Joe Verghese1, Cuiling Wang2, Emmeline Ayers2, Meltem Izzetoglu2, Roee Holtzer2. 1. From the Departments of Neurology (J.V., E.A., R.H.), Medicine (J.V.), and Epidemiology (C.W.), Albert Einstein College of Medicine; Ferkauf Graduate School of Psychology (R.H.), Yeshiva University, Bronx, NY; and Drexel University School of Biomedical Engineering (M.I.), Philadelphia, PA. joe.verghese@einstein.yu.edu. 2. From the Departments of Neurology (J.V., E.A., R.H.), Medicine (J.V.), and Epidemiology (C.W.), Albert Einstein College of Medicine; Ferkauf Graduate School of Psychology (R.H.), Yeshiva University, Bronx, NY; and Drexel University School of Biomedical Engineering (M.I.), Philadelphia, PA.
Abstract
OBJECTIVE: To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. METHOD: We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet). Incident falls were prospectively assessed over a 50-month study period. RESULTS: Over a mean follow-up of 33.9 ± 11.9 months, 116 falls occurred. Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls (hazard ratio adjusted for age, sex, education, medical illnesses and general mental status 1.32, 95% confidence interval 1.03-1.70). Neither behavioral outcomes (velocity or letter rate) on the dual task nor brain activation patterns on the single tasks (normal walk or talk alone) predicted falls in this high-functioning sample. The results remained robust after accounting for multiple confounders and for cognitive status, slow gait, previous falls, and frailty. CONCLUSIONS: Prefrontal brain activity levels while performing a cognitively demanding walking condition predicted falls in high-functioning seniors. These findings implicate neurobiological processes early in the pathogenesis of falls.
OBJECTIVE: To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. METHOD: We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet). Incident falls were prospectively assessed over a 50-month study period. RESULTS: Over a mean follow-up of 33.9 ± 11.9 months, 116 falls occurred. Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls (hazard ratio adjusted for age, sex, education, medical illnesses and general mental status 1.32, 95% confidence interval 1.03-1.70). Neither behavioral outcomes (velocity or letter rate) on the dual task nor brain activation patterns on the single tasks (normal walk or talk alone) predicted falls in this high-functioning sample. The results remained robust after accounting for multiple confounders and for cognitive status, slow gait, previous falls, and frailty. CONCLUSIONS: Prefrontal brain activity levels while performing a cognitively demanding walking condition predicted falls in high-functioning seniors. These findings implicate neurobiological processes early in the pathogenesis of falls.
Authors: Joe Verghese; Herman Buschke; Lisa Viola; Mindy Katz; Charles Hall; Gail Kuslansky; Richard Lipton Journal: J Am Geriatr Soc Date: 2002-09 Impact factor: 5.562
Authors: Joe Verghese; Jeannette Mahoney; Anne F Ambrose; Cuiling Wang; Roee Holtzer Journal: J Gerontol A Biol Sci Med Sci Date: 2010-07-19 Impact factor: 6.053
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Sarah E England; Joe Verghese; Jeannette R Mahoney; Constantin Trantzas; Roee Holtzer Journal: Gait Posture Date: 2014-09-22 Impact factor: 2.840
Authors: Azizah J Jor'dan; Brad Manor; Jeffrey M Hausdorff; Lewis A Lipsitz; Daniel Habtemariam; Vera Novak; Peter M Wayne Journal: Adv Mind Body Med Date: 2018 Summer