzaki, Japan
| | - Mizuki Hachiya
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Nishikyushu University, Kanzaki, Japan
| | - Shinichi Tanaka
- Department of Physical Therapy, Faculty of Rehabilitation Science, Reiwa Health Sciences University, Fukuoka, Japan
| | - Kohei Ochishi
- Medical Corporation Ito Clinic Day-Care Rehabilitation, Fukuoka, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Michio Maruta
- Department of Occupational Therapy, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Gwanghee Han
- Faculty of Medicine, Kagoshima University, Kagoshima, Japan
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Yoshihiko Akasaki
- Department of Rehabilitation, Tarumizu Chuo Hospital, Tarumizu, Japan
| | - Yuma Hidaka
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, Kagoshima, Japan
| | - Takayuki Tabira
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
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Duan Q, Zhang Y, Zhuang W, Li W, He J, Wang Z, Cheng H. Gait Domains May Be Used as an Auxiliary Diagnostic Index for Alzheimer's Disease. Brain Sci 2023; 13:1599. [PMID: 38002557 PMCID: PMC10669801 DOI: 10.3390/brainsci13111599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disorder with cognitive dysfunction and behavioral impairment. We aimed to use principal components factor analysis to explore the association between gait domains and AD under single and dual-task gait assessments. METHODS A total of 41 AD participants and 41 healthy control (HC) participants were enrolled in our study. Gait parameters were measured using the JiBuEn® gait analysis system. The principal component method was used to conduct an orthogonal maximum variance rotation factor analysis of quantitative gait parameters. Multiple logistic regression was used to adjust for potential confounding or risk factors. RESULTS Based on the factor analysis, three domains of gait performance were identified both in the free walk and counting backward assessments: "rhythm" domain, "pace" domain and "variability" domain. Compared with HC, we found that the pace factor was independently associated with AD in two gait assessments; the variability factor was independently associated with AD only in the counting backwards assessment; and a statistical difference still remained after adjusting for age, sex and education levels. CONCLUSIONS Our findings indicate that gait domains may be used as an auxiliary diagnostic index for Alzheimer's disease.
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Affiliation(s)
- Qi Duan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Yinuo Zhang
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou 325000, China;
| | - Weihao Zhuang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Wenlong Li
- Radiotherapy Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Zhen Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Haoran Cheng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
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Seifer AK, Dorschky E, Küderle A, Moradi H, Hannemann R, Eskofier BM. EarGait: Estimation of Temporal Gait Parameters from Hearing Aid Integrated Inertial Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:6565. [PMID: 37514858 PMCID: PMC10383770 DOI: 10.3390/s23146565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Wearable sensors are able to monitor physical health in a home environment and detect changes in gait patterns over time. To ensure long-term user engagement, wearable sensors need to be seamlessly integrated into the user's daily life, such as hearing aids or earbuds. Therefore, we present EarGait, an open-source Python toolbox for gait analysis using inertial sensors integrated into hearing aids. This work contributes a validation for gait event detection algorithms and the estimation of temporal parameters using ear-worn sensors. We perform a comparative analysis of two algorithms based on acceleration data and propose a modified version of one of the algorithms. We conducted a study with healthy young and elderly participants to record walking data using the hearing aid's integrated sensors and an optical motion capture system as a reference. All algorithms were able to detect gait events (initial and terminal contacts), and the improved algorithm performed best, detecting 99.8% of initial contacts and obtaining a mean stride time error of 12 ± 32 ms. The existing algorithms faced challenges in determining the laterality of gait events. To address this limitation, we propose modifications that enhance the determination of the step laterality (ipsi- or contralateral), resulting in a 50% reduction in stride time error. Moreover, the improved version is shown to be robust to different study populations and sampling frequencies but is sensitive to walking speed. This work establishes a solid foundation for a comprehensive gait analysis system integrated into hearing aids that will facilitate continuous and long-term home monitoring.
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Affiliation(s)
- Ann-Kristin Seifer
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Eva Dorschky
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Arne Küderle
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Hamid Moradi
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | | | - Björn M Eskofier
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
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Andrews AW, Vallabhajosula S, Boise S, Bohannon RW. Normal gait speed varies by age and sex but not by geographical region: a systematic review. J Physiother 2023; 69:47-52. [PMID: 36528509 DOI: 10.1016/j.jphys.2022.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
QUESTIONS What are comfortable gait speed values for apparently healthy adults? How do these differ by age group, sex and geographical region? DESIGN Systematic review of observational studies with meta-analysis. PARTICIPANTS Apparently healthy, community-dwelling adults who have undergone measurement of comfortable gait speed. SEARCH METHOD Potentially relevant studies were identified in four databases. Extracted data from studies that satisfied the eligibility criteria were added to a database containing the same information from a meta-analysis published a decade ago. OUTCOME MEASURES The weighted mean comfortable gait speed was calculated along with the 95% confidence interval for each stratum of age/sex using a random-effects model. Mean gait speeds were further stratified by the continent where the study took place. Tests of homogeneity included I2 and prediction intervals. RESULTS Meta-analysis of data from 51,248 apparently healthy adults was stratified by age (in decades) and sex. Male gait speed slowed beyond age 50 years whereas female gait speed slowed beyond age 30 years. The weighted mean gait speed ranged from 97 cm/s (females aged ≥ 80 years) to 140 cm/s (males aged 40 to 49 years). The I2 values ranged from 0 to 34.07; prediction interval ranges varied from a low of 30 (125 to 155 cm/s; males aged 40 to 49 years) to a high of 77 (83 to 160 cm/s; females aged 60 to 69 years). There was considerable overlap in confidence intervals between continents for each sex/age group. CONCLUSIONS Comfortable gait speed slowed through the adult years, but males maintained a faster walking speed than females. Further stratification of comfortable gait speed by geographical region is not warranted.
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Affiliation(s)
| | | | - Sarah Boise
- Department of Physical Therapy Education, Elon University, Elon, USA
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Chung CM, Shin S, Lee Y, Lee DY. Determination of the Predictors with the Greatest Influence on Walking in the Elderly. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1640. [PMID: 36422178 PMCID: PMC9693411 DOI: 10.3390/medicina58111640] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023]
Abstract
Background and Objectives: Previous studies have revealed that independent variables (lower extremity strength, postural control ability, and body composition) influence gait performance and variability, but the difference in the relative influence between these variables is unclear. Hence, this study determines the variable that is the most influential predictor of gait performance and variability among potential independent variables in the elderly. Materials and Methods: Seventy-eight subjects aged ≥60 years participated. For each subject, the gait variables and lower extremity muscle strength were measured using an accelerometer worn on both feet during a 6-minute walk and a manual force sensor, respectively. The static balance ability was measured through two force plates, and the body composition was measured by applying bioelectrical impedance analysis. Linear regression analyses were performed stepwise to determine whether these variables affect gait performance and variability. Results: After adjusting for sex and gait performance, the ankle strength, body fat mass, mean velocity in the medial-lateral direction, ankle plantar flexion strength, and girth were predictors of gait speed dorsiflexion, gait performance, swing width of the gait performance, walking speed, and gait variability, respectively. Conclusions: Overall, gait performance in the elderly is related to muscle strength, postural control, and body composition in a complex manner, but gait variability appears to be more closely related to ankle muscle strength. This study provides further evidence that muscle strength is important in motor function and stability.
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Affiliation(s)
- Chul-Min Chung
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Yungon Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
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Le Floch M, Gautier J, Annweiler C. Vitamin D Concentration and Motoric Cognitive Risk in Older Adults: Results from the Gait and Alzheimer Interactions Tracking (GAIT) Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13086. [PMID: 36293666 PMCID: PMC9602422 DOI: 10.3390/ijerph192013086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR would exhibit hypovitaminosis D more often compared to Cognitively Healthy Individuals (CHI). The objective of this cross-sectional analysis was to determine whether hypovitaminosis D was associated with MCR. METHODS Participants without dementia from the GAIT (Gait and Alzheimer Interactions Tracking) cohort study were classified into MCR or Cognitively Healthy Individuals (CHI) groups. Hypovitaminosis D was defined as the lowest quartile of serum 25-hydroxyvitamin D (25OHD) concentration compared to the other three combined. Age, sex, body mass index (BMI), the Frontal Assessment Battery (FAB) score, the Mini-Mental Short Examination (MMSE) score, education level, use of psychoactive drugs, and the number of chronic diseases were used as covariates. RESULTS Among 244 nondemented and nonMCInonMCR participants from the GAIT cohort (mean age 71.4 ± 3.7 years, 40.6% women), 66 participants were classified as MCR (36.9%) and 178 as CHI (63.1%). The lowest quartile of 25OHD concentration was directly associated with MCR (unadjusted OR = 2.85, p = 0.003) even after adjustment for studied potential confounders (fully adjusted OR = 2.61, p = 0.025). The BMI (adjusted OR = 6.65, p < 0.001), MMSE score (adjusted OR = 0.74, p = 0.009), FAB score (adjusted OR = 0.51, p < 0.001), number of chronic diseases (adjusted OR = 1.29, p = 0.043) and use of psychoactive drugs (adjusted OR = 2.55, p = 0.044) were also associated with MCR. CONCLUSIONS Hypovitaminosis D was associated with MCR in older community-dwellers without dementia.
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Affiliation(s)
- Maxime Le Floch
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
- Health Faculty, School of Medicine, University of Angers, F-49000 Angers, France
| | - Jennifer Gautier
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
| | - Cédric Annweiler
- Research Center on Autonomy and Longevity, UPRES EA 4638, Department of Geriatric Medicine, Angers University Hospital, University of Angers, F-49000 Angers, France
- Health Faculty, School of Medicine, University of Angers, F-49000 Angers, France
- Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
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Mochizuki G, Bayley M, Chandra T, Comper P, Danells C, Foster E, Habib Perez O, Hameed H, Inness E, Khimji F, Sweeny M. The Toronto Concussion Study: Reference Data for Balance and Gait Measures in Community-Dwelling Adults With Concussion. Phys Ther 2022; 102:6585839. [PMID: 35588230 DOI: 10.1093/ptj/pzac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/19/2021] [Accepted: 02/26/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Concussion can cause deficits in balance and gait. Much of what is known about how concussion affects balance and gait has been derived from studies involving youth, high school, and university athletes. However, investigation into the effects of concussion on balance and gait in community-dwelling young, middle-age, and older aged adults is limited. This study aimed to present descriptive reference values for common balance and gait measures in community-dwelling adults between the ages of 20 and 69 years with concussion. METHODS In this observational study, 318 participants were enrolled from a concussion care clinic at a rehabilitation hospital in an urban center and were assessed within 7 days of injury. Balance measures included the Balance Error Scoring System (BESS), modified BESS, and center-of-pressure root mean square during quiet standing. Gait measures included velocity (absolute and height adjusted), cadence, and step length during self-paced gait. Data were binned by decade-long age range. RESULTS Mean (SD) per-decade scores for the BESS ranged from 14.8 (5.1) to 21.8 (5.6) errors and 4.0 (3.0) to 9.4 (4.6) errors for the modified BESS. Mean values for center-of-pressure root mean square in the anteroposterior direction ranged from 0.42 (0.18) to 0.52 (0.26) with the eyes open, and from 0.49 (0.19) to 0.62 (0.39) with eyes closed. Mean absolute gait velocity ranged from 98.5 (9.1) to 119.3 (21.3) cm/s. The range of step length values was 58.2 (6.8) to 66.3 (7.3) cm and cadence ranged from 102.1 (9.8) to 108.6 (10.8) steps/min across age groups. CONCLUSION These data provide insight into the impact of concussion on balance and mobility in community-dwelling adults across the lifespan. IMPACT Community-dwelling adults can experience concussion across the lifespan. Availability of reference values for commonly used balance and gait measures can help to inform clinical strategies and progression of recovery of balance and mobility after injury.
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Affiliation(s)
- George Mochizuki
- School of Kinesiology and Health Science, York University, Toronto, Canada
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tharshini Chandra
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Paul Comper
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Cynthia Danells
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Evan Foster
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Translational Research Program, University of Toronto, Toronto, Canada
| | - Olinda Habib Perez
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Hajr Hameed
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Elizabeth Inness
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Fatema Khimji
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Michelle Sweeny
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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11
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Rincé G, Couturier C, Berrut G, Dylis A, Montero-Odasso M, Deschamps T. Impact of an individual personalised rehabilitation program on mobility performance in older-old people. Aging Clin Exp Res 2021; 33:2821-2830. [PMID: 33625687 DOI: 10.1007/s40520-021-01812-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Studies have shown benefits of exercise interventions on preferred and fast gait speed in healthy older adults, but the impact of a personalised rehabilitation program targeting a large cohort of non-disabled older-old adults has rarely been examined. AIMS The purpose was to determine whether personalised intervention-related improvements in gait and mobility performance in older-old adults were dependent on cognitive status and/or history of falls. METHODS Based on a pre-post design, 483 older-old persons (mean age: 83.3 ± 5.1 years) were followed during a personalised rehabilitation program over a period of 7 weeks, with twice-weekly sessions (45 min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), static postural sway, Timed Up and Go test, Five Times Sit to Stand test, the ability to rise from the floor, and handgrip strength test were assessed. RESULTS Using a pre-post analysis of covariance, a significant increase in preferred gait speed (+ 20.1%), fast gait speed (+ 15.8%), and dual-task speed while counting (+ 13.4%) was observed after the rehabilitation, regardless of the baseline cognitive status and fall history. Similar improvements in TUG and maximal handgrip force were observed, with a significant reduction of performance time (-19.5%) or an increase of handgrip strength (+ 6.2%). DISCUSSION Results suggest the effectiveness of personalised intervention to improve a battery of physical performance measures in older-old adults, even for the frailest participants. CONCLUSION Implementing a personalised intervention for targeting the high-risk older-old adults in priority is critical regarding the clinically meaningful change in gait speed.
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Affiliation(s)
- Guy Rincé
- Clinical Gerontology Department, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Catherine Couturier
- Clinical Gerontology Department, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Gilles Berrut
- Clinical Gerontology Department, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
- Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, 4334, F-44000, Nantes, EA, France
| | - Anthony Dylis
- Clinical Gerontology Department, Centre Hospitalier Universitaire de Nantes, 44000, Nantes, France
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada
- Schulich School of Medicine & Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, ON, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON, Canada
| | - Thibault Deschamps
- Nantes Université, CHU Nantes, Movement - Interactions - Performance, MIP, 4334, F-44000, Nantes, EA, France.
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12
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Trentzsch K, Schumann P, Śliwiński G, Bartscht P, Haase R, Schriefer D, Zink A, Heinke A, Jochim T, Malberg H, Ziemssen T. Using Machine Learning Algorithms for Identifying Gait Parameters Suitable to Evaluate Subtle Changes in Gait in People with Multiple Sclerosis. Brain Sci 2021; 11:brainsci11081049. [PMID: 34439668 PMCID: PMC8391565 DOI: 10.3390/brainsci11081049] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
In multiple sclerosis (MS), gait impairment is one of the most prominent symptoms. For a sensitive assessment of pathological gait patterns, a comprehensive analysis and processing of several gait analysis systems is necessary. The objective of this work was to determine the best diagnostic gait system (DIERS pedogait, GAITRite system, and Mobility Lab) using six machine learning algorithms for the differentiation between people with multiple sclerosis (pwMS) and healthy controls, between pwMS with and without fatigue and between pwMS with mild and moderate impairment. The data of the three gait systems were assessed on 54 pwMS and 38 healthy controls. Gaussian Naive Bayes, Decision Tree, k-Nearest Neighbor, and Support Vector Machines (SVM) with linear, radial basis function (rbf) and polynomial kernel were applied for the detection of subtle walking changes. The best performance for a healthy-sick classification was achieved on the DIERS data with a SVM rbf kernel (κ = 0.49 ± 0.11). For differentiating between pwMS with mild and moderate disability, the GAITRite data with the SVM linear kernel (κ = 0.61 ± 0.06) showed the best performance. This study demonstrates that machine learning methods are suitable for identifying pathologic gait patterns in early MS.
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Affiliation(s)
- Katrin Trentzsch
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Paula Schumann
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Grzegorz Śliwiński
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Paul Bartscht
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Rocco Haase
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Dirk Schriefer
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Andreas Zink
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Andreas Heinke
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Thurid Jochim
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Hagen Malberg
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
- Correspondence: ; Tel.: +49-351-458-4465; Fax: +49-351-458-5717
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13
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Verghese J, Ayers E, Sathyan S, Lipton RB, Milman S, Barzilai N, Wang C. Trajectories of frailty in aging: Prospective cohort study. PLoS One 2021; 16:e0253976. [PMID: 34252094 PMCID: PMC8274857 DOI: 10.1371/journal.pone.0253976] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background Emerging evidence suggests that there is significant variability in the progression of frailty in aging. We aimed to identify latent subpopulations of frailty trajectories, and examine their clinical and biological correlates. Methods We characterized frailty using a 41-item cumulative deficit score at baseline and annual visits up to 12 years in 681 older adults (55% women, mean age 74·6 years). Clinical risk profile and walking while talking performance as a clinical marker of trajectories were examined. Mortality risk associated with trajectories was evaluated using Cox regression adjusted for established survival predictors, and reported as hazard ratios (HR). Proteome-wide analysis was done. Findings Latent class modeling identified 4 distinct frailty trajectories: relatively stable (34·4%) as well as mild (36·1%), moderate (24·1%) and severely frail (5·4%). Four distinct classes of frailty trajectories were also shown in an independent sample of 515 older adults (60% women, 68% White, 26% Black). The stable group took a median of 31 months to accumulate one additional deficit compared to 20 months in the severely frail group. The worst trajectories were associated with modifiable risk factors such as low education, living alone, obesity, and physical inactivity as well as slower walking while talking speed. In the pooled sample, mild (HR 2·33, 95% CI 1·30–4·18), moderate (HR 2·49, 95% CI 1·33–4·66), and severely frail trajectories (HR 5·28, 95% CI 2·68–10·41) had higher mortality compared to the stable group. Proteomic analysis showed 11 proteins in lipid metabolism and growth factor pathways associated with frailty trajectories. Conclusion Frailty shows both stable and accelerated patterns in aging, which can be distinguished clinically and biologically.
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Affiliation(s)
- Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
- * E-mail:
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Sanish Sathyan
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Sofiya Milman
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Nir Barzilai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
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14
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Kulkarni S, Nagarkar A. Basic gait pattern and impact of fall risk factors on gait among older adults in India. Gait Posture 2021; 88:16-21. [PMID: 33951574 DOI: 10.1016/j.gaitpost.2021.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND An unstable gait pattern is an indicator of an increased risk of falls among older adults. Data on basic gait parameters is useful in the early identification of gait impairment. However, reference gait measurements are not available in low- and middle-income countries. RESEARCH QUESTION What are the normative reference values of gait parameters and do fall risk factors such as impaired balance, functional difficulty, and multimorbidity affect the gait patterns of older adults in India? METHODS A cross-sectional data of 659 older adults were collected using a semi-structured schedule. Gait parameters were measured using wearable sensors. Descriptive statistics, independent t-test, and one-way ANCOVA were used to determine the significant difference (p < 0.05) in gait parameters across the risk factors. RESULTS A mean stride length of 123.00 ± 15.19 cm, stride velocity of 110.57 ± 17.57 cm/s, and a cadence of 106.14 ± 11.44 steps/minute were reported in the study. Functional difficulties and balance impairment were the two major risk factors that affected stride velocity, stride length, and cadence after adjusting for age and height. No difference in gait parameters was observed among participants with and without multimorbidity. SIGNIFICANCE This study provides a baseline or reference values of various gait parameters measured on a large sample of population aged 60 and above from India. Assessment of gait patterns and associated risk factors in a clinical setup will help identify the older adults at risk of falls and reduce the enormous burden of fall injuries. Since gait parameters show a large variation across geographical regions, it is important to have region-specific reference values.
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Affiliation(s)
- Snehal Kulkarni
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
| | - Aarti Nagarkar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
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15
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Roche N, Chorin F, Gerus P, Deshayes M, Guerin O, Zory R. Effects of age, gender, frailty and falls on spatiotemporal gait parameters: a retrospective cohort study. Eur J Phys Rehabil Med 2021; 57:923-930. [PMID: 34002975 DOI: 10.23736/s1973-9087.21.06831-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Many studies have explored spatial and temporal gait parameters in the elderly, and showed that frailty status, fall history, age, and gender may individually strongly influence these parameters. However, it appears necessary to investigate the confounding factors more deeply in order to better know the specific role of each of these factors impacting the evolution of gait with the increase of age. AIM The aim of the present study was to determine the influence of frailty status, fall history, age and gender on spatiotemporal gait parameters. We hypothesized that frailty was the factor that most influence gait parameters. SETTING This is a monocentric retrospective study performed at Nice University Hospital Center on older out-patients. POPULATION Older adults were included in the study. This study explored for the first time how frailty status, age, gender and history of falls impact the multiple spatiotemporal parameters of gait using linear mixed models (LMM). RESULTS 479 older adults (360 women and 119 men; 213 non-frail, 228 pre-frail and 38 frail; aged from 65 to 94 years; 403 non-fallers and 73 fallers). Frailty status explained fully: i) the gait speed; ii) the cadence: iii) the initial double contact: DS1; iv) the percentage of the single support phase v) the final double contact: DS2; v) the percentage of the swing phase of the gait cycle. CONCLUSIONS The results of this study allow a deeper understanding of the confounding factors since LMM highlighted the importance of frailty status for explaining all the spatiotemporal gait parameters. CLINICAL REHABILITATION IMPACT These results showed that to improve gait, clinical intervention should focus on reducing frailty status. It is also interesting to note that a history of falls explains none of the spatiotemporal gait parameters which suggests that it may be possible to improve gait in all frail subjects irrespective of their history of falls.
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Affiliation(s)
| | - Frédéric Chorin
- LAMHESS, Université Côte d'Azur, Nice, France.,CHU, Service de médecine gériatrique et thérapeutique, Université Côte d'Azur, Nice, France
| | | | - Maxime Deshayes
- CHU, Service de médecine gériatrique et thérapeutique, Université Côte d'Azur, Nice, France.,CHROME - Equipe APSY-v, Université de Nîmes, EA 7352 Nîmes, France
| | - Olivier Guerin
- CHU, Service de médecine gériatrique et thérapeutique, Université Côte d'Azur, Nice, France.,IRCAN, Université Côte d'Azur, Nice, France
| | - Raphael Zory
- LAMHESS, Université Côte d'Azur, Nice, France.,Institut Universitaire de France (IUF), Paris, France
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16
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Granacher U, Muehlbauer T, Göstemeyer G, Gruber S, Gruber M. The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults. BMC Geriatr 2021; 21:257. [PMID: 33865308 PMCID: PMC8052548 DOI: 10.1186/s12877-021-02206-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics. Objective The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults. Methods Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]). Results Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables. Conclusions The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.
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Affiliation(s)
- Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Am Neuen Palais 10, Bldg 12, 14469, Potsdam, Germany.
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, 45141, Essen, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Markus Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
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17
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Pophal da Silva L, Boneti Moreira N, Barbosa de Freitas P, Pereira G, Rodacki ALF. Gait Parameters of Older Adults according to Their Fall History and Functional Capacity While Walking at Different Speeds. Gerontology 2021; 67:532-543. [PMID: 33677447 DOI: 10.1159/000513601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION It is believed that functional capacity and fall history are factors capable of influencing the gait parameters of older adults. Thus, the objective of this study was to verify whether gait parameters of community-dwelling older adults differ according to their functional capacity and fall history when walking at self-selected walking speed (SSWS) and fast walking speed (FWS) using principal component analysis (PCA). METHODS Two hundred ninety-five participants (82.3% women and 17.7% men) were allocated in four groups according to their fall history and functional capacity: non-fallers with higher functional capacity (NFHFC, n = 94; 69.3 ± 5.5 years), non-fallers with lower functional capacity (NFLFC, n = 114; 72.0 ± 8.1 years), fallers with higher functional capacity (FHFC, n = 29; 70.0 ± 6.0 years), and fallers with lower functional capacity (FLFC, n = 58; 72.5 ± 8.2 years). Fall history, anthropometric data, functional capacity by short physical performance battery and mobility by Timed Up and Go (TUG), and spatiotemporal gait parameters were evaluated. RESULTS Data analysis indicated that FLFC presented the lowest scores, especially in the Five Times Sit-to-Stand Test and TUG. The PCA showed that the first principal component (PC1) explained the most substantial amount of the data variability in both walking speeds (SSWS and FWS), predominantly including temporal parameters. PC2 composed by spatial outcomes (stride and step length and walking speed) showed the highest effect size. PC1 and PC2 were able to differentiate functional status, regardless of fall history. CONCLUSIONS Functional capacity showed great importance when analyzing gait parameters at different walking speeds (SSWS and FWS), regardless of fall history. Older adults with high functional capacity demonstrate better performance during gait. Besides, spatiotemporal parameters are the main factors explaining gait variability, both in SSWS and FWS.
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Affiliation(s)
- Letícia Pophal da Silva
- Department of Physical Education, Setor de Ciências Biológicas, Federal University of Paraná, Curitiba, Brazil,
| | - Natália Boneti Moreira
- Department of Physiotherapy, Setor de Ciências Biológicas, Federal University of Paraná, Curitiba, Brazil
| | - Paulo Barbosa de Freitas
- Interdisciplinary Graduate Program in Healthy Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Gleber Pereira
- Department of Physical Education, Setor de Ciências Biológicas, Federal University of Paraná, Curitiba, Brazil
| | - André Luiz Felix Rodacki
- Department of Physical Education, Setor de Ciências Biológicas, Federal University of Paraná, Curitiba, Brazil
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Verghese J, Ayers E. Subjective Motoric Complaints and New Onset Slow Gait. J Gerontol A Biol Sci Med Sci 2020; 76:e245-e252. [PMID: 33373451 DOI: 10.1093/gerona/glaa321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While reports of mobility problems are common with aging, their relationship to new onset of slow gait is unknown. Our objective was to examine the validity of subjective motoric complaints for predicting the incidence of slow gait. METHODS Ambulatory community-residing participants (mean age 76.6, 55% women) with gait speeds in the normal range enrolled in an aging cohort. Five subjective motoric complaints were assessed. Incident slow gait (walking speed 1 SD below age and sex means) was the primary outcome. RESULTS Of the 548 participants at baseline, 90 had prevalent slow gait and 253 participants (73.7%) reported one or more subjective motoric complaints. Subjective motoric complaints were more common in women than men (1.78 vs 1.23). Over a median follow-up of 3.34 years, 68 participants developed new onset slow gait. All 5 questions predicted incident slow gait (adjusted hazard ratios varying from 2.26 to 4.44). More subjective motoric complaints were associated with increased risk of developing incident slow gait (hazard ratio per complaint 1.81). Predictive validity of subjective motoric complaints for incident slow gait was unchanged when using alternate outcome definitions, accounting for diagnostic misclassification, recall bias, or adjusting for multiple confounders. CONCLUSIONS Subjective motoric complaints are a harbinger of mobility disability, and can help improve clinical risk assessments and identify high-risk individuals for interventions to prevent onset of slow gait.
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Affiliation(s)
- Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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19
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Holtzer R, Ross D, Izzetoglu M. Intraindividual variability in neural activity in the prefrontal cortex during active walking in older adults. Psychol Aging 2020; 35:1201-1214. [PMID: 33180518 DOI: 10.1037/pag0000583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intraindividual variability in gait and cognitive performance is distinct from central-tendency measures and associated with clinical outcomes in aging. Knowledge concerning intraindividual variability in neural activity, however, has been relatively scarce, and no research to date has reported on such variability during active walking. The current study addressed this major gap in knowledge. Participants were community-residing older adults (n = 394; mean age = 76.29 ± 6.65 years; %female = 55). Functional near-infrared spectroscopy (fNIRS) was used to measure oxygenated hemoglobin (HbO2) in the prefrontal cortex under three experimental conditions: single-task-walk, single-task-alpha (cognitive task), and dual-task-walk, which required the participants to perform the two single tasks simultaneously. Intraindividual variability in neural activity was operationalized using the standard deviation of fNIRS-derived HbO2 observations assessed during a 30-s interval in each experimental condition. The increase in intraindividual variability in neural activity in the dual-task-walk condition compared to both single-task conditions was associated with the presence of cognitive impairments and being a male. Furthermore, measures of intraindividual variability in neural activity and gait performance were positively correlated only under the dual-task-walk condition. Intraindividual variability in the neural activity of gait may be a novel marker for age-related impairments in mobility and cognitive function. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
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Freiberger E, Sieber CC, Kob R. Mobility in Older Community-Dwelling Persons: A Narrative Review. Front Physiol 2020; 11:881. [PMID: 33041836 PMCID: PMC7522521 DOI: 10.3389/fphys.2020.00881] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/29/2020] [Indexed: 12/21/2022] Open
Abstract
Due to the demographic changes and the increasing awareness of the role of physical function, mobility in older age is becoming an important topic. Mobility limitations have been reported as increasingly prevalent in older persons affecting about 35% of persons aged 70 and the majority of persons over 85 years. Mobility limitations have been associated with increased fall risk, hospitalization, a decreased quality of life, and even mortality. As concepts of mobility are multifactorial and complex, in this narrative review, definitions, physical factors, and their age-related changes associated with mobility will be presented. Also, areas of cognitive decline and their impact on mobility, as well as neuromuscular factors related to mobility will be addressed. Another section will relate psychological factors such as Fall-related psychological concerns and sedentary behavior to mobility. Assessment of mobility as well as effective exercise interventions are only shortly addressed. In the last part, gaps and future work on mobility in older persons are discussed.
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Affiliation(s)
- Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
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21
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Caballero-Mora MA, Rodríguez Mañas L, Valdés-Aragonés M, García-Sánchez I, Alonso-Bouzon C, Castro Rodríguez M, Nuñez-Jimenez L, Esteban A, Rodriguez-Laso A. Factors associated with impairment in gait speed in older people with clinically normal gait. A cross-sectional study. Aging Clin Exp Res 2020; 32:1043-1048. [PMID: 30989508 DOI: 10.1007/s40520-019-01187-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Health professionals commonly use gait speed in the evaluation of functional status in older people. However, only a limited number of studies have assessed gait speed in the absence of disorders of gait, using confounding factors and exclusion criteria coming from studies conducted in younger people. Our study aims to analyse which factors are associated with gait speed in older people with normal clinical gait. METHODS An observational cross-sectional study was conducted in 119 community-dwelling residents without relevant comorbidities (Charlson index < 2), preserved function (Barthel > 85) and normal gait by visual exploration. Exclusion criteria included suffering from any illness that could modify the characteristics of gait, terminal status or the presence of an acute medical illness in the past 3 months. We used a stepwise linear regression of several variables (sociodemographic characteristics, cognition, body composition, drugs, falls, sarcopenia, frailty and physical activity) on 6-metre gait speed. RESULTS The mean age was 78 years (range 70-96 years) and 71.4% were women. Variables that remained associated with gait speed in the multivariate final model were age (B = - 0.020, p < 0.001); gender (B = - 0.184, p < 0.001); waist-to-height ratio (B = - 0.834, p = 0.002); number of falls (B = - 0.049, p = 0.003) and the number of Fried's frailty criteria (B = - 0.064, p = 0.019). CONCLUSION Falls, frailty and the waist-to-height ratio modify gait speed in older people with normal gait. Studies analysing the potential effect of several factors on gait speed should consider them as confounding factors.
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Affiliation(s)
- M A Caballero-Mora
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain.
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain.
- CIBER de Fragilidad y Envejecimiento Saludable, Madrid, Spain.
| | - L Rodríguez Mañas
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
- CIBER de Fragilidad y Envejecimiento Saludable, Madrid, Spain
| | - M Valdés-Aragonés
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | - I García-Sánchez
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | - C Alonso-Bouzon
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - M Castro Rodríguez
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - L Nuñez-Jimenez
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - A Esteban
- CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - A Rodriguez-Laso
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain.
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Gait Characteristics Based on Shoe-Type Inertial Measurement Units in Healthy Young Adults during Treadmill Walking. SENSORS 2020; 20:s20072095. [PMID: 32276416 PMCID: PMC7180462 DOI: 10.3390/s20072095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/24/2022]
Abstract
This study investigated the gait characteristics of healthy young adults using shoe-type inertial measurement units (IMU) during treadmill walking. A total of 1478 participants were tested. Principal component analyses (PCA) were conducted to determine which principal components (PCs) best defined the characteristics of healthy young adults. A non-hierarchical cluster analysis was conducted to evaluate the essential gait ability, according to the results of the PC1 score. One-way repeated analysis of variance with the Bonferroni correction was used to compare gait performances in the cluster groups. PCA outcomes indicated 76.9% variance for PC1–PC6, where PC1 (gait variability (GV): 18.5%), PC2 (pace: 17.8%), PC3 (rhythm and phase: 13.9%), and PC4 (bilateral coordination: 11.2%) were the gait-related factors. All of the pace, rhythm, GV, and variables for bilateral coordination classified the gait ability in the cluster groups. We suggest that the treadmill walking task may be reliable to evaluate the gait performances, which may provide insight into understanding the decline of gait ability. The presented results are considered meaningful for understanding the gait patterns of healthy adults and may prove useful as reference outcomes for future gait analyses.
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Lord S, Moyes S, Teh R, Port W, Muru-Lanning M, Bacon CJ, Wilkinson T, Kerse N. Gait, cognition and falls over 5 years, and motoric cognitive risk in New Zealand octogenarians: Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ. BMC Geriatr 2020; 20:43. [PMID: 32024482 PMCID: PMC7003444 DOI: 10.1186/s12877-020-1420-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/08/2020] [Indexed: 01/08/2023] Open
Abstract
Background Understanding falls risk in advanced age is critical with people over 80 a rapidly growing demographic. Slow gait and cognitive complaint are established risk factors and together comprise the Motoric Cognitive Risk Syndrome (MCR). This study examined trajectories of gait and cognition and their association with falls over 5 years, and documented MCR in Māori and non-Māori of advanced age living in New Zealand. Method Falls frequency was ascertained retrospectively at annual assessments. 3 m gait speed was measured and cognition was assessed using the Modified Mini-Mental Status Examination (3MS). Frequency of MCR was reported. Gait and cognition trajectories were modelled and clusters identified from Latent Class Analysis. Generalised linear models examined association between changes in gait, cognition, MCR and falls. Results At baseline, 138 of 408 Māori (34%) and 205 of 512 non-Māori (40%) had fallen. Mean (SD) gait speed (m/s) for Māori was 0.66 (0.29) and 0.82 (0.26) for non-Māori. Respective 3MS scores were 86.2 (15.6) and 91.6 (10.4). Ten (4.3%) Maori participants met MCR criteria, compared with 7 (1.9%) non-Māori participants. Māori men were more likely to fall (OR 1.56; 95% CI 1.0–2.43 (P = 0.04) whilst for non-Māori slow gait increased falls risk (OR 0.40; 95% CI 0.24–0.68(P < 0.001). Non-Māori with MCR were more than twice as likely to fall than those without MCR (OR 2.45; 95% CI 1.06–5.68 (P = 0.03). Conclusions Māori and non-Māori of advanced age show a mostly stable pattern of gait and cognition over time. Risk factors for falls differ for Māori, and do not include gait and cognition.
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Affiliation(s)
- Sue Lord
- Health & Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, 1142, New Zealand.
| | - Simon Moyes
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Tamaki Campus, Auckland, New Zealand
| | - Ruth Teh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Tamaki Campus, Auckland, New Zealand
| | - Waiora Port
- James Henare Māori Research Centre, University of Auckland, Auckland, New Zealand
| | - Marama Muru-Lanning
- James Henare Māori Research Centre, University of Auckland, Auckland, New Zealand
| | - Catherine J Bacon
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Tamaki Campus, Auckland, New Zealand
| | | | - Ngaire Kerse
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Tamaki Campus, Auckland, New Zealand
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Frailty and Its Correlates in Adults With Late Life Depression. Am J Geriatr Psychiatry 2020; 28:145-154. [PMID: 31734083 PMCID: PMC6997042 DOI: 10.1016/j.jagp.2019.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the rates of frailty and frailty characteristics and examine the clinical and neuropsychological correlates of frailty in adults with late life depression (LLD). METHODS Data were used from the evaluation of 134 individuals over the age of 60 years (45 men, 89 women) with a depressive diagnosis who enrolled in studies for the treatment of their depression. Depression, neuropsychological functioning, white matter hyperintensity (WMH) burden via magnetic resonance imaging, and characteristics of frailty were assessed. RESULTS Fried frailty burden (≥3 characteristics) was present in 25% of the sample, with this rate increasing to 45.5% when using clinically meaningful cut-scores for gait speed (<1 m/s) and physical activity levels (<1000 kcal/week). Moreover, 62% of the sample exhibited gait slowing (<1 m/s) or weakness (grip strength), with 29% demonstrating both. Greater frailty burden was associated with greater Hamilton Depression Rating Scale severity in covariate adjusted linear regression models (t127 = 2.41, p = 0.02). Greater frailty burden was not associated with neuropsychological dysfunction, nor was it associated with greater WMH burden. CONCLUSION Findings from this study show that frailty, specifically physical frailty deficits in mobility and strength, is highly comorbid in adults with LLD, associated with greater depressive symptom severity, and does not appear to be associated with the vascular depression subtype of LLD. Future research should investigate the relationship between frailty and antidepressant treatment response as well as test whether there are age-related biological processes that result in the manifestation of the frail-depressed subtype of LLD.
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25
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Magnani PE, Freire Junior RC, Zanellato NFG, Genovez MB, Alvarenga IC, Abreu DCCD. The influence of aging on the spatial and temporal variables of gait during usual and fast speeds in older adults aged 60 to 102 years. Hum Mov Sci 2019; 68:102540. [DOI: 10.1016/j.humov.2019.102540] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
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Motoric cognitive risk syndrome and predictors of transition to dementia: A multicenter study. Alzheimers Dement 2019; 15:870-877. [PMID: 31164315 DOI: 10.1016/j.jalz.2019.03.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 01/09/2023]
Abstract
INTRODUCTION To report clinical predictors of transition to dementia in motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by cognitive complaints and slow gait. METHODS We examined if cognitive or motoric impairments predicted transition to dementia in 610 older adults with MCR from three cohorts. Association of cognitive (logical memory, clinical dementia rating, cognitive complaint severity, and Mini-Mental State Examination) and motoric factors (gait velocity) with dementia risk was computed using Cox models. RESULTS There were 156 incident dementias (134 Alzheimer's disease). In the pooled sample, logical memory (adjusted hazard ratio [aHR] 0.91), cognitive complaint severity (aHR 1.53), and Mini-Mental State Examination (aHR 0.75) predicted transition of MCR to dementia. Clinical dementia rating score ≥0.5 predicted dementia (aHR 3.18) in one cohort. Gait velocity did not predict dementia. DISCUSSION While MCR is a motoric-based predementia syndrome, severity of cognitive but not motoric impairments predicts conversion to dementia.
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27
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Lindemann U. Spatiotemporal gait analysis of older persons in clinical practice and research : Which parameters are relevant? Z Gerontol Geriatr 2019; 53:171-178. [PMID: 30770991 DOI: 10.1007/s00391-019-01520-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/25/2019] [Accepted: 01/31/2019] [Indexed: 01/01/2023]
Abstract
For older persons walking is a basic activity of daily life which characterizes the person's functional mobility. Therefore, the improvement of walking performance is a major clinical outcome during geriatric rehabilitation. Furthermore, walking performance is relevant for several geriatric research issues. Quantitative gait analysis can describe walking performance in detail. Besides gait speed, various qualitative parameters related to different aspects of walking performance, such as symmetry, regularity, coordination, dynamic balance and foot movement during the swing phase, can serve as outcome parameters in geriatric research and in clinical practice. Clinicians and researchers have to decide which parameters are appropriate to be used as relevant outcome parameters in the investigated person or group of persons.
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Affiliation(s)
- Ulrich Lindemann
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany.
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28
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Buckley C, Alcock L, McArdle R, Rehman RZU, Del Din S, Mazzà C, Yarnall AJ, Rochester L. The Role of Movement Analysis in Diagnosing and Monitoring Neurodegenerative Conditions: Insights from Gait and Postural Control. Brain Sci 2019; 9:E34. [PMID: 30736374 PMCID: PMC6406749 DOI: 10.3390/brainsci9020034] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/31/2019] [Indexed: 12/22/2022] Open
Abstract
Quantifying gait and postural control adds valuable information that aids in understanding neurological conditions where motor symptoms predominate and cause considerable functional impairment. Disease-specific clinical scales exist; however, they are often susceptible to subjectivity, and can lack sensitivity when identifying subtle gait and postural impairments in prodromal cohorts and longitudinally to document disease progression. Numerous devices are available to objectively quantify a range of measurement outcomes pertaining to gait and postural control; however, efforts are required to standardise and harmonise approaches that are specific to the neurological condition and clinical assessment. Tools are urgently needed that address a number of unmet needs in neurological practice. Namely, these include timely and accurate diagnosis; disease stratification; risk prediction; tracking disease progression; and decision making for intervention optimisation and maximising therapeutic response (such as medication selection, disease staging, and targeted support). Using some recent examples of research across a range of relevant neurological conditions-including Parkinson's disease, ataxia, and dementia-we will illustrate evidence that supports progress against these unmet clinical needs. We summarise the novel 'big data' approaches that utilise data mining and machine learning techniques to improve disease classification and risk prediction, and conclude with recommendations for future direction.
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Affiliation(s)
- Christopher Buckley
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Lisa Alcock
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Ríona McArdle
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Rana Zia Ur Rehman
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Silvia Del Din
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
| | - Claudia Mazzà
- Department of Mechanical Engineering, Sheffield University, Sheffield S1 3JD, UK.
| | - Alison J Yarnall
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
| | - Lynn Rochester
- Institute of Neuroscience/ Institute for Ageing, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK.
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
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Wagshul ME, Lucas M, Ye K, Izzetoglu M, Holtzer R. Multi-modal neuroimaging of dual-task walking: Structural MRI and fNIRS analysis reveals prefrontal grey matter volume moderation of brain activation in older adults. Neuroimage 2019; 189:745-754. [PMID: 30710680 DOI: 10.1016/j.neuroimage.2019.01.045] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 11/28/2022] Open
Abstract
It has been well established over the last two decades that walking is not merely an automatic, motoric activity; it also utilizes executive function circuits, which play an increasingly important role in walking for older people and those with mobility and cognitive deficits. Dual-task walking, such as walking while performing a cognitive task, is a necessary skill for everyday functioning, and has been shown to activate prefrontal lobe areas in healthy older people. Another well-established point in healthy aging is the loss of grey matter, and in particular loss of frontal lobe grey matter volume. However, the relationship between increased frontal lobe activity during dual-task walking and loss of frontal grey matter in healthy aging remains unknown. In the current study, we combined oxygenated hemoglobin (HbO2) data from functional near-infrared spectroscopy (fNIRS), taken during dual-task walking, with structural MRI volumetrics in a cohort of healthy older subjects to identify this relationship. We studied fifty-five relatively healthy, older participants (≥65 years) during two separate sessions: fNIRS to measure HbO2 changes between single-task (i.e., normal walking) and dual-task walking-while-talking, and high-resolution, structural MRI to measure frontal lobe grey matter volumes. Linear mixed effects modeling was utilized to determine the moderation effect of grey matter volume on the change in prefrontal oxygenated hemoglobin between the two walking tasks, while controlling for covariates including task performance. We found a highly significant interaction effect between frontal grey matter volume and task on HbO2 levels (p < 0.0001). Specifically, increased HbO2 levels during dual-task compared to single-task walking were associated with reduced frontal grey matter volume. Regional analysis identified bilateral superior and rostral middle gyri as the primary areas driving these results. The findings provide support for the concept of neural inefficiency: in the absence of behavioral gains, grey matter loss in relatively healthy, older individuals leads to over-activation of frontal lobe during a cognitively demanding walking task with established clinical and predictive utility.
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Affiliation(s)
- Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA; Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Melanie Lucas
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Kenny Ye
- Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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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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Spatiotemporal variability underlying skill in curved-path walking. Gait Posture 2019; 67:137-141. [PMID: 30336347 DOI: 10.1016/j.gaitpost.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/24/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Daily life walking frequently involves curved paths. While mean gait characteristics and orientation of the body during curved path walking have been described, little has been reported about spatiotemporal variability during curved path walking and its relation to the motor skill of walking in older adults. RESEARCH QUESTION Among community-dwelling older adults, is greater spatiotemporal variability during curved path walking related to better curved path walking ability? METHODS Community dwelling older adults (n = 34) completed the Figure-of-8 Walk Test (F8W, a measure of curved path walking ability) and usual straight path walking on an instrumented walkway. Standard deviations for step length, stride width and step time (step length variability, SLV, stride width variability, SWV, step time variability, STV) during both conditions were determined, along with time and number of steps to complete F8W. Associations were examined with Pearson r correlation coefficients, regressions determined contributions of variability during curved path walking to F8W performance, and AUC analyses were used to determine the ability of variability during curved path walking to distinguish better vs poorer F8W performance. RESULTS F8W time and steps were negatively associated with both SLV (r's = -0.37, p < 0.05) and SWV (r's = -0.67 to -0.82, p < 0.001). Both SLV and SWV independently contributed to F8W performance (SLV βs = -0.26 to -0.29, p < 0.03; SWV βs = -0.74 to -0.76, p < 0.001). The AUC of the ROC curve for SLV was 0.716, and for SWV was 0.765. SIGNIFICANCE Greater spatial variability, particularly SWV, was associated with better motor skill of curved path walking. It is important for clinicians to understand the variables that contribute to successful performance of complex walking tasks as these can be targets for rehabilitation. The findings suggest that practice of adjustment of stride width and step length during walking are important.
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Herrero-Larrea A, Miñarro A, Narvaiza L, Gálvez-Barrón C, León NG, Valldosera E, Felipe E, Valverde RA, Kruse L, Sabater JB, Rodríguez-Molinero A. Normal limits of home measured spatial gait parameters of the elderly population and their association with health variables. Sci Rep 2018; 8:13193. [PMID: 30181569 PMCID: PMC6123415 DOI: 10.1038/s41598-018-31507-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/02/2018] [Indexed: 11/16/2022] Open
Abstract
Gait studies in the elderly population have been always conducted in gait labs or spacious clinical facilities, which influence gait parameters, and also implies that the participants have to be able to move to these facilities. Indoors gait characteristics of the elderly population have been very little studied. In this study, we aim to define the normal limits of the spatial gait parameters of the elderly, when walking at home, and to analyze relationship existing between the spatial gait parameters to other health variables. For such purpose, we conducted a transversal study on a probabilistic sample of 431 Spanish community-dwelling older, in which the spatial gait parameters were recorded by using an ink footprints method. We found that the mean stride length indoors was 88.47 cm (SD:26.05 cm; mean CI95%:85.52–91.41 cm), and the mean step width was 10.34 cm (SD:4.37 cm; mean CI95%:9.84–10.83 cm). Stride length was shorter in women and the oldest group, and was significantly influenced by the strength, balance, and physical activity. Stride width was larger in the oldest group and mainly affected by balance. A composite parameter including width and normalized stride length was independent from sex, and strongly differentiated between age groups. This parameter was affected by strength.
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Affiliation(s)
| | - Antonio Miñarro
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Leire Narvaiza
- Consorci Sanitari del Garraf, Vilanova i la Geltrú, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Centre de Salut Mental del Garraf. Vilanova i la Geltrú, Barcelona, Spain
| | | | | | - Esther Valldosera
- Consorci Sanitari del Garraf, Vilanova i la Geltrú, Barcelona, Spain
| | - Elisabet Felipe
- Consorci Sanitari del Garraf, Vilanova i la Geltrú, Barcelona, Spain
| | - Rosa Ana Valverde
- Consorci Sanitari del Garraf, Vilanova i la Geltrú, Barcelona, Spain
| | - Liane Kruse
- Consorci Sanitari del Garraf, Vilanova i la Geltrú, Barcelona, Spain
| | - Joan Bosch Sabater
- Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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Virmani T, Gupta H, Shah J, Larson-Prior L. Objective measures of gait and balance in healthy non-falling adults as a function of age. Gait Posture 2018; 65:100-105. [PMID: 30558914 PMCID: PMC9115806 DOI: 10.1016/j.gaitpost.2018.07.167] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Neurodegenerative diseases increase in incidence with age. Prior studies using differing populations and gait paradigms have reported various parameters changing with age, some of which correlate with falls and mortality. Here we use three different paradigms to evaluate gait and balance in healthy non-fallers. RESEARCH QUESTION What objective gait and balance parameters are correlated with aging. METHODS Healthy subjects aged 21-79 years without histories of falls, lower extremity orthopedic procedures or chronic pain were included. Subjects walked on a 20 × 4 foot pressure sensor mat (Zeno Walkway, Protokinetics, Havertown, PA) under three different gait paradigms, (i) steady-state gait, (ii) dual-task while texting on a cellular phone and (iii) tandem gait. Data was collected and analyzed using PKMAS software (Protokinetics). Linear regression analysis, stepwise multivariate analysis, and grouped analysis of gait parameters was performed using SPSS 24 (IBM). RESULTS Seventy-five subjects were enrolled. Grouped analysis and linear regression analysis showed differing significance in parameters tested. Step-wise multivariate analysis of all 31 parameters assessed from three different gait paradigms, showed weak but significant correlations in age with (i) stride-to-stride variability in (i) integrated-pressure of footsteps and (ii) stride-length during steady-state gait, (iii) mean stride-length on dual-task, and (iv) mean step-width on tandem gait (R2 = 0.382, t = 2.26, p = 0.026). SIGNIFICANCE In a population of healthy subjects without prior history of falls or medical illness that should affect gait, there were weak but significant age-related changes in objective measures of steady state gait and balance. Future prospective longitudinal data will help predict the relevance of this in relation to falls in the elderly.
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Affiliation(s)
- Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Center for Translational Neuroscience, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Harsh Gupta
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jesal Shah
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Linda Larson-Prior
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Center for Translational Neuroscience, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Psychiatry, Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Paraschiv-Ionescu A, Büla CJ, Major K, Lenoble-Hoskovec C, Krief H, El-Moufawad C, Aminian K. Concern about Falling and Complexity of Free-Living Physical Activity Patterns in Well-Functioning Older Adults. Gerontology 2018; 64:603-611. [PMID: 29972821 DOI: 10.1159/000490310] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fall-related psychological concerns are common among older adults, potentially contributing to functional decline as well as to restriction of activities and social participation. To effectively prevent such negative consequences, it is important to understand how even very low concern about falling could affect physical activity behavior in everyday life. We hypothesized that concern about falling is associated with a reduction in diversity, dynamics, and performance of daily activities, and that these features can be comprehensively quantified in terms of complexity of physical activity patterns. METHODS A sample of 40 community-dwelling older adults were assessed for concern about falling using the Falls Efficacy Scale-International (FES-I). Free-living physical activity was assessed using a set of metrics derived from data recorded with a chest-worn tri-axial accelerometer. The devised metrics characterized physical activity behavior in terms of endurance (total locomotion time, longest locomotion period, usual walking cadence), performance (cadence of longest locomotion period, locomotion periods with at least 30 steps and 100 steps/min), and complexity of physical activity patterns. Complexity was quantified according to variations in type, intensity, and duration of activities, and was considered as an adaptive response to environmental exigencies over the course of the day. RESULTS Based on FES-I score, participants were classified into two groups: not concerned at all/fully confident (n = 25) and concerned/less confident (n = 15). Demographic and health-related variables did not differ significantly between groups. Comparison of physical activity behavior indicated no significant differences for endurance-related metrics. In contrast, performance and complexity metrics were significantly lower in the less confident group compared to the fully confident group. Among all metrics, complexity of physical activity patterns appeared as the most discriminative feature between fully confident and less confident participants (p = 0.001, non-parametric Cliff's delta effect size = 0.63). CONCLUSIONS These results extend our understanding of the interplay between low concern about falling and physical activity behavior of community-dwelling older persons in their everyday life context. This information could serve to better design and evaluate personalized intervention programs in future prospective studies.
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Affiliation(s)
| | - Christophe J Büla
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | - Kristof Major
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | | | - Hélène Krief
- Service of Geriatric Medicine, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland
| | - Christopher El-Moufawad
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Kamiar Aminian
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Proessl F, Swanson CW, Rudroff T, Fling BW, Tracy BL. Good agreement between smart device and inertial sensor-based gait parameters during a 6-min walk. Gait Posture 2018; 64:63-67. [PMID: 29859414 DOI: 10.1016/j.gaitpost.2018.05.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/07/2018] [Accepted: 05/27/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traditional laboratory-based kinetic and kinematic gait analyses are expensive, time-intensive, and impractical for clinical settings. Inertial sensors have gained popularity in gait analysis research and more recently smart devices have been employed to provide quantification of gait. However, no study to date has investigated the agreement between smart device and inertial sensor-based gait parameters during prolonged walking. RESEARCH QUESTION Compare spatiotemporal gait metrics measured with a smart device versus previously validated inertial sensors. METHODS Twenty neurologically healthy young adults (7 women; age: 25.0 ± 3.7 years; BMI: 23.4 ± 2.9 kg/m2) performed a 6-min walk test (6MWT) wearing inertial sensors and smart devices to record stride duration, stride length, cadence, and gait speed. Pearson correlations were used to assess associations between spatiotemporal measures from the two devices and agreement between the two methods was assessed with Bland-Altman plots and limits of agreement. RESULTS All spatiotemporal gait metrics (stride duration, cadence, stride length and gait speed) showed strong (r>0.9) associations and good agreement between the two devices. SIGNIFICANCE Smart devices are capable of accurately reflecting many of the spatiotemporal gait metrics of inertial sensors. As the smart devices also accurately reflected individual leg output, future studies may apply this analytical strategy to clinical populations, to identify hallmarks of disability status and disease progression in a more ecologically valid environment.
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Affiliation(s)
- F Proessl
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - C W Swanson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - T Rudroff
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA; Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA.
| | - B W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA; Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA
| | - B L Tracy
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
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Mikos V, Yen SC, Tay A, Heng CH, Chung CLH, Liew SHX, Tan DML, Au WL. Regression analysis of gait parameters and mobility measures in a healthy cohort for subject-specific normative values. PLoS One 2018; 13:e0199215. [PMID: 29912992 PMCID: PMC6005486 DOI: 10.1371/journal.pone.0199215] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/04/2018] [Indexed: 11/23/2022] Open
Abstract
Background Deviation in gait performance from normative data of healthy cohorts is used to quantify gait ability. However, normative data is influenced by anthropometry and such differences among subjects impede accurate assessment. De-correlation of anthropometry from gait parameters and mobility measures is therefore desirable. Methods 87 (42 male) healthy subjects varying form 21 to 84 years of age were assessed on gait parameters (cadence, ankle velocity, stride time, stride length) and mobility measures (the 3-meter/7-meter Timed Up-and-Go, 10-meter Walk Test). Multiple linear regression models were derived for each gait parameter and mobility measure, with anthropometric measurements (age, height, body mass, gender) and self-selected walking speed as independent variables. The resulting models were used to normalize the gait parameters and mobility measures. The normalization’s capability in de-correlating data and reducing data dispersion were evaluated. Results Gait parameters were predominantly influenced by height and walking speed, while mobility measures were affected by age and walking speed. Normalization de-correlated data from anthropometric measurements from |rs| < 0.74 to |rs| < 0.23, and reduced data dispersion by up to 69%. Conclusion Normalization of gait parameters and mobility measures through linear regression models augment the capability to compare subjects with varying anthropometric measurements.
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Affiliation(s)
- Val Mikos
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Shih-Cheng Yen
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Arthur Tay
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Chun-Huat Heng
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Chloe Lau Ha Chung
- Department of Physiotherapy, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Dawn May Leng Tan
- Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore
| | - Wing Lok Au
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- * E-mail:
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Allali G, Laidet M, Armand S, Saj A, Krack P, Assal F. Apathy in idiopathic normal pressure hydrocephalus: A marker of reversible gait disorders. Int J Geriatr Psychiatry 2018; 33:735-742. [PMID: 29292530 DOI: 10.1002/gps.4847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/27/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Apathy-the most common behavioral disturbance in idiopathic normal pressure hydrocephalus (iNPH)-is associated with poor gait, but the role of apathy on gait improvement after cerebrospinal fluid (CSF) tapping has not been studied yet. This study aims to compare gait improvement after CSF tapping in iNPH patients with and without apathy. METHODS Stride time variability (STV), a marker of higher level of gait control, was measured in 33 iNPH patients (78.4 ± 5.7 years; 36.4% women) with an optoelectronic system during usual walking (single task) and during walking while dual tasking of counting and verbal fluency before and 24 hours after CSF tapping. Apathy was defined by a score ≥14 on the Starkstein apathy scale. RESULTS Apathy was present in 60.6% of patients. Cerebrospinal fluid tapping led to greater improvement of STV (ie, decrease) during dual-task walking (and more specifically categorical verbal fluency) in apathetic compared to nonapathetic patients (-44.7 ± 58.1% versus +4.24 ± 67.6%, respectively; P = .040), even after adjusting for age and depressive symptoms. More severe apathy was correlated with better STV improvement while dual tasking (categorical verbal fluency) after CSF tapping (r = -0.412; P-value = 0.021), while it was not correlated with improvement on executive tests. CONCLUSIONS Our findings suggest that the presence of apathy is a predictor of better outcomes of gait disorders after CSF tapping in patients with iNPH.
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Affiliation(s)
- Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Magali Laidet
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Arnaud Saj
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paul Krack
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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The Effects of Ridged Perimeter Insoles on Gait Parameters in Older Adults. TOPICS IN GERIATRIC REHABILITATION 2018. [DOI: 10.1097/tgr.0000000000000184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Cognitive abilities and gait with its physical parameters are important for mobility. There is clinically sound evidence that a reduction of gait speed can be seen as an early subclinical indicator of cognitive decline of even higher risk of onset of dementia. The dual-task paradigm is a method in which the older person has to simultaneously solve two different task. It is of utmost importance to identify older persons at risk of falls or onset of dementia. The dual-task paradigm seems to be an important method in this process.
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Kiriella JB, Araujo T, Vergara M, Lopez-Hernandez L, Cameron JI, Herridge M, Gage WH, Mathur S. Quantitative Evaluation of Muscle Function, Gait, and Postural Control in People Experiencing Critical Illness After Discharge From the Intensive Care Unit. Phys Ther 2018; 98:8-15. [PMID: 29088390 PMCID: PMC5819851 DOI: 10.1093/ptj/pzx102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The path to recovery of muscle strength and mobility following discharge from the intensive care unit (ICU) has not been well described. OBJECTIVE The study objective was to quantify muscle function, gait, and postural control at 3 and 6 months after discharge in people who were recovering from critical illness and who were ventilated for 7 days or more. DESIGN This was a nested longitudinal study with continuous inclusion of individuals over a 2-year period and with age- and sex-matched controls. METHODS Twenty-four people were tested at 3 months after ICU discharge; 16 of them (67%) were reevaluated at 6 months (post-ICU group). Healthy controls (n = 12) were tested at a single time point. Muscle function of the knee extensors (KEs), plantar flexors (PFs), and dorsiflexors (DFs) was assessed on a dynamometer. Gait was measured using an electronic walkway, and postural control was measured with 2 portable force plates. RESULTS Muscle weakness was observed across all muscle groups at 3 months, with the greatest strength reductions in the ankle PFs (45%) and DFs (30%). Muscle power was reduced in the PFs and DFs but was not reduced in the KEs. Gait in the post-ICU group was characterized by a narrower step, longer stride, and longer double-support time than in the controls. Improvements were found in KE strength and in stride time and double-support time during gait at 6 months. Leg muscle strength and power had moderate associations with gait velocity, step width, and stride length (r = .44–.65). LIMITATIONS The small heterogeneous sample of people with a high level of function was a limitation of this study. CONCLUSIONS Muscle strength and power were impaired at 6 months after ICU discharge and were associated with gait parameters. Future studies are needed to examine the role of muscle strength and power training in post-ICU rehabilitation programs to improve mobility.
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Affiliation(s)
- Jeevaka B Kiriella
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada,Address all correspondence to Jeevaka B. Kiriella at:
| | - Tamara Araujo
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Martin Vergara
- School of Kinesiology and Health Science, York University
| | | | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, and Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | - William H Gage
- School of Kinesiology and Health Science, York University
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, and Toronto Rehabilitation Institute, University Health Network
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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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Ayers E, Barzilai N, Crandall JP, Milman S, Verghese J. Association of Family History of Exceptional Longevity With Decline in Physical Function in Aging. J Gerontol A Biol Sci Med Sci 2017; 72:1649-1655. [PMID: 28379407 DOI: 10.1093/gerona/glx053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 03/27/2017] [Indexed: 11/14/2022] Open
Abstract
Background Although many genetic and nongenetic factors interact to determine an individual's physical phenotype, there has been limited examination of the contribution of family history of exceptional parental longevity on decline in physical function in aging. Methods The LonGenity study recruited a relatively genetically homogenous cohort of Ashkenazi Jewish adults age 65 and older, who were defined as either offspring of parents with exceptional longevity ([OPEL]: having at least one parent who lived to age 95 or older) or offspring of parents with usual survival ([OPUS]: neither parent survived to age 95). Decline in performance on objective measures of strength (grip strength), balance (unipedal stance), and mobility (gait speed) as well as a composite physical function measure, the Short physical performance battery (SPPB), were compared between the two groups over a median follow-up of 3.2 years, accounting for age, sex, education, and comorbidities. Results Of the 984 LonGenity participants (mean age 76, 55% women), 448 were OPEL and 536 were OPUS. Compared to OPUS, OPEL had slower decline on measures of unipedal stance (-0.03 log-units/year, p = .026), repeated chair rise (0.13 s/year, p = .020) and SPPB (-0.11 points/year, p = .002). OPEL women had slower decline on chair rise and SPPB scores compared to OPUS women, although OPEL men had slower decline on unipedal stance compared to OPUS men. Conclusion Our findings provide evidence that variation in late-life decline in physical function is associated with familial longevity, and may vary for men and women.
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Affiliation(s)
| | - Nir Barzilai
- Department of Medicine.,Department of Genetics, Albert Einstein College of Medicine, Bronx, New York
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A Kinematic Symmetry Index of Gait Patterns Between Older Adults With and Without Low Back Pain. Spine (Phila Pa 1976) 2017; 42:E1350-E1356. [PMID: 28306641 DOI: 10.1097/brs.0000000000002161] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE To investigate the symmetry index for limb support patterns in right limb-dominant older adults with and without low back pain (LBP). SUMMARY OF BACKGROUND DATA The effects of bilateral asymmetry on gait performance were reported; however, there is a lack of understanding on kinematic symmetry to assess subjects with LBP. This asymmetry might be related to increased compensatory patterns to the dominant side in subjects with LBP. METHODS Eighty-two right limb-dominant older adults (45 control subjects and 37 subjects with LBP) participated in the study. A three-dimensional motion capture system was used to measure temporal-spatial gait parameters (cadence, speed, stride length, step length, and limb support times). The symmetry index was the ratio of the gait cycle between the limbs to compare the dominance pattern between groups. RESULTS Although the symmetry index was not different between groups, the initial limb support (t = 2.07, P = 0.04) and terminal limb support (t = -2.26, P = 0.02) times were significantly different. The LBP group demonstrated significantly greater nondominant initial support times and dominant terminal support times. The single-limb support was not different between groups (t = 1.72, P = 0.09). The limb support pattern demonstrated a significant interaction between groups (F = 4.72, P = 0.03) regardless of gait speed (F = 0.91, P = 0.34). CONCLUSION An asymmetrical gait pattern was evident in the LBP group as they demonstrated a longer double-limb support pattern due to a possible pain avoidance strategy. The control group demonstrated a symmetrical pattern for limb support in the stance phase. Clinicians need to consider asymmetric limb support patterns of gait modification similar to the control group when developing rehabilitation strategies for patients with LBP. LEVEL OF EVIDENCE 3.
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Perice L, Barzilai N, Verghese J, Weiss EF, Holtzer R, Cohen P, Milman S. Lower circulating insulin-like growth factor-I is associated with better cognition in females with exceptional longevity without compromise to muscle mass and function. Aging (Albany NY) 2017; 8:2414-2424. [PMID: 27744417 PMCID: PMC5115897 DOI: 10.18632/aging.101063] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 09/28/2016] [Indexed: 12/21/2022]
Abstract
Mutations that reduce somatotropic signaling result in improved lifespan and health-span in model organisms and humans. However, whether reduced circulating insulin-like growth factor-I (IGF-I) level is detrimental to cognitive and muscle function in older adults remains understudied. A cross-sectional analysis was performed in Ashkenazi Jews with exceptional longevity (age ≥95 years). Cognition was assessed using the Mini-Mental State Examination and muscle function with the chair rise test, grip-strength, and gait speed. Muscle mass was estimated using the skeletal muscle index. Serum IGF-I was measured with liquid chromatography mass spectrometry. In gender stratified age-adjusted logistic regression analysis, females with IGF-I levels in the first tertile had lower odds of being cognitively impaired compared to females with IGF-I levels within the upper two tertiles, OR (95% CI) 0.39 (0.19-0.82). The result remained significant after adjustment for multiple parameters. No significant association was identified in males between IGF-I and cognition. No relationship was found between IGF-I tertiles and muscle function and muscle mass in females or males. Lower circulating IGF-I is associated with better cognitive function in females with exceptional longevity, with no detriment to skeletal muscle mass and function.
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Affiliation(s)
- Leland Perice
- Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nir Barzilai
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Joe Verghese
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Erica F Weiss
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461
| | - Pinchas Cohen
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Sofiya Milman
- Department of Medicine, Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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McKay MJ, Baldwin JN, Ferreira P, Simic M, Vanicek N, Wojciechowski E, Mudge A, Burns J. Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3-101 years. Gait Posture 2017; 58:78-87. [PMID: 28763713 DOI: 10.1016/j.gaitpost.2017.07.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/07/2017] [Accepted: 07/03/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics. METHODS In 1000 healthy males and females aged 3-101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3-9 years, adolescents aged 10-19 years, adults aged 20-59 years and older adults aged over 60 years. RESULTS A comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength. CONCLUSION This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.
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Affiliation(s)
- Marnee J McKay
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Jennifer N Baldwin
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Paulo Ferreira
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Milena Simic
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Natalie Vanicek
- Department of Sport, Health and Exercise Science, School of Life Sciences, University of Hull, United Kingdom.
| | - Elizabeth Wojciechowski
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
| | - Anita Mudge
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
| | - Joshua Burns
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia; Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
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Beauchet O, Allali G, Sekhon H, Verghese J, Guilain S, Steinmetz JP, Kressig RW, Barden JM, Szturm T, Launay CP, Grenier S, Bherer L, Liu-Ambrose T, Chester VL, Callisaya ML, Srikanth V, Léonard G, De Cock AM, Sawa R, Duque G, Camicioli R, Helbostad JL. Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative. Front Hum Neurosci 2017; 11:353. [PMID: 28824393 PMCID: PMC5540886 DOI: 10.3389/fnhum.2017.00353] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities. Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the "Gait, cOgnitiOn & Decline" (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy-free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)-participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls declined with increasing age (mean values and CoV) and demonstrated sex differences (mean values). Conclusions: Based on an international multicenter collaboration, we propose consensus guidelines for gait assessment and spatiotemporal gait analysis based on the recorded footfalls, and reference values for healthy older adults.
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Affiliation(s)
- Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill UniversityMontreal, QC, Canada.,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill UniversityMontreal, QC, Canada.,Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health NetworkQC, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of GenevaGeneva, Switzerland.,Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva UniversityBronx, NY, United States
| | - Harmehr Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill UniversityMontreal, QC, Canada
| | - Joe Verghese
- Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva UniversityBronx, NY, United States
| | - Sylvie Guilain
- Geriatric Department, Liège University HospitalLiege, Belgium.,Laboratory of Human Motion Analysis, Liège UniversityLiege, Belgium
| | | | - Reto W Kressig
- Basel University Center for Medicine of Aging, Felix Platter Hospital and University of BaselBasel, Switzerland
| | - John M Barden
- Faculty of Kinesiology and Health Studies, Neuromechanical Research Centre, University of ReginaRegina, SK, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of ManitobaWinnipeg, MB, Canada
| | - Cyrille P Launay
- Division of Geriatrics, Angers University HospitalAngers, France
| | - Sébastien Grenier
- Centre de Recherche, Institut Universitaire de Gériatrie de MontréalMontreal, QC, Canada
| | - Louis Bherer
- Centre de Recherche, Institut Universitaire de Gériatrie de MontréalMontreal, QC, Canada.,Department of Medicine and Montreal Heart Institute, University of MontrealMontreal, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British ColumbiaVancouver, BC, Canada
| | - Vicky L Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New BrunswickFredericton, NB, Canada
| | - Michele L Callisaya
- Menzies Institute of Medical Research, University of TasmaniaHobart, TAS, Australia.,Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash UniversityMelbourne, VIC, Australia
| | - Velandai Srikanth
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash UniversityMelbourne, VIC, Australia
| | - Guillaume Léonard
- Research Center on Aging, CIUSSS de l'Estrie-CHUSSherbrooke, QC, Canada
| | - Anne-Marie De Cock
- Department of Geriatrics and Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp and AZ St. Maarten MechelenAntwerp, Belgium
| | - Ryuichi Sawa
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and WelfareNarita, Japan
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science, University of Melbourne and Western HealthSt. Albans, VIC, Australia
| | - Richard Camicioli
- Division of Neurology, Department of Medicine, University of AlbertaEdmonton, AB, Canada
| | - Jorunn L Helbostad
- Department of Neuro-Medicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and TechnologyTrondheim, Norway.,Clinic for Clinical Services, St. Olav University HospitalTrondheim, Norway
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[Subjective Gait Stability in the Elderly]. Z Gerontol Geriatr 2017; 52:17-22. [PMID: 28695318 DOI: 10.1007/s00391-017-1288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND It can be assumed that the feeling of gait stability or gait instability in the elderly may be independent of a possible fear of falling or a history of falling when walking. Up to now, there has been a lack of spatiotemporal gait parameters for older people who subjectively feel secure when walking. OBJECTIVE The aim of the study is to analyse the distribution of various gait parameters for older people who subjectively feel secure when walking. MATERIALS AND METHODS In a cross-sectional study, the gait parameters stride time, step time, stride length, step length, double support, single support, and walking speed were measured using a Vicon three-dimensional motion capture system (Plug-In Gait Lower-Body Marker Set) in 31 healthy people aged 65 years and older (mean age 72 ± 3.54 years) who subjectively feel secure when walking. RESULTS There was a homogeneous distribution in the gait parameters examined, with no abnormalities. The mean values have a low variance with narrow confidence intervals. CONCLUSION This study provides evidence that people who subjectively feel secure when walking demonstrate similarly objective gait parameters..
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Kirkwood RN, Gomes HA, Sampaio RF, Furtado SRC, Moreira BS. Spatiotemporal and variability gait data in community-dwelling elderly women from Brazil. Braz J Phys Ther 2017; 20:258-66. [PMID: 27437717 PMCID: PMC4946842 DOI: 10.1590/bjpt-rbf.2014.0157] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/26/2015] [Indexed: 12/02/2022] Open
Abstract
Background Gait is an extremely complex motor task; therefore, gait data should encompass as
many gait parameters as possible. Objective To provide reference values for gait measurements obtained from a Brazilian group
of community-dwelling elderly females between the ages of 65 and 89 years and to
apply the PCA-biplot to yield insight into different walking strategies that might
occur during the aging process. Method 305 elderly community-dwelling females living in Brazil were stratified into four
age groups: 65-69 years (N=103); 70-74 years (N=95); 75-79 years (N=77); and ≥80
years (N=30). Age, height, and BMI were assessed to describe the characteristics
of the groups. Gait spatiotemporal and variability data were obtained using the
GAITRite® system. Principal component analysis, followed by MANOVA and the
PCA-biplot approach were used to analyze the data. Results 95% CI showed that only three components – rhythm, variability, and support -
together explained 74.2% of the total variance in gait that were different among
the groups. The older groups (75-79 and ≥80 years) walked with lower than average
velocity, cadence, and step length and were above average for the variables
stance, step, swing, and double support time and the ≥80 year old group presented
the highest gait variability compared to the other groups. Conclusion Aging is associated with decreased gait velocity and cadence and increased stance,
step time, and variability, but not associated with changes in base of support. In
addition, the PCA-biplot indicates a decline towards decreased rhythm and
increased variability with aging.
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Affiliation(s)
- Renata N Kirkwood
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Henrique A Gomes
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rosana F Sampaio
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sheyla R C Furtado
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno S Moreira
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Verghese J, Lipton R, Ayers E. Spatial navigation and risk of cognitive impairment: A prospective cohort study. Alzheimers Dement 2017; 13:985-992. [PMID: 28264767 DOI: 10.1016/j.jalz.2017.01.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/17/2017] [Accepted: 01/20/2017] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established. METHODS This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes. RESULTS Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06-1.48) and MCR (aHR: 1.53; 95% CI: 1.23-1.90). DMT predicted MCR but not MCI. DISCUSSION Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias.
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Affiliation(s)
- Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Richard Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Holtzer R, Schoen C, Demetriou E, Mahoney JR, Izzetoglu M, Wang C, Verghese J. Stress and gender effects on prefrontal cortex oxygenation levels assessed during single and dual-task walking conditions. Eur J Neurosci 2017; 45:660-670. [PMID: 28028863 DOI: 10.1111/ejn.13518] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 01/13/2023]
Abstract
The ability to walk is critical for functional independence and wellbeing. The pre-frontal cortex (PFC) plays a key role in cognitive control of locomotion, notably under attention-demanding conditions. Factors that influence brain responses to cognitive demands of locomotion, however, are poorly understood. Herein, we evaluated the individual and combined effects of gender and perceived stress on stride velocity and PFC Oxygenated Hemoglobin (HbO2 ) assessed during single and dual-task walking conditions. The experimental paradigm included Normal Walk (NW); Cognitive Interference (Alpha); and Walk-While-Talk (WWT) tasks. An instrumented walkway was used to assess stride velocity in NW and WWT conditions. Functional Near-Infrared-Spectroscopy (fNIRS) was used to quantify PFC HbO2 levels during NW, Alpha and WWT. Perceived task-related stress was evaluated with a single 11-point scale item. Participants were community residing older adults (age = 76.8 ± 6.7 years; %female = 56). Results revealed that higher perceived stress was associated with greater decline in stride velocity from single to dual-task conditions among men. Three-way interactions revealed that gender moderated the effect of perceived stress on changes in HbO2 levels comparing WWT to NW and Alpha. Attenuation in the increase in HbO2 levels, in high compared to low perceived stress levels, from the two single task conditions to WWT was observed only in men. Thus, older men may be more vulnerable to the effect of perceived stress on the change in PFC oxygenation levels across walking conditions that vary in terms of cognitive demands. These findings confer important implications for assessment and treatment of individuals at risk of mobility impairments.
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, 1225 Morris Park Avenue, Van Etten, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.,Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, NY, USA
| | - Chelsea Schoen
- Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, NY, USA
| | - Eleni Demetriou
- Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, NY, USA
| | - Jeannette R Mahoney
- Department of Neurology, 1225 Morris Park Avenue, Van Etten, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Meltem Izzetoglu
- Drexel University School of Biomedical Engineering, Philadelphia, PA, USA
| | - Cuiling Wang
- Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joe Verghese
- Department of Neurology, 1225 Morris Park Avenue, Van Etten, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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