Dataset Information

Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

ABSTRACT: Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks- the default mode network (DMN), fronto-executive network (FEN), fronto-parietal network (FPN), and the primary motor sensory network (SMN)--between community-dwelling older adults with ? two falls in the last 12 months and their non-falling counterparts (? one fall in the last 12 months). Functional connectivity was examined both at rest and during a simple motor tapping task. Compared with non-fallers, fallers showed more connectivity between the DMN and FPN during right finger tapping (p ?= 0.04), and significantly less functional connectivity between the SMN and FPN during rest (p ? 0.05). Less connectivity between the SMN and FPN during rest was significantly associated with greater decline in both cognitive function and mobility over the12-month period (r = ?-0.32 and 0.33 respectively; p ? 0.04). Thus, a recent history of multiple falls among older adults without a diagnosis of dementia may indicate sub-clinical changes in brain function and increased risk for subsequent decline.

SUBMITTER: Hsu CL

PROVIDER: S-EPMC3977422 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

Hsu Chun Liang CL Voss Michelle W MW Handy Todd C TC Davis Jennifer C JC Nagamatsu Lindsay S LS Chan Alison A Bolandzadeh Niousha N Liu-Ambrose Teresa T

PloS one 20140403 4

Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks- the default mode network (DMN), fronto-executive network (FEN), fronto-p ...[more]

PMID: 24699668

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Project description:INTRODUCTION:Compared to controlled laboratory settings, the real world is highly distracting with constant demands on visual attention to avoid hazards and falling. Fall-risk assessments do not adequately take into account the potential role of everyday distractions and environmental hazards. The purpose of this project was to identify the effect of the environment on gait and gaze behavior during walking in older adult fallers relative to non-fallers. METHODS:Thirteen older adult fallers (76.8±9.4 years, 3.2±2.3 falls in last year) and 13 age-matched non-fallers (78.3±7.3 years, 0 falls in last year) participated. Participants walked in a real-world and lab setting while gait and gaze were recorded. Gait variables were stride length variability, stride duration variability, and stride velocity. Gaze was analyzed for percentage of time fixating and average fixation duration coded across 6 areas of interest (AOIs) in the visual surroundings. RESULTS:Non-fallers walked faster than fallers, but there were no other group or environment effects on gait. For gaze behavior, fallers had shorter fixation durations on the near environment than non-fallers, but only in the real world. In the real world relative to the lab, fallers decreased fixation durations on the near environment but increased durations on near people. In the real world, participants spent a greater proportion of time fixating on people than on the walking path or the near environment compared to the lab. After adjusting for baseline gait speed, fallers had shorter fixation durations than non-fallers in both environments. CONCLUSIONS:Our results indicate that in a busy environment, older adults concentrate most of their overt visual attention on people when navigating their walking path. Fallers in particular focus longer on people near to them and have overall shorter fixations than non-fallers. Visual focus while walking in a busy environment should be further explored as a fall-risk factor.

Dataset Information

Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

Publications

Disruptions in brain networks of older fallers are associated with subsequent cognitive decline: a 12-month prospective exploratory study.

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