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Pizzonia KL, Suhr JA, Clark LA, Clark BC. The relation of ApoE and COMT gene-gene interactions to cognitive and motor function in community-dwelling older adults: a pilot study. Front Aging Neurosci 2023; 15:1206473. [PMID: 37744392 PMCID: PMC10513033 DOI: 10.3389/fnagi.2023.1206473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Certain genes increase the risk of age-related neurological dysfunction and/or disease. For instance, ApoE is a well-known gene carrying risk for Alzheimer's disease, while COMT has been associated with age-related reductions in motor function. There is growing interest in the interrelationship between age-related changes in cognitive and motor function, and examining gene-gene interactions in this context. In this pilot study we examined the relations of the ApoE and COMT genes and their interaction to both cognitive and motor performance in community-dwelling older adults. Methods We leveraged an archived dataset from a prior study on age-related muscle weakness in community-dwelling older adults. Sample size was between 72 and 82 individuals based on missing data. We examined the relationship of ApoE (Ɛ4 presence/absence), rs4680 SNP on the COMT gene (Val/Met, Val/Val, Met/Met), and sex on (1) overall cognitive functioning and specific cognitive domains known to decline in aging (processing speed, immediate and delayed memory, semantic and phonemic fluency, and executive functioning), and (2) indices of motor function (four square step test, short physical performance battery, grip strength/forearm lean mass, and purdue pegboard test). Results Homozygous COMT genotypes were associated with worse global cognitive performance, immediate memory, and semantic fluency, but only for older adults with at least one ApoE Ɛ4 allele. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for coding and phonemic fluency. Women scored higher than men in overall cognition, immediate and delayed memory, and semantic fluency. There were no main effects or gene interactions for a measure of executive functioning (trial making test part B) or any of the measures of motor function. Discussion COMT, ApoE, and their interaction influence cognitive performance, but not motor functioning, in community dwelling older adults. Our work supports prior literature concluding that a heterozygous COMT genotype may be beneficial to sustain healthy cognitive functioning with advancing age for those who have a higher ApoE genetic risk status (at least one Ɛ4 allele). Future research should investigate interactions between COMT and ApoE in larger samples with comprehensive assessment of cognition and motor functioning.
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Affiliation(s)
- Kendra L. Pizzonia
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Julie A. Suhr
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Leatha A. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
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Santanasto AJ, Wojczynski MK, Cvejkus RK, Lin S, Wang L, Thyagarajan B, Christensen K, Schupf N, Feitosa MF, An P, Zmuda JM. Identification of a Novel Locus for Gait Speed Decline With Aging: The Long Life Family Study. J Gerontol A Biol Sci Med Sci 2021; 76:e307-e313. [PMID: 34156441 PMCID: PMC8436996 DOI: 10.1093/gerona/glab177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Gait speed is a powerful indicator of health with aging. Potential genetic contributions to gait speed and its decline with aging are not well defined. We determined the heritability of and potential genetic regions underlying change in gait speed using longitudinal data from 2379 individuals belonging to 509 families in the Long Life Family Study (mean age 64 ± 12, range 30-110 years; 45% men). METHODS Gait speed was measured over 4 m at baseline and follow-up (7 ± 1 years). Quantitative trait linkage analyses were completed using pedigree-based maximum likelihood methods with logarithm of the odds (LOD) scores greater than 3.0, indicating genome-wide significance. We also performed linkage analysis in the top 10% of families contributing to LOD scores to allow for heterogeneity among families (HLOD). Data were adjusted for age, sex, height, and field center. RESULTS At baseline, 26.9% of individuals had "slow" gait speed less than 1.0 m/s (mean: 1.1 ± 0.2 m/s) and gait speed declined at a rate of -0.02 ± 0.03 m/s per year (p < .0001). Baseline and change in gait speed were significantly heritable (h2 = 0.24-0.32, p < .05). We did not find significant evidence for linkage for baseline gait speed; however, we identified a significant locus for change in gait speed on chromosome 16p (LOD = 4.2). A subset of 21 families contributed to this linkage peak (HLOD = 6.83). Association analyses on chromosome 16 showed that the strongest variant resides within the ADCY9 gene. CONCLUSION Further analysis of the chromosome 16 region, and ADCY9 gene, may yield new insight on the biology of mobility decline with aging.
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Affiliation(s)
- Adam J Santanasto
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Mary K Wojczynski
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan K Cvejkus
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Shiow Lin
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lihua Wang
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, USA
| | - Kaare Christensen
- The Danish Aging Research Center, Epidemiology Unit, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nicole Schupf
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Mary F Feitosa
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ping An
- Department of Genetics, Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
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Rosso AL, Marcum ZA, Zhu X, Bohnen N, Rosano C. Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls. J Gerontol A Biol Sci Med Sci 2021; 77:1042-1047. [PMID: 34463739 DOI: 10.1093/gerona/glab258] [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: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anticholinergic medications are associated with fall risk. Higher dopaminergic signaling may provide resilience to these effects. We tested interactions between anticholinergic medication use and dopaminergic genotype on risk for recurrent falls over 10 years. METHODS Participants in the Health ABC study (n=2372, mean age=73.6; 47.8% men; 60.0% White) without disability or anticholinergic use at baseline were followed for up to 10 years for falls. Medication use was documented in 7 of 10 years. Highly anticholinergic medications were defined by Beers criteria, 2019. Recurrent falls were defined as ≥2 in the 12 months following medication assessment. Generalized estimating equations tested the association of anticholinergic use with recurrent falls in the following 12 months, adjusted for demographics, health characteristics, and anticholinergic use indicators. Effect modification by dopaminergic genotype (catechol-O-methyltransferase (COMT); Met/Met, higher dopamine signaling, n=454 vs Val carriers, lower dopamine signaling, n=1918) was tested and analyses repeated stratified by genotype. RESULTS During follow-up, 841 people reported recurrent falls. Anticholinergic use doubled the odds of recurrent falls (adjusted OR [95% CI]=2.09 (1.45, 3.03)), with suggested effect modification by COMT (p=0.1). The association was present in Val carriers (adjusted OR [95% CI]=2.16 (1.44, 3.23)) but not in Met/Met genotype (adjusted OR [95% CI]=1.70 (0.66, 4.41)). Effect sizes were stronger when excluding baseline recurrent fallers. CONCLUSION Higher dopaminergic signaling may provide protection against increased 12-month fall risk from anticholinergic use. Assessing vulnerability to the adverse effects of anticholinergic medications could help in determination of risk/benefit ratio for prescribing and deprescribing anticholinergics in older adults.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
| | | | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
| | - Nicolaas Bohnen
- Departments of Radiology and Neurology, School of Medicine, University of Michigan
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
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Sprague BN, Rosso AL, Zhu X, Bohnen NI, Rosano C. Catechol-O-methyltransferase (COMT) polymorphism predicts rapid gait speed changes in healthy older adults. J Am Geriatr Soc 2021; 69:3194-3202. [PMID: 34231207 DOI: 10.1111/jgs.17351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/31/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
IMPORTANCE Adapting one's gait speed to external circumstances is critical for safe ambulation. Dopamine (DA), critical for adapting to increased task demands, predicts usual gait speed and may exert a greater role in complex tasks like rapid gait speed. OBJECTIVE We hypothesized that a genotypic proxy indicator of greater prefrontal DA signaling would predict significantly faster rapid gait. DESIGN Longitudinal cohort study over 8 years. SETTING Community-dwelling adults with no baseline mobility disability. PARTICIPANTS N = 2353 participants from the Health ABC Study. MEASUREMENTS Repeated measures of walking speed (meters/sec) were obtained in response to: "walk as fast as possible… (rapid gait) or "walk at your usual pace (usual gait)." Catechol-O-methyltransferase (COMT) val158met polymorphism indicated DA signaling (val/val = higher metabolism, lower DA signaling; met/met = lower metabolism, higher DA signaling). RESULTS Participants declined in rapid gait from 1.55 (SD = 0.33) to 1.35 m/s (SD = 0.34). Across the full follow-up period, the met/met genotype was associated with significantly greater rapid gait slowing. In mixed effect models, between-group differences were independent of covariates, and remained similar after adjustment for sensorimotor function, cognition, depressive symptoms, and energy. Follow-up analyses indicated the met/met genotype had a significantly faster rapid gait speed compared to the val/val genotype for the first 3 years (p < 0.01) but not years 4-8 (p > 0.05). CONCLUSION Greater prefrontal DA measured with COMT polymorphism may facilitate short-term adaptation to rapid walking demands that are lost over time. Studies should examine whether these effects are long-term and the underlying mechanistic pathways.
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Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xiaonan Zhu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nicolaas I Bohnen
- Department of Radiology and Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Ann Arbor VAMC, Ann Arbor, Michigan, USA
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Clark BC, Carson RG. Sarcopenia and Neuroscience: Learning to Communicate. J Gerontol A Biol Sci Med Sci 2021; 76:1882-1890. [PMID: 33824986 DOI: 10.1093/gerona/glab098] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Indexed: 12/11/2022] Open
Abstract
In the 1990s and early 2000s, the common definition for sarcopenia was age-related loss of skeletal muscle, and low levels of muscle mass were central to sarcopenia diagnosis. In more recent consensus definitions, however, low muscle strength displaces low muscle mass as a defining feature of sarcopenia. The change stems from growing evidence that muscle weakness is a better predictor of adverse health outcomes (e.g., mobility limitations) than muscle mass. This evidence accompanies an emerging recognition that central neural mechanisms are critical determinants of age-related changes in strength and mobility that can occur independently of variations in muscle mass. However, strikingly little practical attention is typically given to the potential role of the central nervous system in the aetiology or remediation of sarcopenia (i.e., low muscle function). In this article, we provide an overview of some mechanisms that mediate neural regulation of muscle contraction and control, and highlight the specific contributions of neural hypoexcitability, dopaminergic dysfunction, and degradation of functional and structural brain connectivity in relation to sarcopenia. We aim to enhance the lines of communication between the domains of sarcopenia and neuroscience. We believe that appreciation of the neural regulation of muscle contraction and control is fundamental to understanding sarcopenia and to developing targeted therapeutic strategies for its treatment.
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Affiliation(s)
- Brian C Clark
- Ohio Musculoskeletal & Neurological Institute and the Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
| | - Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland.,School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK.,School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Rosano C, Metti AL, Rosso AL, Studenski S, Bohnen NI. Influence of Striatal Dopamine, Cerebral Small Vessel Disease, and Other Risk Factors on Age-Related Parkinsonian Motor Signs. J Gerontol A Biol Sci Med Sci 2021; 75:696-701. [PMID: 31425570 DOI: 10.1093/gerona/glz161] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Parkinsonian motor signs are common and disabling in older adults without Parkinson's disease (PD), but its risk factors are not completely understood. We assessed the influence of striatal dopamine levels, cerebral small vessel disease, and other factors on age-related parkinsonian motor signs in non-PD adults. METHODS Striatal dopamine transporter (DAT) binding was quantified via [11C]-CFT positron emission tomography in 87 neurologically intact adults (20-85 years, 57.47% female) with concurrent data on: Unified Parkinson's Disease Rating Scale motor (UPDRSm), white matter hyperintensities (WMH), and other risk factors (grip strength, vibratory sensitivity, cardio- and cerebro-vascular comorbidities). Sex-adjusted nonparametric models first estimated the associations of age, DAT, WMH, and other factors with UPDRSm; next, interactions of age by DAT, WMH, or other factors were tested. To quantify the influence of DAT, WMH, and other risk factors on the main association of age with UPDRSm, multivariable mediation models with bootstrapped confidence intervals (CI) were used. RESULTS Older age, lower DAT, higher WMH, and worse risk factors significantly predicted worse UPDRSm (sex-adjusted p < .04 for all). DAT, but not WMH or other factors, positively and significantly interacted with age (p = .02). DAT significantly reduced the age-UPDRSm association by 30% (results of fully adjusted mediation model: indirect effect: 0.027; bootstrapped 95% CI: 0.0007, 0.074). CONCLUSIONS Striatal dopamine appears to influence to some extent the relationship between age and parkinsonian signs. However, much of the variance of parkinsonian signs appears unexplained. Longitudinal studies to elucidate the multifactorial causes of this common condition of older age are warranted.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Andrea L Metti
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Stephanie Studenski
- Department of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Nicolaas I Bohnen
- Departments of Radiology, Neurology and Division of Nuclear Medicine and Department of Veterans Affairs, University of Michigan, Ann Arbor
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Moskowitz S, Russ DW, Clark LA, Wages NP, Grooms DR, Woods AJ, Suhr J, Simon JE, O'Shea A, Criss CR, Fadda P, Clark BC. Is impaired dopaminergic function associated with mobility capacity in older adults? GeroScience 2020; 43:1383-1404. [PMID: 33236263 DOI: 10.1007/s11357-020-00303-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/18/2020] [Indexed: 01/14/2023] Open
Abstract
The capacity to move is essential for independence and declines with age. Slow movement speed, in particular, is strongly associated with negative health outcomes. Prior research on mobility (herein defined as movement slowness) and aging has largely focused on musculoskeletal mechanisms and processes. More recent work has provided growing evidence for a significant role of the nervous system in contributing to reduced mobility in older adults. In this article, we report four pieces of complementary evidence from behavioral, genetic, and neuroimaging experiments that, we believe, provide theoretical support for the assertion that the basal ganglia and its dopaminergic function are responsible, in part, for age-related reductions in mobility. We report four a posteriori findings from an existing dataset: (1) slower central activation of ballistic force development is associated with worse mobility among older adults; (2) older adults with the Val/Met intermediate catecholamine-O-methyl-transferase (COMT) genotype involved in dopamine degradation exhibit greater mobility than their homozygous counterparts; (3) there are moderate relationships between performance times from a series of lower and upper extremity tasks supporting the notion that movement speed in older adults is a trait-like attribute; and (4) there is a relationship of functional connectivity within the medial orbofrontal (mOFC) cortico-striatal network and measures of mobility, suggesting that a potential neural mechanism for impaired mobility with aging is the deterioration of the integrity of key regions within the mOFC cortico-striatal network. These findings align with recent basic and clinical science work suggesting that the basal ganglia and its dopaminergic function are mechanistically linked to age-related reductions in mobility capacity.
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Affiliation(s)
- Simon Moskowitz
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA
| | - David W Russ
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH, USA.,School of Physical Therapy & Rehabilitation Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Leatha A Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,Department of Biomedical Sciences at Ohio University, Athens, OH, USA.,Department of Family Medicine at Ohio University, Athens, OH, USA
| | - Nathan P Wages
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,Department of Biomedical Sciences at Ohio University, Athens, OH, USA
| | - Dustin R Grooms
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,School of Applied Health and Wellness, Ohio University, Athens, OH, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Julie Suhr
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,Department of Psychology, Ohio University, Athens, OH, USA
| | - Janet E Simon
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA.,School of Applied Health and Wellness, Ohio University, Athens, OH, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Cody R Criss
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA
| | - Paolo Fadda
- Genomics Shared Resource-Comprehensive Cancer Center, The Ohio State University, Athens, OH, USA
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, 250 Irvine Hall, Athens, OH, 45701, USA. .,Department of Biomedical Sciences at Ohio University, Athens, OH, USA. .,Division of Geriatric Medicine at Ohio University, Athens, OH, USA.
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Mance S, Rosso A, Bis J, Studenski S, Bohnen N, Rosano C. Catechol-O-Methyltransferase Genotype, Frailty, and Gait Speed in a Biracial Cohort of Older Adults. J Am Geriatr Soc 2020; 69:357-364. [PMID: 33043988 DOI: 10.1111/jgs.16842] [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: 04/08/2020] [Revised: 07/29/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine whether the association between dopamine-related genotype and gait speed differs according to frailty status or race. DESIGN Cross-sectional population-based study (Cardiovascular Health Study). SETTING Multicenter study, four U.S. sites. PARTICIPANTS Volunteer community-dwelling adults aged 65 years and older, without evidence of Parkinson's disease (N = 3,744; 71 years; 82% White; 39% male). MEASUREMENTS Gait speed (usual pace; m/s), physical frailty (Fried definition), and genetic polymorphism of catechol-O-methyltransferase (COMT; rs4680), an enzyme regulating tonic brain dopamine levels, were assessed. Interaction of COMT by frailty and by race predicting gait speed were tested, and, if significant, analyses were stratified. Multivariable regression models of COMT predicting gait speed were adjusted for demographics and locomotor risk factors. Sensitivity analyses were repeated, stratified by clinical cutoffs of gait speed (0.6 and 1.0 m/s) instead of frailty status. RESULTS The interaction of COMT by frailty and COMT by race were P = .02 and P = .01, respectively. Compared with Met/Met (higher dopaminergic signaling), the Val/Val group (lower dopaminergic signaling) walked marginally more slowly in the full cohort (0.87 vs 0.89 m/s; P = .2). Gait speed differences were significant for frail (n = 220; 0.55 vs 0.63 m/s; P = .03), but not for prefrail (n = 1,691; 0.81 vs 0.81 m/s; P = .9) or nonfrail (n = 1,833; 0.98 vs 0.97 m/s; P = .7); results were similar in fully adjusted models. Among frail, associations were similar for Whites and Blacks, with statistical significance for Whites only. Associations stratified by clinical cutoffs of gait speed were not significant. CONCLUSION The association of dopamine-related genotype with gait speed is stronger among adults with frailty compared with those without frailty. The potential effects of dopaminergic signaling on preserving physical function in biracial cohorts of frail adults should be further examined.
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Affiliation(s)
- Shannon Mance
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Andrea Rosso
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Joshua Bis
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA
| | | | - Nico Bohnen
- Departments of Radiology & Neurology, University of Michigan School of Medicine & Ann Arbor VA, Ann Arbor, Michigan, USA
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
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Abstract
The capacity to move is essential for independence and declines with age. Limitations in mobility impact ~35% of adults over 70 and the majority of adults over 85. These limitations are highly associated with disability, dependency, and survival. More than 25-years ago the term “sarcopenia” was coined to highlight the age-related loss of muscle mass and strength with the assumption being that sarcopenia led to limitations in mobility. However, contrary to expectations, recent findings clearly indicate these variables only modestly explain limitations in mobility. One likely reason the current sarcopenia variables of muscle mass and strength do not discriminate, or predict, mobility limitations well is because they are heavily influenced by musculoskeletal mechanisms and do not incorporate measures reflective of the central neural control of mobility. Unfortunately, the precise central neural changes associated with aging that lead to decreased mobility are poorly understood. This knowledge gap has hampered the development of effective interventions for mobility limitations and the subsequent reduction of major functional disability for older adults. Here, we discuss the potential role of the motor control circuit of the dorsal basal ganglia as well as dopaminergic function in age-related reductions in mobility.
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Rosso AL, Metti AL, Faulkner K, Brach JS, Studenski SA, Redfern M, Rosano C. Associations of Usual Pace and Complex Task Gait Speeds With Incident Mobility Disability. J Am Geriatr Soc 2019; 67:2072-2076. [PMID: 31318048 DOI: 10.1111/jgs.16049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES To assess whether gait speed under complex conditions predicts long-term risk for mobility disability as well as or better than usual-pace gait speed. DESIGN Longitudinal cohort study. SETTING/PARTICIPANTS Subsample of Health Aging and Body Composition study with follow-up from 2002 to 2003 to 2010 to 2011, including 337 community-dwelling adults (mean age = 78.5 years, 50.7% female, 26.1% black). MEASUREMENTS Associations of gait speed measured under usual-pace, fast-pace, dual-task, and narrow-path conditions with mobility disability, defined by any self-reported difficulty walking ¼ mile assessed annually, were tested by Cox proportional hazard models adjusted for demographic and health characteristics. Models were fitted for each walking condition, and R2 statistics were used to compare predictive value across models. Models were repeated for persistent mobility disability, defined as at least two consecutive years of mobility disability. RESULTS Mobility disability occurred in 204 (60.5%) participants over the 8-year follow-up. There was a lower hazard of developing mobility disability with faster gait speed under all conditions. Hazard ratios, confidence intervals, and R2 of gait speed predicting mobility disability were similar across all four walking conditions (R2 range = 0.22-0.27), but were strongest for dual-task gait speed (hazard ratio [95% confidence interval], R2 of fully adjusted models = 0.81 [0.75-0.88], 0.27). Results were comparable for persistent mobility disability (R2 range = 0.26-0.28). CONCLUSION Slower gait speed under both usual-pace and complex conditions may be a clinical indicator of future risk of mobility disability. These results support the call for increased use of gait speed measures in routine geriatric care. J Am Geriatr Soc 67:2072-2076, 2019.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrea L Metti
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kimberly Faulkner
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer S Brach
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stephanie A Studenski
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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11
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Rosso AL, Bohnen NI, Launer LJ, Aizenstein HJ, Yaffe K, Rosano C. Vascular and dopaminergic contributors to mild parkinsonian signs in older adults. Neurology 2017; 90:e223-e229. [PMID: 29247072 DOI: 10.1212/wnl.0000000000004842] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/04/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Mild parkinsonian signs (MPS) are an underappreciated neurologic condition in older adults; we assessed associations of MPS with measures of dopaminergic (catechol-O-methyltransferase [COMT] genotype, an indicator of synaptic dopamine levels) and vascular (white matter hyperintensities [WMH], an indicator of cerebral small vessel disease) factors. METHODS In a cohort of older adults (mean age 82.6 years [SD 2.6]; 58.0% female; 38.8% black), we assessed cross-sectional associations of WMH volume and COMT Val158Met (rs4680) genotype (n = 35 Met/Met, n = 180 Val carriers) with MPS by regression models adjusted for demographic and health characteristics. Interactions between WMH and COMT were assessed and analyses were repeated stratified by COMT genotype (Met/Met related to higher synaptic dopamine vs Val carriers related to lower synaptic dopamine). RESULTS MPS was present in 42.3% of our sample. WMH (odds ratio [OR] 1.16, confidence interval [CI] 1.05-1.27) but not COMT (Met/Met compared to Val carrier: OR 0.62, CI 0.27-1.42) was related to MPS. There was a significant interaction between WMH and COMT (p = 0.03). Stratified analyses reveled a strong association between WMH and MPS among COMT Val carriers (OR 1.23, CI 1.09-1.38), but not for Met/Met (OR 0.68, CI 0.45-1.02), independent of covariates. CONCLUSIONS WMH had a direct relation with MPS. In contrast, COMT was not associated with MPS, but it did modify the effect of WMH on MPS. The dopaminergic system may provide compensation for the effects of WMH on MPS. These findings suggest that MPS has a vascular rather than dopaminergic origin in older adults, but both factors are important in MPS manifestation.
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Affiliation(s)
- Andrea L Rosso
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco.
| | - Nicolaas I Bohnen
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco
| | - Lenore J Launer
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco
| | - Howard J Aizenstein
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco
| | - Kristine Yaffe
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco
| | - Caterina Rosano
- From the Department of Epidemiology, Graduate School of Public Health (A.L.R., C.R.), and Department of Psychiatry (H.J.A.), University of Pittsburgh, PA; Departments of Radiology and Neurology (N.I.B.), University of Michigan, Ann Arbor; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Baltimore, MD; and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics (K.Y.), University of California, San Francisco
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