Slower Gait Velocity Research Articles

Exploring Responsiveness to Highly Challenging Balance and Gait Training in Parkinson's Disease.

Exercise potentially improves gait, balance, and habitual physical activity in Parkinson's disease (PD). However, given the heterogeneous nature of the disease, it is likely that people respond differently to exercise interventions. Factors determining responsiveness to exercise interventions remain unclear. To address this uncertainty, we explored the responsiveness to our highly challenging balance and gait intervention (HiBalance) in people with PD. Thirty-nine participants with mild-moderate PD who underwent the HiBalance intervention from our randomized controlled trial were included. We defined response in three domains: (1) balance based on Mini-BESTest, (2) gait based on gait velocity, and (3) physical activity based on accelerometry-derived steps per day. In each domain, we explored three responsiveness levels: high, low, or non-responders according to the change from pre- to post-intervention. Separate Random Forests for each responder domain classified these responsiveness levels and identified variable importance. Only the Random Forest for the balance domain classified all responsiveness levels above the chance level indicated by a Cohen's kappa of "slight" agreement. Variable importance differed among the responsiveness levels. Slow gait velocity indicated high responders in the balance domain but showed low probabilities for low and non-responders. For low and non-responders, fall history or no falls, respectively, were more important. Among three responder domains and responsiveness levels, we could moderately classify responders in the balance domain, but not for the gait or physical activity domain. This can guide inclusion criteria for balance-targeted, personalized intervention studies in people with PD.

Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.

A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction. To explore open-label tolerability and associations between trial outcomes and asymmetry data. We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry. 14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS. Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.

Analysis of gait pattern related to high cerebral small vessel disease burden using quantitative gait data from wearable sensors

Background and ObjectivesSensor-based wearable devices help to obtain a wide range of quantitative gait parameters, which provides sufficient data to investigate disease-specific gait patterns. Although cerebral small vessel disease (CSVD) plays a significant role in gait impairment, the specific gait pattern associated with a high burden of CSVD remains to be explored. MethodsWe analyzed the gait pattern related to high CSVD burden from 720 participants (aged 55–65 years, 42.5 % male) free of neurological disease in the Taizhou Imaging Study. All participants underwent detailed quantitative gait assessments (obtained from an insole-like wearable gait tracking device) and brain magnetic resonance imaging examinations. Thirty-three gait parameters were summarized into five gait domains. Sparse sliced inverse regression was developed to extract the gait pattern related to high CSVD burden. ResultsThe specific gait pattern derived from several gait domains (i.e., angles, phases, variability, and spatio-temporal) was significantly associated with the CSVD burden (OR=1.250, 95 % CI: 1.011–1.546). The gait pattern indicates that people with a high CSVD burden were prone to have smaller gait angles, more stance time, more double support time, larger gait variability, and slower gait velocity. Furthermore, people with this gait pattern had a 25 % higher risk of a high CSVD burden. ConclusionsWe established a more stable and disease-specific quantitative gait pattern related to high CSVD burden, which is prone to facilitate the identification of individuals with high CSVD burden among the community residents or the general population.

The association of gait velocity and cognitive performance in a sample of older Chinese Americans: A pilot study

AbstractBackgroundGait velocity and cognition generally decline as individuals age. Studies have indicated that gait velocity can be used as a simple, novel, and relatively culture‐free cognitive assessment tool in older adults, particularly in domains of memory, attention, and executive function. There is limited research in this area with racial/ethnic minority groups. This study examined the association between performance on specific cognitive domains and gait velocity in older Chinese Americans – a growing, yet underrepresented group in US‐based research.Method71 Chinese American older adults (age 73.6 ± 6.9) with normal cognition (n = 27), mild cognitive impairment (n = 32), and early dementia (n = 12) were included in a pilot study at the Alzheimer’s Disease Research Center (ADRC) at Mount Sinai. Participants underwent a standard dementia evaluation in Mandarin/Cantonese, which included a clinical interview, medical exam, and neuropsychological testing. All participants self‐reported as Chinese Americans who were primarily Cantonese‐ or Mandarin‐speaking. Exclusion criteria included: not proficient in Cantonese/Mandarin, mobility impairment, as well as history of psychiatric disorder(s) and cerebrovascular accident. Diagnoses were assigned at a consensus conference. Exploratory factor analysis was conducted to determine cognitive domains encompassing the neuropsychological battery, which included tests of processing speed/attention, executive function, memory, and language/verbal fluency. Gait velocity was measured with a walking speed test measured in seconds. Multiple linear regression was used to examine the association between gait velocity and cognitive performance, while controlling for age, education, depression measured by Geriatric Depression Scale (GDS), and lifestyle/medical factors (e.g., tobacco/alcohol use, hypertension).ResultFactor analysis demonstrated 4 principal neuropsychological factors: non‐contextual memory, contextual memory, processing speed, and language/verbal fluency. The regression model showed that lower scores on a test of non‐contextual memory was associated with slower gait velocity. Higher GDS scores were associated with slower gait velocity.ConclusionConsistent with previous studies with predominately non‐Hispanic White samples, we found an association between gait velocity and non‐contextual memory in older Chinese Americans. In contrast to the literature, no other cognitive domains were significant in this small sample. The finding provides preliminary data to support the use of gait velocity as a novel cognitive assessment in this historically underrepresented group.

Apathy as a Predictor of Motoric Cognitive Risk Syndrome

AbstractBackgroundApathy is a psychological syndrome, characterized by lack of motivation and interest, flattening of affect, and social withdrawal; that predicts cognitive decline including dementia. Current literature highlights apathy as a separate entity from depression, which is uniquely correlated to cognitive and functional decline in neurologic diseases like stroke and Parkinson’s Disease as well as in community dwelling‐older adults. Further, apathy may mediate the previously described association between depression and cognitive/functional decline. Our objectives were to 1) investigate the association between apathy at baseline and incident predementia syndromes including mild cognitive impairment (MCI) and motoric cognitive risk syndrome (MCR) and 2) explore the direct and indirect relationships of apathy and motoric cognitive outcomes.MethodWe prospectively studied the association between apathy (3‐item subscale of the Geriatric Depression Scale) and incident predementia syndromes in 542 community‐dwelling older adults enrolled in the Central Control of Mobility in Aging study, using Cox proportional hazard models. Associations were reported as hazard ratio (HR) with 95% confidence intervals (CIs), adjusting for age, education, baseline cognitive performance, and dysphoria. In a subset of 347 participants, we examined the mediating role of cytokines on the association between apathy and gait velocity in linear regression models at cross section. We also looked at the mediating role of apathy on the association between dysphoria and multimorbidity and gait velocity.ResultApathy was associated with incident MCR (HR 2.39, 95% CI: 1.10‐5.20), but not MCI. Linear regression models showed that Interleukin‐6 (Il‐6), but not C‐Reactive Protein was significantly associated with apathy adjusted for age, gender, and years of education (B = 0.037, 95% CI: 0.002–0.072, p = 0.04). Apathy was associated with a slower gait velocity (B = 14.45, 95% CI: 24.89–4.01, p = 0.01), cross sectionally. Mediation analyses demonstrated that IL‐6 modestly mediates the relationship between apathy and gait velocity. Additionally, apathy mediated the relationships between dysphoria and multimorbidity and gait velocity.ConclusionOverall, our findings indicate that apathy may be an early predictor of motoric cognitive decline, which precedes predementia syndromes. Inflammation plays a modest role, but the underlying biology of apathy warrants further investigation.

The semicircular canal function is preserved with little impact on falls in patients with mild Parkinson's disease

IntroductionPostural instability is a cardinal symptom of Parkinson's disease (PD), which suggests the vestibular system may be affected in PD. This study aimed to determine whether vestibular dysfunction is associated with the risk of falls in PD. MethodsWe prospectively recruited patients with de-novo PD at a tertiary medical center between December 2019 and March 2023. During initial assessment, each patient was queried about falls within the preceding year. All patients underwent evaluation of video head-impulse tests (video-HITs), motion analysis, mini-mental state examination (MMSE), and Montreal Cognitive Assessment (MOCA). We determined whether head impulse gain of the vestibulo-ocular reflex (VOR) was associated with clinical severity of PD or risk of falls. ResultsOverall, 133 patients (mean age ± SD = 68 ± 10, 59 men) were recruited. The median Movement Disorder Society-Unified Parkinson's Disease Rating Scale motor part (MDS-UPDRS-III) was 23 (interquartile range = 16–31), and 81 patients (61 %) scored 2 or less on the Hoehn and Yahr scale. Fallers were older (p = 0.001), had longer disease duration (p = 0.001), slower gait velocity (p = 0.009), higher MDS-UPDRS-III (p < 0.001) and H&Y scale (p < 0.001), lower MMSE (p = 0.018) and MOCA scores (p = 0.001) than non-fallers. Multiple logistic regression showed that MDS-UPDRS-III had a positive association with falling (p = 0.004). Falling was not associated with VOR gain (p = 0.405). The VOR gain for each semicircular canal showed no correlation with the MDS-UPDRS-III or disease duration. ConclusionsThe semicircular canal function, as determined by video-HITs, is relatively spared and has little effect on the risk of falls in patients with mild-to-moderate PD.

Speech and gait abnormalities in motor subtypes of de-novo Parkinson's disease.

To investigate the presence and relationship of temporal speech and gait parameters in patients with postural instability/gait disorder (PIGD) and tremor-dominant (TD) motor subtypes of Parkinson's disease (PD). Speech samples and instrumented walkway system assessments were acquired from a total of 60 de-novo PD patients (40 in TD and 20 in PIGD subtype) and 40 matched healthy controls. Objective acoustic vocal assessment of seven distinct speech timing dimensions was related to instrumental gait measures including velocity, cadence, and stride length. Compared to controls, PIGD subtype showed greater consonant timing abnormalities by prolonged voice onset time (VOT) while also shorter stride length during both normal walking and dual task, while decreased velocity and cadence only during dual task. Speaking rate was faster in PIGD than TD subtype. In PIGD subtype, prolonged VOT correlated with slower gait velocity (r=-0.56, p=0.01) and shorter stride length (r=-0.59, p=0.008) during normal walking, whereas relationships were also found between decreased cadence in dual task and irregular alternating motion rates (r=-0.48, p=0.04) and prolonged pauses (r=-0.50, p=0.03). No correlation between speech and gait was detected in TD subtype. Our findings suggest that speech and gait rhythm disorder share similar underlying pathomechanisms specific for PIGD subtype.

Predictors of incident reversible and potentially reversible cognitive frailty among Taiwanese older adults

BackgroundFew studies emphasize on predictors of incident cognitive frailty (CF) and examine relationships between various gait characteristics and CF. Therefore, we conducted a 2-year prospective study to investigate potential predictors, including gait characteristics, of incident reversible CF (RCF) and potentially RCF (PRCF) among Taiwanese older adults.MethodsEligible participants were individuals aged ≥ 65 years, who could ambulate independently, and did not have RCF/PRCF at the baseline. The baseline assessment collected information on physical frailty and cognitive measures, in addition to sociodemographic and lifestyle characteristics, preexisting comorbidities and medications, gait characteristics, Tinetti’s balance, balance confidence as assessed by Activities-specific Balance Confidence (ABC) scale, and the depressive status as assessed by the Geriatric Depression Scale. The Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, and Digit Symbol Substitution Test were used to evaluate cognitive functions. Incident RCF and PRCF were ascertained at a 2-year follow-up assessment.ResultsResults of the multinomial logistic regression analysis showed that incident RCF was significantly associated with older age (odds ratio [OR] = 1.05) and lower ABC scores (OR = 0.97). Furthermore, incident PRCF was significantly associated with older age (OR = 1.07), lower ABC scores (OR = 0.96), the presence of depression (OR = 3.61), lower MMSE scores (OR = 0.83), slower gait velocity (OR = 0.97), and greater double-support time variability (OR = 1.09).ConclusionsIncident RCF was independently associated with older age and lower balance confidence while incident PRCF independently associated with older age, reduced global cognition, the presence of depression, slower gait velocity, and greater double-support time variability. Balance confidence was the only modifiable factor associated with both incident RCF and PRCF.

Kinematic and Kinetic Gait Characteristics in People with Patellofemoral Pain: A Systematic Review and Meta-analysis.

Patellofemoral pain (PFP) is a prevalent knee condition with many proposed biomechanically orientated etiological factors and treatments. We aimed to systematically review and synthesize the evidence for biomechanical variables (spatiotemporal, kinematic, kinetic) during walking and running in people with PFP compared with pain-free controls, and determine if biomechanical variables contribute to the development of PFP. Systematic review and meta-analysis. We searched Medline, CINAHL, SPORTDiscus, Embase, and Web of Science from inception to October 2021. All study designs (prospective, case-control [± interventional component, provided pre-intervention data were reported for both groups], cross-sectional) comparing spatiotemporal, kinematic, and/or kinetic variables during walking and/or running between people with and without PFP. We identified 55 studies involving 1300 people with PFP and 1393 pain-free controls. Overall pooled analysis identified that people with PFP had slower gait velocity [moderate evidence, standardized mean difference (SMD) -0.50, 95% confidence interval (CI) -0.72, -0.27], lower cadence (limited evidence, SMD -0.43, 95% CI -0.74, -0.12), and shorter stride length (limited evidence, SMD -0.46, 95% CI -0.80, -0.12). People with PFP also had greater peak contralateral pelvic drop (moderate evidence, SMD -0.46, 95% CI -0.90, -0.03), smaller peak knee flexion angles (moderate evidence, SMD -0.30, 95% CI -0.52, -0.08), and smaller peak knee extension moments (limited evidence, SMD -0.41, 95% CI -0.75, -0.07) compared with controls. Females with PFP had greater peak hip flexion (moderate evidence, SMD 0.83, 95% CI 0.30, 1.36) and rearfoot eversion (limited evidence, SMD 0.59, 95% CI 0.03, 1.14) angles compared to pain-free females. No significant between-group differences were identified for all other biomechanical variables. Data pooling was not possible for prospective studies. A limited number of biomechanical differences exist when comparing people with and without PFP, mostly characterized by small-to-moderate effect sizes. People with PFP ambulate slower, with lower cadence and a shortened stride length, greater contralateral pelvic drop, and lower knee flexion angles and knee extension moments. It is unclear whether these features are present prior to PFP onset or occur as pain-compensatory movement strategies given the lack of prospective data. PROSPERO # CRD42019080241.

Mindfulness stress-buffering model of health: implications for successful aging

Objectives Age-related variations in emotional, physical, and cognitive health are poorly understood. This multimethod study extends previous work by investigating mechanistic models by which trait mindfulness, perceived stress, and negative affect (NA) influence health outcomes in adults aged 57–87 years old. Method In this cross-sectional study, 119 adults completed clinical interviews, cognitive and gait assessments, the Mindful Attention and Awareness Scale, Positive and Negative Affect Schedule, and Perceived Stress Scale. Gait velocity and executive function (Flanker test of inhibitory control), which are important predictors of global health and functioning in older adults, served as objective health outcome measures. Results Correlational analyses found that trait mindfulness is positively associated with age, gait velocity, and inhibitory control and negatively associated with NA and perceived stress. NA but not perceived stress was associated with slower gait velocity. PROCESS mediation analyses suggested that those higher in trait mindfulness showed lower NA as a result of less perceived stress, while moderation analyses indicated the relationship between gait velocity and age varied by levels of trait mindfulness. Conclusion Our findings are consistent with a mindfulness stress-buffering model of health. It is plausible that trait mindfulness, which has both mediating and moderating effects on health, might help to promote more successful aging and provide resilience to age-related declines in physical health.

Mediation Analyses of the Role of Apathy on Motoric Cognitive Outcomes.

Recent literature indicates that apathy is associated with poor cognitive and functional outcomes in older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome. However, the underlying biological pathway is unknown. The objectives of this study were to (1) examine the cross-sectional associations between inflammatory cytokines (Interleukin 6 (IL-6) and C-Reactive Protein (CRP)) and apathy and (2) explore the direct and indirect relationships of apathy and motoric cognitive outcomes as it relates to important cognitive risk factors. N = 347 older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging Study (CCMA). Linear and logic regression models showed that IL-6, but not CRP was significantly associated with apathy adjusted for age, gender, and years of education (β = 0.037, 95% CI: 0.002–0.072, p = 0.04). Apathy was associated with a slower gait velocity (β = −14.45, 95% CI: −24.89–4.01, p = 0.01). Mediation analyses demonstrated that IL-6 modestly mediates the relationship between apathy and gait velocity, while apathy mediated the relationships between dysphoria and multimorbidity and gait velocity. Overall, our findings indicate that apathy may be an early predictor of motoric cognitive decline. Inflammation plays a modest role, but the underlying biology of apathy warrants further investigation.

Corelation of gait parameters, cognitive impairment and brain atrophy in patients with Parkinson’s disease and the «normally aging population»

Objective — to identify the most significant markers of gait that indicate a decrease in cognitive function based on investigation of the corelation of cognitive impairment, gait parameters and atrophy of brain structures in groups of patients with Parkinson’s disease and the «normally aging population».&#x0D; Methods and subjects. 66 subjects were examined: 30 patients with Parkinson’s disease (mean age 54.9 ± 5.9, 50 % men) and 33 without neurological pathology (mean age 52.7 ± 7.6, 66 % men). All of them underwent neurological examination, assessment of temporal and spatial gait parameters using the GaitRite system, grading of brain atrophy using a comprehensive visual rating scale of MRI scans and assessment of cognitive status using the Montreal Cognitive Assessment Scale.&#x0D; Results. Cognitive performance was significantly lower in the subgroup of patients with Parkinson’s disease compared to the subgroup of «normally aging population». The gait profile of patients with Parkinson’s disease significantly differed from the gait profile of individuals from the «normal aging» subgroup by slower gait velocity, shorter step length and stride length for both limbs. The gait parameters, which showed a strong correlation with cognitive tests, differed in the subgroups, but gait velocity, stride length and step length for both extremities were common among them. These common gait parameters showed a strong direct correlation with brain atrophy in the subgroup of patients with Parkinson’s disease, but only velocity correlated with atrophy in the subgroup of «normal aging» among all of them. It was determined by the method of multiple regression analysis that it was precisely the atrophy of the brain that turned out to be the most influential factor in the decrease in cognitive function in the general group and subgroups.&#x0D; Conclusions. The gait profile in Parkinson’s disease subgroup is characterized by lower velocity, shorter step length, stride length for both limbs and significantly differs from the subgroup of «normal aging». These changes are a consequence of the influence of the disease on the motor sphere. Velocity showed a strong correlation in both subgroups not only with cognitive abilities, but also with cerebral atrophy. This confirms the hypothesis about the possibility of using gait velocity as a universal sensitive marker for current and longitudinal assessment of cognitive function, especially in clinical practice.&#x0D;

Laboratory based assessment of gait and balance impairment in patients with progressive supranuclear palsy

BackgroundGait and balance abnormalities are a significant source of morbidity and mortality in progressive supranuclear palsy (PSP). Gait impairment in PSP is primarily assessed clinically on exam or with the use of rating scales. Three dimensional video based gait and balance analysis performed in a laboratory setting is a highly accurate method of motion analysis (Wren et al., 2020), however limited data is available in patients with PSP. Research questionIn this study we assess the objective features of postural control, kinematics, kinetic and temporal-spatial gait metrics in PSP, using three-dimensional video motion analysis in a laboratory setting compared to normal controls. MethodsThree-dimensional motion was captured using a 10-camera motion capture system, 41 body markers and ground embedded force plates in 16 patients with PSP patients and compared to motorically normal controls. ResultsSpatiotemporal, kinematic, and kinetic gait measures effectively differentiated patients with PSP from controls. Patients had slower gait velocity, lower cadence, increased double support time and abnormal antero-posterior sway. Joint kinematics and kinetics were reduced and showed less variation among patients with PSP compared to controls which is suggestive of bradykinesia. Objective gait measures of abnormality correlated with clinical disease severity. Postural sway metrics distinguished PSP from controls and captured gait imbalance. SignificanceObjective measures of gait and balance abnormalities in patients with PSP provide an outcome measure that can be potentially used for early disease detection, in clinical trials and to validate portable motion capture devices in the future.

Concern about falling is associated with segmental control when turning in older adults.

Healthy young adults typically exhibit a progressive 'top-down' reorientation of body segments (i.e., head, trunk, then pelvis) during turning. This behaviour is less evident in older adults at risk of falling, who often reduce angular displacement between body segments during turns. The potential functional and psychological contributors to this so-called 'en-bloc' turning strategy are not yet understood. Are there associations between concern about falling and variables representing en-bloc turning (i.e., increased coupling between body segments)? Twenty-one older adults were assessed while turning during an adaptive walking task. We collected data from markers forming the head, trunk, and pelvis segments, while gait velocity throughout the turn was calculated from a sternum marker. We correlated several variables with concern about falling alone, as well as while controlling for functional balance ability. Correlation analyses revealed that concern about falling was related to en-bloc turning strategies and slower gait velocity throughout the turn, when analysed independently of functional balance. When controlling for balance ability, en-bloc turning strategies between the head and trunk, as well as the head and pelvis, remained significantly associated with concern about falling. Findings offer an insight into the potential role that psychological characteristics may have in determining older adults' turning behaviour and associated risk of falling.

Differences in the association between white matter hyperintensities and gait performance among older adults with and without cognitive impairment.

Gait impairment implies subtle cognitive impairment (CI) and is associated with severity of white matter hyperintensities (WMHs). However, cognitive differences in such an association are not yet fully understood. This study examined the association between WMHs and gait performance among three cognitively different older groups. Gait performance and WMHs were assessed in 150 community-dwelling older adults, comprising 53 with CI (Mini-Mental State Examination [MMSE] score <24), 63 with mild CI (MMSE score ≥24 and Montreal Cognitive Assessment [MoCA] score <25), and 34 who were cognitively normal or preserved (MMSE ≥24 and MoCA score ≥25). Gait velocity and variability were assessed on a 5-m electronic walkway. Furthermore, WMH volume was derived by automated segmentation using 1.5 T magnetic resonance imaging. Adjusted multiple regression analyses showed that greater WMHs were associated with slower gait velocity and greater temporal (stride time) and spatial (stride and step lengths) variabilities among older adults with CI. In contrast, WMH was only associated with spatial variability in older adults with mild CI and in cognitively normal or preserved older adults. Our findings suggest that gait variability measures are more sensitive to subtle underlying neurological pathologies including WMHs in older adults. The cognitive-dependent differences found in the association between WMHs and gait performance suggests that the level of cognitive function interferes with the association between WMH and gait performance. Geriatr Gerontol Int 2021; ••: ••-••.

Video analysis of long-term effects of levodopa-carbidopa intestinal gel on gait and posture in advanced Parkinson's disease.

Gait and posture parameters of ten advanced Parkinson's disease (PD) patients were assessed before and after starting levodopa-carbidopa intestinal gel (LCIG) treatment by means of both objective video analysis and clinical assessment. After 3years of treatment, gait and posture remained stable. A slower gait velocity at baseline significantly correlates with a higher axial and motor severity at follow-up. This pilot study suggests that validated video analysis software may support the clinical assessment of axial signs in PD patients who are candidates for device-aided therapies.

The Effects of Dog Walking on Gait and Mobility in People with Parkinson Disease: A Pilot Study.

The objective of this study was to assess the effects of dog walking on gait and mobility in people with Parkinson disease (PD). This single-group, single-session, observational pilot study included nineteen participants with PD in Hoehn and Yahr stages II (n = 9) and III (n = 10). Primary measures were a gait analysis and the Timed Up and Go (TUG). Three trials of two conditions (walking with and without a dog) were completed. Walking with a dog resulted in slower gait velocity (mean difference = 0.11 m/s, p = 0.003, d = 0.77), shorter step length (left: mean difference = 7.11 cm, p = 0.000; right: mean difference = 3.05, p = 0.01), and stride length (left: mean difference = 7.52, p = 0.003; right: mean difference = 8.74, p = 0.001). The base of support was more narrowed (Z = −2.13, p = 0.03), with increased double limb stance time (left: Z = −2.89, p = 0.004; right: Z = −2.59, p = 0.01). Walking with a dog caused slower TUG times (mean difference = −1.67, p = 0.000) and increased number of steps (Z = −3.73, p = 0.000). No significant change shown in step time (left: mean difference = −0.001, p = 0.81; right: mean difference = 0.002, p = 0.77) or cadence (Z = −1.67, p = 0.10). In conclusion, there was an overall decline of gait parameters in people with PD when walking with a dog.

A socially-engaged lifestyle moderates the association between gait velocity and cognitive impairment

Objective: Cognitive status has been linked to impaired gait velocity, and diminished social and physical engagement. To date, the potential moderating influence of lifestyle engagement on gait-cognitive status associations has not been systematically explored. The present investigation examines whether a socially- or physically-engaged lifestyle moderates the association between diminished gait velocity and likelihood of amnestic mild cognitive impairment (a-MCI) classification.Methods: Participants (aged 65+, Mage=73 years) were classified as either healthy controls (n = 30) or a-MCI (n = 24), using neuropsychological test scores and clinical judgement. Gait velocity was indexed using a GAITRite computerized walkway, engaged lifestyle (social and physical subdomains) were measured using a well-validated self-report measure, the revised Activity Lifestyle Questionnaire.Results: Logistic regression, evaluating likelihood of a-MCI classification, yielded a significant interaction between a socially-engaged lifestyle and gait velocity (b=.01, SE=.003, p=.015). Follow-up simple effects were derived for two levels (+/-1SD) of social engagement; for individuals 1 SD below the mean, the association between gait velocity and increased likelihood of a-MCI classification was exacerbated (probability of a-MCI classification for those with slower gait velocity was 60% higher for individuals 1 SD below vs 1 SD above the mean of social engagement). Physically-engaged lifestyle did not significantly moderate the gait-cognitive status association.Conclusions: The significant moderating influence of social engagement has several implications, including the likelihood that distinct mechanisms underlie the relationships of social engagement and gait velocity to cognitive function, the value of social variables for well-being, and the potential utility of socially-based interventions that may prevent/delay a-MCI onset.

Domain-Specific and Total Sedentary Behavior Associated with Gait Velocity in Older Adults: The Mediating Role of Physical Fitness.

Although it has been well-documented that older adults spend a significant amount of time being sedentary and have slower gait velocity, little is known of how physical fitness mediates the association between them. The main purpose of this study was to explore whether objectively measured physical fitness mediates the association between domain-specific and total sedentary behavior and gait velocity. We recruited 120 older adults aged ≥ 60 years. Sedentary behavior was assessed by the Measure of Older Adults’ Sedentary Time questionnaire. We used a Zebris pressure platform to assess gait velocity. To assess the level of overall physical fitness, we summed the z-scores of seven tests: (1) waist circumference, (2) chair stand in 30 s, (3) arm curl in 30 s, (4) 2-min step test, (5) chair sit-and-reach test, (6) back scratch test, and (7) 8-foot up-and-go test. Overall physical fitness was obtained by summing up all physical test z-scores. Gait velocity was significantly associated with all domain-specific and total sedentary behavior (β = −0.04 to −0.35, p < 0.05). Overall physical fitness was significantly associated with all domain-specific and total sedentary behavior (β = −0.21 to −1.24, p < 0.001) and gait velocity (β = 0.23 to 0.24, p < 0.001). When physical fitness was put as the mediator, significant direct effects between sedentary behavior and gait velocity disappeared. Results indicate that physical fitness fully mediates the association between sedentary behavior and gait velocity in older adults.

An Epidemiological Study of the Risk Factors of Bicycle-Related Falls Among Japanese Older Adults.

BackgroundConsidering the rate of growth of the older population in several countries, accidental falls in older cyclists are expected to increase. However, the prevalence and correlates of bicycle-related falls (BR-falls) are unknown. The aim of the present study was to explore the characteristics of BR-falls, focusing on the risk factors.MethodsSeven-hundred and ninety-one older adults participated in a comprehensive baseline assessment that included questions on bicycle use, BR-falls, lifestyle, and physical and cognitive evaluations. A cyclist was defined as a person who cycled at least a few times per month. The incidence of BR-falls in participants who did not report BR-falls at baseline was again ascertained 3 years later. Logistic regression analyses examined the predictors of BR-falls incidence.ResultsAt baseline, 395 older adults were cyclists and 45 (11.4%) of them had experienced BR-falls. Adjusted regression analysis showed that slower gait velocity, shorter one-leg standing time, and experience of falls (ie, non-BR-falls) were associated with BR-falls. Among the 214 cyclists who did not report BR-falls at baseline and who participated in both baseline and follow-up assessments, 35 (16.4%) cyclists experienced BR-falls during the 3-year follow-up. Adjusted regression analysis revealed that higher body mass index and non-BR-falls were predictors of future incidence of BR-falls, independent of physical function.ConclusionsOur results showed that experience of falls, irrespective of bicycling, is an independent correlate and risk factor of BR-falls. This suggests that experience of falls and BR-falls may share the same risk factors.