Brain structural change and gait decline: a longitudinal population-based study
| Autor: | Richard Beare, Velandai Srikanth, Amanda G. Thrift, Michele L. Callisaya, Jian Shen Chen, Leigh Blizzard, Thanh G. Phan |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Aging Population Nerve Fibers Myelinated Statistics Nonparametric White matter Disability Evaluation Atrophy Physical medicine and rehabilitation medicine Humans Longitudinal Studies education Geriatric Assessment Gait Disorders Neurologic Cognitive reserve Aged Geriatrics Aged 80 and over education.field_of_study medicine.diagnostic_test business.industry Brain Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Hyperintensity medicine.anatomical_structure Physical therapy Disease Progression Linear Models Female Geriatrics and Gerontology Cadence business |
| Zdroj: | Journal of the American Geriatrics Society. 61(7) |
| ISSN: | 1532-5415 |
| Popis: | Objectives: To investigate longitudinal associations between changes in brain structure and gait decline. Design: Longitudinal. Setting: Population-based Tasmanian Study of Cognition and Gait. Participants: Two hundred twenty-five individuals aged 60 to 86 (mean age 71.4 ± 6.8) randomly selected from the electoral roll with baseline and follow-up data. Measurements: Volumes of gray matter, white matter, hippocampi, and white matter lesions (WML) were estimated using automated segmentation from magnetic resonance imaging (MRI). Gait variables were measured using a computerized walkway. Linear regression was used to estimate the association between change in brain MRI measures and change in gait. Time between measurements, age, sex, BMI, education level, total intracranial volume, baseline infarcts, and medical history were used as baseline covariates. Results: Mean follow-up was 30.6 months. White matter atrophy was associated with a decline in gait speed (P = .001), step length (P = .005), and cadence (P = .001). WML progression was associated with a decline in gait speed (P = .04), and its association with decline in step length was stronger with greater baseline age (P for interaction = .04). Hippocampal atrophy was associated with a decline in gait speed (P = .006) and step length (P = .001). Total gray matter atrophy was associated with decline in cadence in those with cerebral infarcts (P for interaction = .02). Conclusion: These are the first longitudinal data demonstrating the relative contributions of brain atrophy and WML progression to gait decline in older people. Effect modification according to age and infarcts suggests a contribution of reduced physiological and brain reserve. Interventions targeting brain health may be important in preventing mobility decline in older people. © 2013, The American Geriatrics Society. |
| Databáze: | OpenAIRE |
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