Unlocking the Brain’s Secrets: Gait Speed and Cognitive Decline in Older Adults

Published on October 4, 2023

Imagine your brain as a bustling city, with different neighborhoods representing different regions. A team of scientists used special techniques called deformation-based morphometry (DBM) to explore which brain regions are associated with slower gait speed in older adults. They discovered that regions like the frontal white matter, temporal grey matter, and subcortical areas were smaller in individuals with slower gait. Surprisingly, larger ventricles (hollow spaces in the brain) and smaller volumes in the medial temporal lobe were also observed. Over a span of several years, these same individuals showed not just decline in gait speed, but also declines in global cognition, executive functioning, and memory abilities. It turns out that the larger ventricles and smaller medial temporal lobe volumes played a key role in this association between slow gait and cognitive decline. By understanding these brain changes, we can potentially improve our ability to predict cognitive decline in older adults.

ObjectiveTo determine the extent to which the regional brain volumes associated with slow gait speed can inform subsequent cognitive decline in older adults from the Rush Memory and Aging Project.ApproachWe utilized deformation-based morphometry (DBM) in a whole-brain exploratory approach to identify the regional brain volumes associated with gait speed assessed over a short distance during an in-home assessment. We created deformation scores to summarize the gait-associated regions and entered the scores into a series of longitudinal mixed effects models to determine the extent to which deformation predicted change in cognition over time, controlling for associations between gait and cognition.ResultsIn 438 older adults (81 ± 7; 76% female), DBM revealed that slower gait speed was associated with smaller volumes across frontal white matter, temporal grey matter, and subcortical areas and larger volumes in the ventricles during the same testing cycle. When a subset was followed over multiple (5 ± 2) years, slower gait speed was also associated with annual declines in global cognition, executive functioning, and memory abilities. Several of the gait-related brain structures were associated with these declines in cognition; however, larger ventricles and smaller medial temporal lobe volumes proved most robust and attenuated the association between slow gait and cognitive decline.ConclusionRegional brain volumes in the ventricles and temporal lobe associated with both slow gait speed and faster cognitive decline have potential to improve risk stratification for cognitive decline in older adults.

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