Abstract
BackgroundGait impairments increase with advancing age and can lead to falls and loss of independence. Brain atrophy also occurs in older age and may contribute to gait decline. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people.MethodsIn a population-based study, participants aged >60 years without Parkinson's disease or brain infarcts underwent magnetic resonance imaging and gait measurements using a computerized walkway. Linear regression was used to study associations of total gray and white matter volumes with gait, adjusting for each other, age, sex, height and white matter hyperintensity volume. Other covariates considered in analyses included weight and vascular disease history. Voxel-based morphometry was used to study regional relationships of gray and white matter with gait.ResultsThere were 305 participants, mean age 71.4 (6.9) years, 54% male, mean gait speed 1.16 (0.22) m/s. Smaller total gray matter volume was independently associated with poorer gait speed (p = 0.001) and step length (p<0.001), but not cadence. Smaller volumes of cortical and subcortical gray matter in bilateral regions important for motor control, vision, perception and memory were independently associated with slower gait speed and shorter steps. No global or regional associations were observed between white matter volume and gait independent of gray matter volume, white matter hyperintensity volume and other covariates.ConclusionSmaller gray matter volume in bilaterally distributed brain networks serving motor control was associated with slower gait speed and step length, but not cadence.
Highlights
Gait speed has recently been identified as an important vital sign in aging individuals [1] due to its associations with falling, cognitive decline [2] and death [3]
In our linear regression described in the previous section, we found that weight was a potential confounder only in the associations between white matter volume and gait
Compared with the full sample, those excluded for the presence of magnetic resonance imaging (MRI) brain infarcts were older (p,0.001), walked with poorer gait speed, cadence and step length and had smaller volumes of gray (p = 0.002) and white matter (p = 0.02)
Summary
Gait speed has recently been identified as an important vital sign in aging individuals [1] due to its associations with falling, cognitive decline [2] and death [3]. In two other studies [16,17], a region-of-interest approach was used to demonstrate associations of smaller volumes of dorsolateral prefrontal and parietal lobe gray matter with step length [16], and of left cerebellar and prefrontal gray matter with gait speed [17] Informative, these studies did not adopt a whole-brain approach and may have been limited in their ability to provide a comprehensive regional analysis. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people
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