Frederico Pieruccini-Faria1,2, Yanina Sarquis-Adamson1, Ivan Anton-Rodrigo3, Alicia Noguerón-García4, Nick W Bray1,5, Richard Camicioli6, Susan W Muir-Hunter6, Mark Speechley7, Bill McIlroy8, Manuel Montero-Odasso1,2,5,9. 1. Gait and Brain Laboratory, Parkwood Institute and Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada. 2. Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. 3. Department of Geriatric Medicine, Matia Fundazioa, Hospital Ricardo Bermingham, San Sebastian, Spain. 4. Department of Geriatrics, Complejo Hospitalario Universitario of Albacete, Albacete, Spain. 5. Faculty of Health Sciences, School of Kinesiology, University of Western Ontario, London, Ontario, Canada. 6. Faculty of Health Sciences, School of Physical Therapy, University of Western Ontario, London, Ontario, Canada. 7. Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada. 8. Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada. 9. Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Abstract
OBJECTIVES: Compared to their cognitively healthy counterparts, older adults with mild cognitive impairment (MCI) exhibit higher risk of falls, specifically with injuries. We sought to determine whether fall risk in MCI is associated with decline in higher-level brain gait control. DESIGN: Longitudinal study. SETTING: Community-dwelling adults from the Gait and Brain Study Cohort. PARTICIPANTS: A total of 110 participants, aged 65 years or older, with MCI. MEASUREMENTS: Biannual assessments for medical characteristics, cognitive performance, fall incidence, and gait performance for up to 7 years. Seven spatiotemporal gait parameters, including variabilities, were recorded using a 6-meter electronic walkway. Principal components analysis was used to identify independent gait domains related to higher-level (pace and variability domains) and lower-level (rhythm domain) brain control. Associations between gait decline and incident falls were studied with Cox regression models adjusted for baseline covariates. RESULTS: Of participants enrolled, 40% experienced at least one fall (28% of them with injuries) over a mean follow-up of 31.6 ± 23.9 months. From the pace domain, slower gait speed (adjusted hazard ratio [aHR] per 10-cm/s decrease = 4.62; 95% confidence interval [CI] = 1.84-11.61; P = .001) was associated with severe injurious falls requiring emergency room (ER) visit; from the variability domain, stride time variability (aHR per 10% increase during follow-up = 2.17; 95% CI = 1.02-4.63; P = .04) was associated with higher risk of all injurious falls. Rhythm domain was not associated with fall risk. Decline in pace domain was significantly associated with falls with ER visit (aHR = 3.67; 95% CI = 1.46-9.19; P = .005). After adjustments for multiple comparisons, gait speed and pace domain remained significantly associated with falls with ER visits. No statistically significant associations were found between gait domains and overall falls (P ≥ .06). CONCLUSION: Higher risk of injurious falls in older adults with MCI is associated with decline in gait parameters related to higher-level brain control. J Am Geriatr Soc 68:576-584, 2020.
OBJECTIVES: Compared to their cognitively healthy counterparts, older adults with mild cognitive impairment (MCI) exhibit higher risk of falls, specifically with injuries. We sought to determine whether fall risk in MCI is associated with decline in higher-level brain gait control. DESIGN: Longitudinal study. SETTING: Community-dwelling adults from the Gait and Brain Study Cohort. PARTICIPANTS: A total of 110 participants, aged 65 years or older, with MCI. MEASUREMENTS: Biannual assessments for medical characteristics, cognitive performance, fall incidence, and gait performance for up to 7 years. Seven spatiotemporal gait parameters, including variabilities, were recorded using a 6-meter electronic walkway. Principal components analysis was used to identify independent gait domains related to higher-level (pace and variability domains) and lower-level (rhythm domain) brain control. Associations between gait decline and incident falls were studied with Cox regression models adjusted for baseline covariates. RESULTS: Of participants enrolled, 40% experienced at least one fall (28% of them with injuries) over a mean follow-up of 31.6 ± 23.9 months. From the pace domain, slower gait speed (adjusted hazard ratio [aHR] per 10-cm/s decrease = 4.62; 95% confidence interval [CI] = 1.84-11.61; P = .001) was associated with severe injurious falls requiring emergency room (ER) visit; from the variability domain, stride time variability (aHR per 10% increase during follow-up = 2.17; 95% CI = 1.02-4.63; P = .04) was associated with higher risk of all injurious falls. Rhythm domain was not associated with fall risk. Decline in pace domain was significantly associated with falls with ER visit (aHR = 3.67; 95% CI = 1.46-9.19; P = .005). After adjustments for multiple comparisons, gait speed and pace domain remained significantly associated with falls with ER visits. No statistically significant associations were found between gait domains and overall falls (P ≥ .06). CONCLUSION: Higher risk of injurious falls in older adults with MCI is associated with decline in gait parameters related to higher-level brain control. J Am Geriatr Soc 68:576-584, 2020.
Authors: Matthew D Czech; Dimitrios Psaltos; Hao Zhang; Tomasz Adamusiak; Monica Calicchio; Amey Kelekar; Andrew Messere; Koene R A Van Dijk; Vesper Ramos; Charmaine Demanuele; Xuemei Cai; Mar Santamaria; Shyamal Patel; F Isik Karahanoglu Journal: NPJ Digit Med Date: 2020-09-30
Authors: Thanwarat Chantanachai; Morag E Taylor; Stephen R Lord; Jasmine Menant; Kim Delbaere; Perminder S Sachdev; Nicole A Kochan; Henry Brodaty; Daina L Sturnieks Journal: PeerJ Date: 2022-05-30 Impact factor: 3.061