We recently found that dual decline in memory and gait speed was consistently associated with an increased risk of dementia compared to decline in memory or gait only or no decline across six aging cohorts. The mechanisms underlying this relationship are unknown. We hypothesize that individuals who experience dual decline may have specific pathophysiological pathways to dementia which can be indicated by specific metabolomic signatures. Here, we summarize blood-based metabolites that are associated with memory and gait from existing literature and discuss their relevant pathways. A total of 39 eligible studies were included in this systematic review. Metabolites that were associated with memory and gait belonged to five shared classes: sphingolipids, fatty acids, phosphatidylcholines, amino acids, and biogenic amines. The sphingolipid metabolism pathway was found to be enriched in both memory and gait impairments. Existing data may suggest that metabolites from sphingolipids and the sphingolipid metabolism pathway are important for both memory and gait impairments. Future studies using empirical data across multiple cohorts are warranted to identify metabolomic signatures of dual decline in memory and gait and to further understand its relationship with future dementia risk.

Introduction Investigations into consequences of the US COVID‐19 pandemic for older adults with dementia have been limited. Methods We used the National Health and Aging Trends Study to examine self‐reported COVID‐19 infection; measures taken to limit its spread; social, behavioral, and emotional responses to the pandemic; and changes in health‐care use and provider communication. We compared adults aged ≥70 with and without dementia in community and residential care settings. Results In residential care settings, infection was substantially higher and social contact less common for those with dementia. In community and residential care settings, those with dementia had 2 to 3 times the odds of reporting sleeping more often. In residential care settings, those with dementia were less likely to put off care and more likely to start telehealth. Discussion Findings highlight the disproportionate social and behavioral consequences of the COVID‐19 pandemic for those living with dementia, particularly in residential care settings. HIGHLIGHTS Data are from the nationally representative National Health and Aging Trends Study. COVID‐19 infection was higher in residential care settings for those with dementia. Social contact was less common for those with dementia in residential care. Pandemic‐related coping behaviors differed by dementia and residential status. In residential care, those with dementia were less likely to delay health care.

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