Slowing gait and risk for cognitive impairment

Andrea L. Rosso, Joe Verghese, Andrea L. Metti, Robert M. Boudreau, Howard J. Aizenstein, Stephen Kritchevsky, Tamara Harris, Kristine Yaffe, Suzanne Satterfield, Stephanie Studenski, Caterina Rosano

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective: To identify the shared neuroimaging signature of gait slowing and cognitive impairment. Methods: We assessed a cohort of older adults (n = 175, mean age 73 years, 57% female, 65% white) with repeated measures of gait speed over 14 years, MRI for gray matter volume (GMV) at year 10 or 11, and adjudicated cognitive status at year 14. Gait slowing was calculated by bayesian slopes corrected for intercepts, with higher values indicating faster decline. GMV was normalized to intracranial volume, with lower values indicating greater atrophy for 10 regions of interest (hippocampus, anterior and posterior cingulate, primary and supplementary motor cortices, posterior parietal lobe, middle frontal lobe, caudate, putamen, pallidum). Nonparametric correlations adjusted for demographics, comorbidities, muscle strength, and knee pain assessed associations of time to walk with GMV. Logistic regression models calculated odds ratios (ORs) of gait slowing with dementia or mild cognitive impairment with and without adjustment for GMV. Results: Gait slowing was associated with cognitive impairment at year 14 (OR per 0.1 s/y slowing 1.47; 95% confidence interval 1.04-2.07). The right hippocampus was the only region that was related to both gait slowing (ρ = -0.16, p = 0.03) and cognitive impairment (OR 0.17, p = 0.009). Adjustment for right hippocampal volume attenuated the association of gait slowing with cognitive impairment by 23%. Conclusions: The association between gait slowing and cognitive impairment is supported by a shared neural substrate that includes a smaller right hippocampus. This finding underscores the value of long-term gait slowing as an early indicator of dementia risk.

Original languageEnglish (US)
Pages (from-to)336-342
Number of pages7
JournalNeurology
Volume89
Issue number4
DOIs
StatePublished - Jul 25 2017

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Gait
Hippocampus
Gyrus Cinguli
Odds Ratio
Dementia
Logistic Models
Parietal Lobe
Globus Pallidus
Cognitive Dysfunction
Putamen
Motor Cortex
Muscle Strength
Frontal Lobe
Neuroimaging
Atrophy
Comorbidity
Knee
Demography
Confidence Intervals
Pain

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Rosso, A. L., Verghese, J., Metti, A. L., Boudreau, R. M., Aizenstein, H. J., Kritchevsky, S., ... Rosano, C. (2017). Slowing gait and risk for cognitive impairment. Neurology, 89(4), 336-342. https://doi.org/10.1212/WNL.0000000000004153

Slowing gait and risk for cognitive impairment. / Rosso, Andrea L.; Verghese, Joe; Metti, Andrea L.; Boudreau, Robert M.; Aizenstein, Howard J.; Kritchevsky, Stephen; Harris, Tamara; Yaffe, Kristine; Satterfield, Suzanne; Studenski, Stephanie; Rosano, Caterina.

In: Neurology, Vol. 89, No. 4, 25.07.2017, p. 336-342.

Research output: Contribution to journalArticle

Rosso, AL, Verghese, J, Metti, AL, Boudreau, RM, Aizenstein, HJ, Kritchevsky, S, Harris, T, Yaffe, K, Satterfield, S, Studenski, S & Rosano, C 2017, 'Slowing gait and risk for cognitive impairment', Neurology, vol. 89, no. 4, pp. 336-342. https://doi.org/10.1212/WNL.0000000000004153
Rosso AL, Verghese J, Metti AL, Boudreau RM, Aizenstein HJ, Kritchevsky S et al. Slowing gait and risk for cognitive impairment. Neurology. 2017 Jul 25;89(4):336-342. https://doi.org/10.1212/WNL.0000000000004153
Rosso, Andrea L. ; Verghese, Joe ; Metti, Andrea L. ; Boudreau, Robert M. ; Aizenstein, Howard J. ; Kritchevsky, Stephen ; Harris, Tamara ; Yaffe, Kristine ; Satterfield, Suzanne ; Studenski, Stephanie ; Rosano, Caterina. / Slowing gait and risk for cognitive impairment. In: Neurology. 2017 ; Vol. 89, No. 4. pp. 336-342.
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AU - Kritchevsky, Stephen

AU - Harris, Tamara

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N2 - Objective: To identify the shared neuroimaging signature of gait slowing and cognitive impairment. Methods: We assessed a cohort of older adults (n = 175, mean age 73 years, 57% female, 65% white) with repeated measures of gait speed over 14 years, MRI for gray matter volume (GMV) at year 10 or 11, and adjudicated cognitive status at year 14. Gait slowing was calculated by bayesian slopes corrected for intercepts, with higher values indicating faster decline. GMV was normalized to intracranial volume, with lower values indicating greater atrophy for 10 regions of interest (hippocampus, anterior and posterior cingulate, primary and supplementary motor cortices, posterior parietal lobe, middle frontal lobe, caudate, putamen, pallidum). Nonparametric correlations adjusted for demographics, comorbidities, muscle strength, and knee pain assessed associations of time to walk with GMV. Logistic regression models calculated odds ratios (ORs) of gait slowing with dementia or mild cognitive impairment with and without adjustment for GMV. Results: Gait slowing was associated with cognitive impairment at year 14 (OR per 0.1 s/y slowing 1.47; 95% confidence interval 1.04-2.07). The right hippocampus was the only region that was related to both gait slowing (ρ = -0.16, p = 0.03) and cognitive impairment (OR 0.17, p = 0.009). Adjustment for right hippocampal volume attenuated the association of gait slowing with cognitive impairment by 23%. Conclusions: The association between gait slowing and cognitive impairment is supported by a shared neural substrate that includes a smaller right hippocampus. This finding underscores the value of long-term gait slowing as an early indicator of dementia risk.

AB - Objective: To identify the shared neuroimaging signature of gait slowing and cognitive impairment. Methods: We assessed a cohort of older adults (n = 175, mean age 73 years, 57% female, 65% white) with repeated measures of gait speed over 14 years, MRI for gray matter volume (GMV) at year 10 or 11, and adjudicated cognitive status at year 14. Gait slowing was calculated by bayesian slopes corrected for intercepts, with higher values indicating faster decline. GMV was normalized to intracranial volume, with lower values indicating greater atrophy for 10 regions of interest (hippocampus, anterior and posterior cingulate, primary and supplementary motor cortices, posterior parietal lobe, middle frontal lobe, caudate, putamen, pallidum). Nonparametric correlations adjusted for demographics, comorbidities, muscle strength, and knee pain assessed associations of time to walk with GMV. Logistic regression models calculated odds ratios (ORs) of gait slowing with dementia or mild cognitive impairment with and without adjustment for GMV. Results: Gait slowing was associated with cognitive impairment at year 14 (OR per 0.1 s/y slowing 1.47; 95% confidence interval 1.04-2.07). The right hippocampus was the only region that was related to both gait slowing (ρ = -0.16, p = 0.03) and cognitive impairment (OR 0.17, p = 0.009). Adjustment for right hippocampal volume attenuated the association of gait slowing with cognitive impairment by 23%. Conclusions: The association between gait slowing and cognitive impairment is supported by a shared neural substrate that includes a smaller right hippocampus. This finding underscores the value of long-term gait slowing as an early indicator of dementia risk.

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