Decline In Speed Research Articles

The Digital Divide and Cognitive Disparities Among Older Adults: Community-Based Cohort Study in China.

The widespread adoption of information and communication technologies (ICTs) further deepens disparities in resource access, particularly among the aging population. However, the relationship between these factors and their resulting impact on cognitive abilities remains uncertain. This study aims to investigate the potential impact of the digital divide on individuals' cognitive function and its association with the development and reversion of mild cognitive impairment (MCI). This cohort study used data from Beijing Aging Brain Rejuvenation (BABRI) study applying a multistage cluster sampling design between 2008 and 2020. The digital divide was quantified by the frequency of using ICTs. Analysis of covariance (ANCOVA), mixed linear models, and Cox proportional hazards models were used to model the association of digital divide and multidomain cognition. Among the 10098 participants, nearly half (n=4941, 48.9%) faced the digital divide, which was associated with a worse performance in processing speed (F10096=10.67; P<.001; effect size r=0.42), rather than memory, executive function, and language. The model indicated that individuals' physical and mental health, combined with their educational and occupational prestige, influenced the resources they attained, which ultimately caused the digital divide. Moreover, longitudinal data revealed that older adults who successfully crossed the digital divide during the tracking process and those who had already done so prior to tracking showed significantly slower rates of decline in processing speed (B=-1.98, P<.05; B=-2.62, P<.01) and general cognitive function (B=3.50, P<.001; B=3.13, P<.01). Additionally, overcoming the digital divide was also associated with a lower risk of developing MCI (hazard ratio [HR] 0.5, 95% CI 0.34-0.74; HR 0.43, 95% CI 0.29-0.62) and a greater probability of reversion from MCI to normal cognition (HR 6, 95% CI 3.77-9.56; HR 9.22, 95% CI 5.63-15.11). Overcoming the digital divide was significantly associated with improved cognitive function, a slower aging rate in cognitive performance, a reduced risk of developing MCI, and a higher likelihood of reverting from MCI to normal cognition.

The Temporal Relation of Physical Function with Cognition and the Influence of Brain Health in the Oldest-Old

Introduction: Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain. Methods: We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable). Results: Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline. Conclusion: In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.

Association between metabolomics-based biomarker scores and 10-year cognitive decline in men and women. The Doetinchem Cohort Study.

Metabolomic scores based on age (MetaboAge) and mortality (MetaboHealth) are considered indicators of overall health, but their association with cognition in the general population is unknown. Therefore, the association between MetaboAge/MetaboHealth and level and decline in cognition was studied, as were differences between men and women. Data of 2821 participants (50% women, age range 45-75) from the Doetinchem Cohort Study was used. MetaboAge and MetaboHealth were calculated from 1H-NMR metabolomics data at baseline. Cognitive domain scores (memory, flexibility and processing speed) and global cognitive functioning were available over a 10-year period. The association between MetaboAge/MetaboHealth and level of cognitive functioning was studied using linear regressions while for the association between MetaboAge/MetaboHealth and cognitive decline longitudinal linear mixed models were used. Analyses were adjusted for demographics and lifestyle factors. Higher MetaboAge, indicating poorer metabolomic ageing, was only associated with lower levels of processing speed in men. Higher MetaboHealth, indicating poorer immune-metabolic health, was associated with lower levels of cognitive functioning for all three domains and global cognitive functioning in both men and women. Only in men, MetaboHealth was also associated with 10-year decline in flexibility, processing speed and global cognition. Metabolites that contributed to the observed associations were in men mainly markers of protein metabolism, and in women mainly markers of lipid metabolism and inflammatory metabolites. MetaboHealth, not MetaboAge, was associated with cognitive functioning independent of conventional risk factors. Individual metabolites affect cognitive functioning differently in men and women, suggesting sex-specific pathophysiological pathways underlying cognitive functioning.

The Influence of Menstruation and Hormonal Birth Control on the Performance of Female Collegiate Lacrosse Players.

This study compared the mechanical and physiological load placed on Division I female collegiate lacrosse athletes (1) with and without hormone contraceptive (HC) use and (2) with and without menstruation during training and games. Athletes' (20.6 ± 1.5 years, HC users = 9, naturally cycling (NC) athletes = 9) workloads-total distance traveled (TD, m), max speed (km∙h-1), accelerations (repetitions), decelerations (repetitions), and high-intensity distance (HID, m)-were measured through VX Sport wearable microtechnology in training sessions (n = 87/athlete) and games (n = 17/athlete). Analyses showed no statistical group differences based on HC use or not, and no differences during menstruation versus non-menstruation for training or games. However, while not statistically different, athletes taking HCs performed worse during menstruation, with a 5.1% decline in decelerations, 3.4% decline in TD and HID, 1.2% decline in max speed, and 1% decline in accelerations. NC athletes did not show this same decline with menses. Given that withdrawal bleeding exacerbates performance reduction of HC users, it may be beneficial for these athletes to consider skipping their withdrawal bleed if it is likely to coincide with a game. Further research needs to be carried out to see if these trends are consistent across other female athletes in other sports.

A Matter of Memory? Age-Invariant Relative Clause Disambiguation and Memory Interference in Older Adults.

Past research suggests that Working Memory plays a role in determining relative clause attachment bias. Disambiguation preferences may further depend on Processing Speed and explicit memory demands in linguistic tasks. Given that Working Memory and Processing Speed decline with age, older adults offer a way of investigating the factors underlying disambiguation preferences. Additionally, older adults might be subject to more severe similarity-based memory interference given their larger vocabularies and slower lexical access. Nevertheless, memory interference and sentence disambiguation have not been combined in studies on older adults before. We used a self-paced reading paradigm under memory load interference conditions. Older (n=30) and Younger (n=35) readers took part in the study online; reading times were recorded and measures of comprehension accuracy and load recall were collected. This setup allowed for the implicit measurement of attachment biases and memory interference effects interactively. Results show that similarity-based interference affected both age groups equally, but was more pronounced in NP2-biased structures, which took participants generally longer to read. Attachment preferences did not differ by group and were unaffected by Working Memory span. However, accuracy on recall prompts was predicted by Working Memory span in both groups. Findings of greater interference in syntactically dispreferred structures support unified processing models where parsing constraints naturally interact. The lack of age differences on our measures further aligns with research finding age-invariant implicit language processing.

Decline in daily maximum wind speed over the Tibetan Plateau during 1973–2020: an examination of likely causes

Decline in daily maximum wind speed over the Tibetan Plateau during 1973–2020: an examination of likely causes

A Longitudinal Decline in Walking Speed Is Linked with Coexisting Hypertension and Arthritis in Community-Dwelling Older Adults.

Objective: The aim was to investigate the association between baseline coexistence of hypertension (HTN) and arthritis, HTN alone, or arthritis alone, and their impact on longitudinal physical function measures among community-dwelling older adults over 5 years of follow-up. Methods: Ours was a longitudinal prospective cohort study from the second wave (2010-2011) and third wave (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP). Data for older adults were used. Participants were categorized based on self-reported diagnoses into four groups: coexisting HTN and arthritis, HTN only, arthritis only, or neither. Physical performance measures included walking speed using the 3-Meter Walk Test and the Five Times Sit-to-Stand Test (FTSST). Multiple generalized estimating equations with linear regression analyses were conducted, adjusting for age, sex, race, body mass index (BMI) educational level, pain severity, and baseline use of pain and hypertension medications. Results: Data for 1769 participants were analyzed. Slower walking speed was only associated with coexisting HTN and arthritis (B = -0.43, p < 0.001) after accounting for covariates. The coexisting HTN and arthritis group showed no significant association with FTSST (B = 0.80, p = 0.072) after accounting for covariates. Conclusions: The coexistence of baseline HTN and arthritis in older adults is associated with a gradual decline in only walking speed as a physical performance measure in older adults.

Multidimensional Analysis of Physiological Entropy during Self-Paced Marathon Running.

The pacing of a marathon is arguably the most challenging aspect for runners, particularly in avoiding a sudden decline in speed, or what is colloquially termed a "wall", occurring at approximately the 30 km mark. To gain further insight into the potential for optimizing self-paced marathon performance through the coding of comprehensive physiological data, this study investigates the complex physiological responses and pacing strategies during a marathon, with a focus on the application of Shannon entropy and principal component analysis (PCA) to quantify the variability and unpredictability of key cardiorespiratory measures. Nine recreational marathon runners were monitored throughout the marathon race, with continuous measurements of oxygen uptake (V˙O2), carbon dioxide output (V˙CO2), tidal volume (Vt), heart rate, respiratory frequency (Rf), and running speed. The PCA revealed that the entropy variance of V˙O2, V˙CO2, and Vt were captured along the F1 axis, while cadence and heart rate variances were primarily captured along the F2 axis. Notably, when distance and physiological responses were projected simultaneously on the PCA correlation circle, the first 26 km of the race were positioned on the same side of the F1 axis as the metabolic responses, whereas the final kilometers were distributed on the opposite side, indicating a shift in physiological state as fatigue set in. The separation of heart rate and cadence entropy variances from the metabolic parameters suggests that these responses are independent of distance, contrasting with the linear increase in heart rate and decrease in cadence typically observed. Additionally, Agglomerative Hierarchical Clustering further categorized runners' physiological responses, revealing distinct clusters of entropy profiles. The analysis identified two to four classes of responses, representing different phases of the marathon for individual runners, with some clusters clearly distinguishing the beginning, middle, and end of the race. This variability emphasizes the personalized nature of physiological responses and pacing strategies, reinforcing the need for individualized approaches. These findings offer practical applications for optimizing pacing strategies, suggesting that real-time monitoring of entropy could enhance marathon performance by providing insights into a runner's physiological state and helping to prevent the onset of hitting the wall.

Low-dose orthotopic cancer implantation permits measurement of longitudinal functional changes associated with cachexia.

Progressive functional decline is a key element of cancer-associated cachexia. Major barriers to translating preclinical therapies into the clinic include lack of cancer models that accurately mimic functional decline, which develops over time, and use of nonspecific measures, like grip strength, as surrogates for physical function. In this study, we aimed to extend the survival and longevity of a cancer model, to investigate cachexia-related function at the basic science level. Survival extension studies were performed by testing multiple cell lines, dilutions, and vehicle-types in orthotopic implantation of K-rasLSL.G12D/+; Trp53R172H/+; Pdx-1-Cre (KPC)-derived cells. One hundred twenty-eight animals in this new model were assessed for cachexia syndrome phenotype using a battery of anatomical, biochemical, and behavioral techniques. We extended the survival of the KPC orthotopic model to 8-9 wk postimplantation using a relatively low 100-cell dose of DT10022 KPC cells (P < 0.001). In this low-dose orthotopic (LO) model, progressive muscle wasting was detected in parallel to systemic inflammation; skeletal muscle atrophy at the fiber level was detected as early as 3 wk postimplantation compared with controls (P < 0.001). Gait speed in LO animals declined as early as 2 wk postimplantation, whereas grip strength change was a late event. Principal component and regression analyses revealed distinct cachectic and noncachectic animal populations, which we leveraged to show that the gait speed decline was specific to cachexia (P < 0.01), whereas grip strength decline was not (P = 0.19). Gait speed represents an accurate surrogate for cachexia-related physical function as opposed to grip strength.NEW & NOTEWORTHY Previous studies of cancer-induced cachexia have been confounded by the relatively rapid death of animal subjects. Using a lower dose of cancer cells in combination with a battery of behavioral, structural, histological, and biochemical techniques, we show that gait speed is actually the best indicator of functional decline due to cachexia. Future studies are required to define the underlying physiological basis of these findings.

Hypertensive Disorders of Pregnancy and Brain Health in Midlife: The CARDIA Study.

To understand the role of hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension (GH), in brain health earlier in life, we investigated the association of HDP with midlife cognition and brain health. We studied a prospective cohort of women, baseline age 18 to 30 years, who were assessed at study years 25 and 30 with a cognitive battery and a subset with brain magnetic resonance imaging. A history of HDP was defined based on self-report. We conducted linear regression to assess the association of a history of preeclampsia, GH, or no HDP with cognition and brain magnetic resonance imaging white matter hyperintensities. Among 1441 women (mean age, 55.2±3.6 years), 202 reported preeclampsia and 112 reported GH. GH was associated with worse cognitive performance: global cognition (mean score, 23.2 versus 24.0; P=0.018), processing speed (67.5 versus 71.3; P=0.01), verbal fluency (29.5 versus 31.1; P=0.033), and a trend for executive function (24.3 versus 22.6; P=0.09), after multivariable adjustment. GH was associated with a greater 5-year decline in processing speed (mean change, -4.9 versus -2.7; P=0.049) and executive function (-1.7 versus 0.3; P=0.047); preeclampsia was associated with a greater 5-year decline on delayed verbal memory (-0.3 versus 0.1; P=0.041). GH and preeclampsia were associated with greater white matter hyperintensities in the parietal and frontal lobes, respectively. GH and preeclampsia are associated with cognition and white matter hyperintensities during midlife, with differences in cognitive domains and brain lobes. Women with HDP may need to be closely monitored for adverse brain outcomes starting in midlife.

Associations between brain structure and dual decline in gait and cognition

Dual decline in gait and cognition is associated with an increased risk of dementia, with combined gait and memory decline exhibiting the strongest association. To better understand the underlying pathology, we investigated the associations of baseline brain structure with dual decliners using three serial gait speed and cognitive assessments in memory, processing speed-attention, and verbal fluency. Participants (n=267) were categorized based on annual decline in gait speed and cognitive measures. Lower gray and white matter volume and higher white matter hyperintensity volume increased the risk of being a dual decliner in gait and both the memory and processing speed-attention groups (all p < 0.05). Lower hippocampal volume (p = 0.047) was only associated with dual decline in gait and memory group. No brain structures were correlated with dual decline in gait and verbal fluency. These results suggest that neurodegenerative pathology and white matter hyperintensities are involved in dual decline in gait and both memory and processing speed-attention. Smaller hippocampal volume may only contribute to dual decline in gait and memory.

Disentangling the contributions of anthropogenic nutrient input and physical forcing to long-term deoxygenation off the Pearl River Estuary, China

Deoxygenation in estuarine and coastal waters worldwide has been largely attributed to the increasing anthropogenic nutrient input, whereas the contribution by long-term (decadal) changes in physical forcing is less investigated. This study aims to disentangle the impacts of three-decade changes in summer river nutrient concentration and physical forcing on the deoxygenation off a large eutrophic estuary, the Pearl River Estuary (PRE) in China. Using a coupled physical-biogeochemical model, we reproduce the observed summer oxygen conditions under the historical (the 1990s) and present (the 2020s) status of river nutrient concentration, freshwater discharge, and wind forcing. We show that the bottom hypoxic (dissolved oxygen < 2 mg/L) area off the PRE in the 2020s has increased by 73 % relative to the 1990s. The expansion is a result of the increased bottom water oxygen consumption outweighing the enhanced vertical oxygen supply, with the former driven by the sharp increase in inorganic nitrogen and phosphorus concentrations (160 %) and the latter caused by the decadal decline in both freshwater discharge (38 %) and wind speed (12.5 %) in summer. Model experiments suggest that if the observed changes in physical forcing had not occurred, the dramatic increase in anthropogenic nutrient concentrations from the 1990s to 2020s could have led to a much greater expansion of hypoxic area (249 %). On the contrary, the decadal decrease in summer freshwater discharge alone (while keeping the nutrient loading the same as in the 1990s) almost eliminates hypoxia off the PRE by weakening water column stratification and limiting the offshore spread of nutrients and organic matter, whereas the declined wind speed increases the hypoxic area by 247 % mainly through enhancing water column stability. Our results reveal that long-term changes in physical forcing are confounding the effects of anthropogenic nutrient input on deoxygenation, underlining the need to consider regional forcing changes in nutrient management to meet water quality goals.

2200 Association between gait speed deterioration and EEG abnormalities

Abstract Introduction Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold: to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. Methods A cross-sectional cohort study was conducted on 95 active functionally independent community-dwelling older adults in Havana, Cuba. We measured their gait speed at the usual pace and their cognitive status using the MMSE. A value of 0.8 m/s was used as the cut-off point to decide whether they presented a decline in gait speed. A quantitative analysis of their EEG at rest was also performed to look for an associated subclinical decline in brain function. Results Results show that 70% of the sample had a gait speed deterioration (i.e. lower than 0.8 m/s), of which 80% also had an abnormal EEG frequency composition for their age. While there was no statistically significant difference in the MMSE score between participants with a gait speed above and below the selected cut-off, individuals with MMSE scores below 25 also had a gait speed&amp;lt;0.8 m/s and an abnormal EEG frequency composition. Conclusions Our results provide further evidence of early decline in older adults – even if still independent and active - and point to the need for clinical pathways that incorporate screening and early intervention targeted at early deterioration to prolong the years of functional life in older age.

An empirical model for world record running speeds with distance, age, and sex: anaerobic and aerobic contributions to performance.

The objective of this study is to derive mathematical equations that closely describe published data on world record running speed as a function of distance, age, and sex. Running speed declines with increasing distance and age. Over long distances, where aerobic metabolism is dominant, speed declines in proportion to the logarithm of distance. Over short distances, anaerobic metabolism contributes significantly to performance, and speed is increased relative to the trend of the long-distance data. Equations are derived that explicitly represent these effects. The decline in speed with age is represented by an age-dependent multiplicative factor, which exhibits increasing sensitivity to age as age increases. Using these equations, data are analyzed separately for males and females, and close fits to published data are demonstrated, particularly for younger age groups. These equations provide insight into the contributions of aerobic and anaerobic components of metabolism to athletic performance and a framework for comparisons of performance across wide ranges of distance and age.NEW & NOTEWORTHY World record speeds at different distances for men and women in different age categories are used to develop a model to predict running performance as a function of race distance, age, and sex. This empirical model quantifies the decline in running speed with distance and age in a way that provides insight into the aerobic and anaerobic contributions to running speed and may help with developing training strategies for different age groups at various distances.

Safety Footwear Impact on Workers' Gait and Foot Problems: A Comparative Study.

In this study, we hypothesized that safety footwear (SF) impacts gait patterns, potentially contributing to the podiatric symptoms reported by workers. The purpose of this work was to compare the gait analyses of workers wearing SF and sneakers using inertial sensors while also examining the occurrence of foot problems. A consecutive cohort of workers from different occupational sectors who wore SF during their work shifts were prospectively assessed through a gait analysis. The gait analysis was conducted under two conditions: first, while wearing SF, and second, while wearing sneakers. In both conditions, inertial sensors were used (Wiva® MOB). Participants also underwent a podiatric physical examination to evaluate foot problems. This study shows that SF resulted in a worsening gait pattern compared to sneakers in both genders. The impact was particularly pronounced in female participants, resulting in a significant decline in walking speed and cadence. Discomfort was reported by 83.3% of participants, with a higher prevalence in females (46.6% vs. 36.6%). The SF group exhibited an elevated prevalence of foot problems, with no significant gender variations. It seems that foot problems are more likely to occur when a foot deformity, such as flat or cavus foot or hallux valgus, is present. This study suggests that SF may contribute to the reported podiatric symptoms among workers. Certain footwear characteristics, including weight, mis-fit, and inadequate design, may be factors associated with footwear discomfort and adverse gait patterns, potentially leading to increased foot problems among workers.

White Matter Hyperintensities Are Associated with Slower Gait Speed in Older Adults without Dementia.

Slow gait speed is associated with poor health outcomes in aging, but the relationship between cerebral small vessel disease (CSVD) pathologies and gait speed in aging is not well understood. We investigated the relationships between CSVD imaging markers and gait speed during simple (normal pace walking [NPW]) and complex (walking while talking [WWT]) as both measures are associated with shared health outcomes such as falls, frailty, disability, mortality, and dementia. A total of 113 Ashkenazi Jewish adults over 65 (M age = 78.6 ± 6.3 years, 45.8% women) and without dementia were examined. Established rating systems were used to quantify white matter hyperintensities (WMHs) and lacunes of presumed vascular origin from fluid-attenuated inversion recovery (FLAIR) images. Linear regression models adjusted for age, sex, global health, and total intracranial volume were used to examine associations between CSVD markers and gait speed during NPW and WWT. Student t tests were used to contrast gait speed in those with "confluent-diffuse" WMH and those with "mild or no" WMH. The number of WMH in the basal ganglia (β = -3.274 cm/s p = 0.047) and temporal lobes (β = -3.113 cm/s p = 0.048) were associated with slower NPW speed in adjusted models. Participants with higher CSVD burden (confluent-diffuse pattern) in the frontal lobe (94.65 cm/s vs. 105.21 cm/s, p = 0.018) and globally (98.98 cm/s vs. 107.24 cm/s, p = 0.028) also had lower NPW speed. WMHs were not associated with WWT speeds. Lacunes were not associated with NPW or WWT speed. Adjusted models found higher CSVD burden as measured by the presence of WMH in the basal ganglia and temporal lobes were associated with slower normal pace gait speed in older adults, but not with complex walking speeds. Participants with confluent-diffuse WMHs in the frontal lobes were found to have slower average normal gait speed. Further studies are needed to establish the temporality of WMH and gait speed decline as well as mechanistic links between the two.

Effects of fermented milk intake and physical activity on the suppression of age-related decline in physical fitness among the elderly.

Physical deterioration in the elderly can lead to disability and mortality. Although the intake of fermented milk has been recently attracting attention as a proposed measure to prevent physical weakness, studies and findings are limited. Here, we investigated the effect of intake of fermented milk products on suppression of age-related decline in physical fitness through a long-term epidemiological study of community-dwelling elderly people who are capable of independent living. A retrospective analysis was conducted on 581 elderly people aged 65-92 years from the Nakanojo Study, with the addition of a 5-year prospective analysis on 240 elderlies. Subjects were arbitrarily grouped on the basis of questionnaire estimates of fermented milk products intake (<3 or ≥3 days/week) and pedometer/accelerometer-determined patterns of physical activity (<7,000 or ≥7,000 steps/day). After adjustment for potential confounders, the retrospective study showed that the group consuming fermented milk products ≥3 days/week showed significantly faster walking speeds than the <3 days/week group. The group taking ≥7,000 steps/day had a significantly faster walking speed than the group taking <7,000 steps/day. Those who did both walked the fastest, indicating an additive effect. Adding protein or energy intake as a covariate to the potential confounders found a correlation between the intake of fermented milk products and walking speed, suggesting that the effect of fermented milk products consumption is independent of nutritional intake status, due to the beneficial properties of bacteria included in fermented milk. The 5-year prospective study confirmed a clear relationship between the frequency of consumption of fermented milk products and the suppression of preferred walking speed decline. Our findings suggest that habitual intake of fermented milk contributes to the suppression of walking speed decline in elderly people.

Poststroke cognitive outcome is better accounted for by white matter abnormalities automated segmentation than visual analysis

Background and aimsThe association between white matter abnormalities (WMA) and cognitive decline previously reported in poststroke patients has been mainly documented using visual scales. However, automated segmentation of WMA provides a precise determination of the volume of WMA. Nonetheless, it is rarely used in the stroke population and its potential advantage over visual scales is still unsettled. The objective of this study was to examine whether automated segmentation of WMA provides a better account than the visual Fazekas and Wahlund scales of the decline in executive functions and processing speed in stroke patients. MethodsThe analyses were conducted on the 358 patients of the GRECogVASC cohort with an MRI performed at six months poststroke in the Amiens center. WMA were visually analyzed using the Fazekas (subcortical abnormalities) and Wahlund scales. Segmentation was performed using LST (3.0.3). Following preliminary studies to determine the optimal segmentation threshold, we examined the relationship between cognitive status and WMA volume computed at each threshold using receiver operating characteristic (ROC) curves. Finally, we assessed the ability of both Fazekas and Wahlund visual scores and WMA volume to account for cognitive scores by using a bivariate Pearson correlation analysis, comparing correlation coefficients with the Fisher transformation and repeating correlation analysis after adjustment for the lesion volume. ResultsIncreasing the threshold led to an underestimation of WMA (P=0.0001) (significant for a threshold ≥0.2) and an improvement in correct rejection of signal changes in the stroke cavity (P=0.02) (significant for a threshold ≤0.5), susceptibility artifacts (P=0.002) (significant for a threshold ≤0.6), and corticospinal degeneration (P=0.03) (significant for a threshold ≤0.5). WMA volume decreased with increasing threshold (P=0.0001). Areas under the curve (AUC) did not differ according to the threshold (processing speed: P=0.85, executive cognitive functions: P=0.7). Correlation coefficients between cognitive scores and WMA were higher for WMA volume than the Fazekas (processing speed: Z=−3.442, P=0.001; executive functions: Z=−2.751, P=0.006) and Wahlund scores (processing speed: Z=−3.615, P=0.0001; executive functions: Z=−2.769, P=0.006). Adjustment for lesion volume did not alter the correlations with WMA volume (processing speed: r=−0.327 [95%CI: −0.416; −0.223], P=0.0001; executive functions: r=−0.262 [95%CI: −0.363; −0.150], P=0.0001). ConclusionThis study shows that WMA volume assessed by automated segmentation provides a better account of cognitive disorders than visual analysis. This should favor its wider use to refine imaging determinants of poststroke cognitive disorders.

Dynapenia and sarcopenia identify walking speed decline in women but not in men

ObjectiveTo determine the best indicator of mobility decline between dynapenia, low skeletal muscle mass index (SMMI), and sarcopenia defined by the EWGSOP2 using different cutoff points for grip strength. MethodsA longitudinal study was conducted with a follow-up of eight years, involving 2,680 individuals aged 60 and older who participated in the ELSA study with a walking speed greater than 0.8 m/s at baseline. Dynapenia was defined using different cutoff points for grip strength. SMMI was defined by the 20th percentile of the entire ELSA sample distribution and sarcopenia was defined based on the EWGSOP2, using different cutoff points for grip strength. Mobility was analysed using the walking speed test. ResultsOver time, the greatest decline in walking speed occurred in dynapenic women with grip strength < 17 kg (-0.005 m/s per year; 95 % CI: -0.01 to -0.001) and < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001). With regards to sarcopenia, the greatest walking speed decline occurred in women with probable sarcopenia when defined by grip strength < 17 kg [(-0.006 m/s per year; 95 % CI: -0.01 to -0.001) or grip strength < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001)]. Dynapenia in men as well as low SMMI and sarcopenia in men and women did not enable identifying the risk of mobility decline. ConclusionDynapenia and probable sarcopenia defined by grip strength < 17 kg and < 20 kg enabled identifying walking speed decline over time only in women.

Association of estimated pulse wave velocity with cognitive function in a multiethnic diverse population: The Northern Manhattan Study.

Arterial stiffness is linked to age-related cognitive dysfunction. Estimated pulse wave velocity (ePWV) is associated with cerebrovascular disease. We sought to determine whether ePWV was associated with cognition in a multiethnic population. We included 1257 participants enrolled in a Northern Manhattan Study magnetic resonance imaging MRI-cognitive study (mean age 64±8 years, 61% women, 67% Hispanic, 18% non-Hispanic Black, 15% non-Hispanic white) and analyzed cognitive performance at two time points, at enrollment and on an average 5.0±0.6 years later. ePWV was calculated using baseline age and blood pressure. Cognition and cognitive change scores were regressed on ePWV in multivariable linear regression models. In adjusted models, ePWV (mean 11±2m/s) was significantly associated with cognition (b=-0.100, 95% CI, -0.120, -0.080) and cognitive change over time (b=-0.063, 95% CI, -0.082, -0.045). Effect modification by race and sex was found. In this multiethnic population, the associations of ePWV with cognitive performance underline the role of vascular stiffness in age-related cognitive decline. ePWV is a modest but independent predictor of cognitive function and cognitive decline among older individuals. After adjustment, the ePWV measure was inversely associated with performance and decline in global cognition, processing speed, episodic memory, executive function, and semantic memory. After adjustment, modification of the association between ePWV and change in episodic memory and executive function by race and ethnicity was suggested by a significant interaction term. The association between ePWV and episodic memory decline was stronger in females.