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Richardson JK, Ellmers TJ. The relationship between clinical measures of cognitive function and grip strength in healthy older adults. BMC Geriatr 2022; 22:907. [PMID: 36434530 PMCID: PMC9701070 DOI: 10.1186/s12877-022-03629-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Handgrip strength is considered a surrogate for musculoskeletal strength, however there is emerging evidence of an association with cognition. The specific neurocognitive attribute which best associates with grip strength is unknown. METHODS We performed a secondary analysis on baseline data in 49 healthy older adults. Grip strength was corrected for body mass index. Control independent variables included age, Montreal Cognitive Assessment, and Trails B. Experimental variables included a clinical measure of simple reaction time, and clinical and computerized go/no-go tasks. The clinical Go/No-Go measure was determined with ReacStick, a rod-shaped device which - when released by the examiner - requires the participant to decide within 390 ms whether to catch the device or let it fall to the ground. RESULTS Bivariate analysis demonstrated that age and all cognitive measures other than the computer go/no-go response accuracy related to grip strength. Multivariate analyses showed that following inclusion of the control variables, only ReacStick measures (reaction accuracy/simple reaction time) significantly predicted grip strength, explaining an additional 15.90% variance (p = 0.026). In contrast, computerized Go/No-Go accuracy (p = 0.391), response time variability (p = 0.463), and the control variables (p value range = 0.566-0.942) did not predict grip strength. CONCLUSION A short latency (< 390 ms) visuomotor Go/No-Go task independently predicted over 15% of grip strength variance, whereas a slower screen-based Go/No-Go task did not. These findings support the notion that declining grip strength likely reflects sub-clinical brain changes as well as musculoskeletal dysfunction, possibly explaining the potent relationships between grip strength, disability, chronic disease, and mortality.
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Affiliation(s)
- James K Richardson
- Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E. Eisenhower Pkwy, Suite 200, Ann Arbor, MI, 48108, USA.
| | - Toby J Ellmers
- Department of Brain Sciences, Imperial College of London, London, UK
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Pani J, Eikenes L, Reitlo LS, Stensvold D, Wisløff U, Håberg AK. Effects of a 5-Year Exercise Intervention on White Matter Microstructural Organization in Older Adults. A Generation 100 Substudy. Front Aging Neurosci 2022; 14:859383. [PMID: 35847676 PMCID: PMC9278017 DOI: 10.3389/fnagi.2022.859383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
Aerobic fitness and exercise could preserve white matter (WM) integrity in older adults. This study investigated the effect on WM microstructural organization of 5 years of exercise intervention with either supervised moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), or following the national physical activity guidelines. A total of 105 participants (70–77 years at baseline), participating in the randomized controlled trial Generation 100 Study, volunteered to take part in this longitudinal 3T magnetic resonance imaging (MRI) study. The HIIT group (n = 33) exercised for four intervals of 4 min at 90% of peak heart rate two times a week, the MICT group (n = 24) exercised continuously for 50 min at 70% peak heart rate two times a week, and the control group (n = 48) followed the national guidelines of ≥30 min of physical activity almost every day. At baseline and at 1-, 3-, and 5-year follow-ups, diffusion tensor imaging (DTI) scans were performed, cardiorespiratory fitness (CRF) was measured as peak oxygen uptake (VO2peak) with ergospirometry, and information on exercise habits was collected. There was no group*time or group effect on any of the DTI indices at any time point during the intervention. Across all groups, CRF was positively associated with fractional anisotropy (FA) and axial diffusivity (AxD) at the follow-ups, and the effect became smaller with time. Exercise intensity was associated with mean diffusivity (MD)/FA, with the greatest effect at 1-year and no effect at 5-year follow-up. There was an association between exercise duration and FA and radial diffusivity (RD) only after 1 year. Despite the lack of group*time interaction or group effect, both higher CRF and exercise intensity was associated with better WM microstructural organization throughout the intervention, but the effect became attenuated over time. Different aspects of exercising affected the WM metrics and WM tracts differently with the greatest and most overlapping effects in the corpus callosum. The current study indicates not only that high CRF and exercise intensity are associated with WM microstructural organization in aging but also that exercise’s positive effects on WM may decline with increasing age.
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Affiliation(s)
- Jasmine Pani
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St Olav's University Hospital, Trondheim, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Line S Reitlo
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Asta Kristine Håberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St Olav's University Hospital, Trondheim, Norway
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Rosso AL, Metti AL, Faulkner K, Redfern M, Yaffe K, Launer L, Elizabeth Shaaban C, Nadkarni NK, Rosano C. Complex Walking Tasks and Risk for Cognitive Decline in High Functioning Older Adults. J Alzheimers Dis 2020; 71:S65-S73. [PMID: 30814353 DOI: 10.3233/jad-181140] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Performance on complex walking tasks may provide a screen for future cognitive decline. OBJECTIVE To identify walking tasks that are most strongly associated with subsequent cognitive decline. METHODS Community-dwelling older adults with Modified Mini-Mental State (3MS) >85 at baseline (n = 223; mean age = 78.7, 52.5% women, 25.6% black) completed usual-pace walking and three complex walking tasks (fast-pace, narrow-path, visuospatial dual-task). Slope of 3MS scores for up to 9 subsequent years (average = 5.2) were used to calculate a cognitive maintainer (slope ≥0) or decliner (slope <0) outcome variable. Logistic regression models assessed associations between gait speeds and being a cognitive decliner. A sensitivity analysis in a subsample of individuals (n = 66) confirmed results with adjudicated mild cognitive impairment (MCI) or dementia at 8-9 years post-walking assessment. RESULTS Cognitive decliners were 52.5% of the sample and on average were slower for all walking tasks compared to maintainers. In models adjusted for demographic and health variables, faster fast-pace (OR = 0.87 per 0.1 m/s, 95% CI: 0.78, 0.97) and dual-task (OR = 0.84 per 0.1 m/s, 95% CI: 0.73, 0.96) gait speeds were associated with lower likelihood of being a cognitive decliner. Usual-pace gait speed was not associated (OR = 0.96 per 0.1 m/s, 95% CI: 0.85, 1.08). Results were nearly identical in analyses with adjudicated MCI or dementia as the outcome. CONCLUSION Fast-pace and dual-task walking may provide simple and effective tools for assessing risk for cognitive decline in older individuals with high cognitive function. Such screening tools are important for strategies to prevent or delay onset of clinically meaningful change.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea L Metti
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kimberly Faulkner
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kristine Yaffe
- Department of Psychiatry, Neurology and Epidemiology, University of California, San Francisco, CA, USA
| | - Lenore Launer
- Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - C Elizabeth Shaaban
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Neelesh K Nadkarni
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Karim HT, Rosso A, Aizenstein HJ, Bohnen NI, Studenski S, Rosano C. Resting state connectivity within the basal ganglia and gait speed in older adults with cerebral small vessel disease and locomotor risk factors. Neuroimage Clin 2020; 28:102401. [PMID: 32932053 PMCID: PMC7495101 DOI: 10.1016/j.nicl.2020.102401] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/31/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM The basal ganglia are critical for planned locomotion, but their role in age-related gait slowing is not well known. Spontaneous regional co-activation of brain activity at rest, known as resting state connectivity, is emerging as a biomarker of functional neural specialization of varying human processes, including gait. We hypothesized that greater connectivity amongst regions of the basal ganglia would be associated with faster gait speed in the elderly. We further investigated whether this association was similar in strength to that of other risk factors for gait slowing, specifically white matter hyperintensities (WMH). METHODS A cohort of 269 adults (79-90 years, 146 females, 164 White) were assessed for gait speed (m/sec) via stopwatch; brain activation during resting state functional magnetic resonance imaging, WMH, and gray matter volume (GMV) normalized by intracranial volume via 3T neuroimaging; and risk factors of poorer locomotion via clinical exams (body mass index (BMI), muscle strength, vision, musculoskeletal pain, cardiometabolic conditions, depressive symptoms, and cognitive function). To understand whether basal ganglia connectivity shows distinct clusters of connectivity, we conducted a k-means clustering analysis of regional co-activation among the substantia nigra, nucleus accumbens, subthalamic nucleus, putamen, pallidum, and caudate. We conducted two multivariable linear regression models: (1) with gait speed as the dependent variable and connectivity, demographics, WMH, GMV, and locomotor risk factors as independent variables and (2) with basal ganglia connectivity as the dependent variable and demographics, WMH, GMV, and locomotor risk factors as independent variables. RESULTS We identified two clusters of basal ganglia connectivity: high and low without a distinct spatial distribution allowing us to compute an average connectivity index of the entire basal ganglia regional connectivity (representing a continuous measure). Lower connectivity was associated with slower gait, independent of other locomotor risk factors, including WMH; the coefficient of this association was similar to those of other locomotor risk factors. Lower connectivity was significantly associated with lower BMI and greater WMH. CONCLUSIONS Lower resting state basal ganglia connectivity is associated with slower gait speed. Its contribution appears comparable to WMH and other locomotor risk factors. Future studies should assess whether promoting higher basal ganglia connectivity in older adults may reduce age-related gait slowing.
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Affiliation(s)
- H T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.
| | - A Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - H J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - N I Bohnen
- Departments of Radiology & Neurology, University of Michigan, Ann Arbor, MI, United States; Neurology Service & Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - S Studenski
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
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Dadar M, Gee M, Shuaib A, Duchesne S, Camicioli R. Cognitive and motor correlates of grey and white matter pathology in Parkinson's disease. Neuroimage Clin 2020; 27:102353. [PMID: 32745994 PMCID: PMC7399172 DOI: 10.1016/j.nicl.2020.102353] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/25/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Previous studies have found associations between grey matter atrophy and white matter hyperintensities (WMH) of vascular origin with cognitive and motor deficits in Parkinson's disease (PD). Here we investigate these relationships in a sample of PD patients and age-matched healthy controls. METHODS Data included 50 PD patients and 45 age-matched controls with T1-weighted and FLAIR scans at baseline, 18-months, and 36-months follow-up. Deformation-based morphometry was used to measure grey matter atrophy. SNIPE (Scoring by Nonlocal Image Patch Estimator) was used to measure Alzheimer's disease-like textural patterns in the hippocampi. WMHs were segmented using T1-weighted and FLAIR images. The relationship between MRI features and clinical scores was assessed using mixed-effects models. The motor subscore of the Unified Parkinson's Disease Rating Scale (UPDRSIII), number of steps in a walking trial, and Dementia Rating Scale (DRS) were used respectively as measures of motor function, gait, and cognition. RESULTS Substantia nigra atrophy was significantly associated with motor deficits, with a greater impact in PDs (p < 0.05). Hippocampal SNIPE scores were associated with cognitve decline in both PD and controls (p < 0.01). WMH burden was significantly associated with cognitive decline and increased motor deficits in the PD group, and gait deficits in both PD and controls (p < 0.03). CONCLUSION While substantia nigra atrophy and WMH burden were significantly associated with additional motor deficits, WMH burden and hippocampal atrophy were associated with cognitive deficits in PD patients. These results suggest an additive contribution of both grey and white matter damage to the motor and cognitive deficits in PD.
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Affiliation(s)
- Mahsa Dadar
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Canada.
| | - Myrlene Gee
- Department of Medicine, Division of Neurology, University of Alberta, Canada.
| | - Ashfaq Shuaib
- Department of Medicine, Division of Neurology, University of Alberta, Canada.
| | - Simon Duchesne
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Canada.
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, Canada.
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Pinter D, Ritchie SJ, Gattringer T, Bastin ME, Hernández MDCV, Corley J, Maniega SM, Pattie A, Dickie DA, Gow AJ, Starr JM, Deary IJ, Enzinger C, Fazekas F, Wardlaw J. Predictors of gait speed and its change over three years in community-dwelling older people. Aging (Albany NY) 2019; 10:144-153. [PMID: 29356686 PMCID: PMC5811248 DOI: 10.18632/aging.101365] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/16/2017] [Indexed: 11/29/2022]
Abstract
We aimed to assess whether and how changes in brain volume and increases in white matter hyperintensity (WMH) volume over three years predict gait speed and its change independently of demographics, vascular risk factors and physical status. We analyzed 443 individuals from the Lothian Birth Cohort 1936, at mean age 73 and 76 years. Gait speed at age 76 was predicted by age, grip strength and body mass index at mean age 73, three-year brain volume decrease and WMH volume increase, explaining 26.1% of variance. Decline in gait speed to age 76 was predicted by the same five variables explaining 40.9% of variance. In both analyses, grip strength and body mass index explained the most variance. A clinically significant decline in gait speed (≥ 0.1 m/s per year) occurred in 24.4%. These individuals had more structural brain changes. Brain volume and WMH changes were independent predictors of gait dysfunction and its three-year change, but the impact of malleable physical factors such as grip strength or body mass index was greater.
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Affiliation(s)
- Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Stuart J Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Maria Del C Valdés Hernández
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Susana Muñoz Maniega
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Alison Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - David A Dickie
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Alan J Gow
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria.,Division of Neuroradiology, Vascular and Interventional Neuroradiology, Department of Radiology, Medical University of Graz, Graz, 8036, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Joanna Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.,Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.,UK Dementia Research Institute at the University of Edinburgh, Edinburgh, EH8 9YL, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chavda R, Cao JS, Benge JF. Neuropsychological impact of white matter hyperintensities in older adults without dementia. Appl Neuropsychol Adult 2019; 28:354-362. [PMID: 31287337 DOI: 10.1080/23279095.2019.1633536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to determine (a) if simple clinical judgements of white matter hyperintensities (WMH) on imaging are associated with measurable cognitive impacts in otherwise cognitively normal older adults, (b) if neuropsychological measures can predict those with WMH, and (c) the frequency of low cognitive scores in those with WMH on a battery of measures. Forty-four individuals judged free of other cognitive disorders despite moderate to extensive WMH were compared with 50 individuals matched on age (mean of 83), education (college educated), and gender (predominantly female). Data was obtained from the National Alzheimer's Coordinating Center database. The group with at least moderate WMH had lower scores on the Trail Making Test A, verbal fluency, and digit span. A component score derived from these measures was a significant predictor of the presence of WMH, though only correctly classified 68% of participants. Even in individuals free from other suspected conditions, clinically judged moderate to extensive WMH was associated with cognitive weaknesses for processing speed, working memory, and executive functioning. This shows that a relatively simple judgment of WMH burden is meaningfully associated with worse cognition. Implications and future directions for are discussed.
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Affiliation(s)
- Rihin Chavda
- College of Medicine, Texas A&M Health Science Center, Temple, Texas, USA
| | - Jeffrey S Cao
- College of Medicine, Texas A&M Health Science Center, Temple, Texas, USA
| | - Jared F Benge
- College of Medicine, Texas A&M Health Science Center, Temple, Texas, USA.,Department of Neurology and Plummer Movement Disorders Center, Baylor Scott and White Health, Temple, Texas, USA
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9
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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10
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Suire CN, Eitan E, Shaffer NC, Tian Q, Studenski S, Mattson MP, Kapogiannis D. Walking speed decline in older adults is associated with elevated pro-BDNF in plasma extracellular vesicles. Exp Gerontol 2017; 98:209-216. [PMID: 28843509 DOI: 10.1016/j.exger.2017.08.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/17/2017] [Accepted: 08/18/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is produced by cleavage of proBDNF, and BDNF and proBDNF may play antagonistic roles in nervous system development, learning, memory and neuronal stress resistance. BDNF and proBDNF are present in blood, but the origin and relative contributions of soluble and extracellular vesicle (EV)-associated levels are unknown. METHODS In this study we used validated immunoassays to measure proBDNF and BDNF levels in plasma, total plasma EVs and a subpopulation of EVs enriched for neuronal origin (expressing the neuronal marker L1CAM) in 150 Baltimore Longitudinal Study of Aging participants with and without decline in walking speed (reflecting aging-associated motor decline). RESULTS Levels of BDNF and proBDNF were highest in L1CAM+ EVs. Participants with walking speed decline had higher levels of proBDNF in L1CAM+ EVs compared to non-decliners, but no differences in proBDNF levels in plasma and total EV. CONCLUSIONS Our findings suggest that levels of proBDNF and BDNF in circulating L1CAM+ EVs might be used as biomarkers for conditions involving altered BDNF signaling.
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Affiliation(s)
- Caitlin N Suire
- Laboratory of Neurosciences, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Erez Eitan
- Laboratory of Neurosciences, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Nancy Chiles Shaffer
- Translational Gerontology Branch, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Qu Tian
- Translational Gerontology Branch, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Stephanie Studenski
- Translational Gerontology Branch, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Mark P Mattson
- Laboratory of Neurosciences, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States
| | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, National Institute on Aging on Intramural Research Program, Baltimore, MD 21224, United States.
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