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Spatial task-related brain activity and its association with preferred and fast pace gait speed in older adults.

ABSTRACT: Task-related brain activity is associated with preferred pace gait speed in older adults. Whether similar regional brain activity relates to fast pace gait speed has yet to be determined, but may provide insight into neural substrate important for walking under various conditions. This study measured regional blood-oxygen-level dependent (BOLD) changes using functional magnetic resonance imaging (fMRI) in response to a spatial Simon/Stroop task in community-dwelling older adults (N?=?20, 63-80y). Preferred pace, fast pace, and dual-task gait speeds (picking up objects at preferred pace; fast walking over obstacles) were measured across a 7-meter course. Time to complete a fast pace 400?m walk test was also recorded. Partial correlations were used for all analyses after adjusting for age. Accuracy on incongruent trials of the spatial task was positively correlated with all fast walking conditions (all p?

SUBMITTER: Gonzales JU

PROVIDER: S-EPMC6858846 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Spatial task-related brain activity and its association with preferred and fast pace gait speed in older adults.

Gonzales Joaquin U JU Al-Khalil Kareem K O'Boyle Michael M

Neuroscience letters 20191001

Task-related brain activity is associated with preferred pace gait speed in older adults. Whether similar regional brain activity relates to fast pace gait speed has yet to be determined, but may provide insight into neural substrate important for walking under various conditions. This study measured regional blood-oxygen-level dependent (BOLD) changes using functional magnetic resonance imaging (fMRI) in response to a spatial Simon/Stroop task in community-dwelling older adults (N = 20, 63-80y) ...[more]

PMID: 31585208

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Project description:BACKGROUND:Hospitalization-associated functional decline is a common problem for older adults, but it is unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in gait speed and likelihood of new limitations in mobility and activities of daily living (ADLs). METHODS:We used longitudinal data over 5 years from the Health, Aging and Body Composition Study, a prospective cohort of black and white community-dwelling men and women, aged 70-79 years, who had no limitations in mobility (difficulty walking 1/4 mile or climbing 10 steps) or ADLs (transferring, bathing, dressing, and eating) at baseline. Gait speed, and new self-reported limitations in mobility and ADLs were assessed annually. Selected participants (n = 2,963) had no limitations at the beginning of each 1-year interval. Hospitalizations were self-reported every 6 months and verified with medical record data. Generalized estimating equations were used to examine hospitalization-associated change in gait speed and odds of new limitations over each 1-year interval. Fully adjusted models included demographics, hospitalization within the past year, health conditions, symptoms, body mass index, and health-related behaviors. RESULTS:In fully adjusted models, any hospitalization was associated with decrease in gait speed (-0.04 m/s; 95% confidence interval [CI]: -0.05 to -0.03) and higher odds of new limitations in mobility or ADLs (odds ratio = 1.97, 95% CI: 1.70-2.28), and separately with increased odds of new mobility limitation (odds ratio = 2.22, 95% CI: 1.90-2.60) and new ADL limitations (odds ratio = 1.84, 95% CI: 1.53-2.21). Multiple hospitalizations within a year were associated with gait speed decline (-0.06 m/s; 95% CI: -0.08 to -0.04) and greater odds of new limitations in mobility or ADLs (odds ratio = 2.96, 95% CI: 2.23-3.95). CONCLUSIONS:Functionally independent older adults experienced hospitalization-associated declines in gait speed and new limitations in mobility and ADLs.

Project description:BackgroundFunctional independence and safe mobility, especially in older people, mostly rely on the ability to perform dual tasks, particularly during activities with variable- and fixed-priority attention. The aim of this study is to compare the dual-task training with progression from variable- to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults.MethodsThis is an assessor- and participant-blinded, two-arm, randomized controlled trial with 60 community-dwelling male and female older adults between the ages of 60 and 80 years old. Participants will be randomly allocated into either the intervention group or the control group using a computer-generated permuted block randomization schedule. The intervention group will undertake a progressive dual-task training in which the participants will be progressively submitted to dual-task walking and postural balance exercises with variable- to fixed-priority instructions. The control group will be submitted to dual-task training with variable-priority attention exercises. Both groups will receive 48 sessions lasting for 60 min each over 24 weeks. The primary outcome will be the gait speed under single- and dual-task conditions. Secondary outcomes will include spatiotemporal gait parameters, functional balance, executive function, falls, quality of life, and depression symptoms. All the analyses will be based on the intention-to-treat principle.DiscussionThis is the first assessor- and participant-blinded, two-arm, randomized controlled trial with 6 months of intervention and an additional 6-month post-training follow up aiming to evaluate the effectiveness of training with progression from variable- to fixed-priority instructions on gait biomechanics, postural balance, falls episodes, executive functioning, and quality of life in community-dwelling older adults. If our hypotheses are confirmed, this training protocol can be implemented widely to improve gait speed and other functional activities and quality of life in community-dwelling older adults. This study protocol can be used to improve these functional aspects of community-dwelling older adults. This study may also contribute to future guidelines for the improvement of these clinical and biomechanical aspects in older people.Trial registrationClinicalTrials.gov Identifier - NCT03886805, Registered 22 March 2019.

Dataset Information

Spatial task-related brain activity and its association with preferred and fast pace gait speed in older adults.

Publications

Spatial task-related brain activity and its association with preferred and fast pace gait speed in older adults.

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