Aim:  Dual‐tasking probes divided attention and causes performance changes that are associated with an increased risk for falls in the elderly. There is no systematic review investigating the effect of task type and complexity on the prediction of elderly falls. This article synthesizes research evidence regarding this issue on the contents of dual‐tasking walking. Methods:  Relevant studies were systematically identified from electronic databases of Medline, PubMed, CINAHL, Cochrane CENTRAL and PsycINFO, and the reference lists of identified articles. The selection criteria were defined a priori. Two independent reviewers classified task types based on properties for cognitive demand, assessed the methodological quality with a customized checklist, and calculated the odds ratio of fall prediction. Results:  There was one study of reaction time, one of discrimination and decision‐making, 10 of mental tracking, three of verbal fluency and five of manual tasks. The methodological heterogeneity was manifested in the selection criteria, faller classification, tasks and measures, resulting in substantial heterogeneity (I2 87–92%). Meta‐analyses resulted in a significant pooled odds ratio 1.33 (95% CI 1.18–1.50). The mental tracking task was the only type that yielded a significant odds ratio 3.30 (95% CI 2.00–5.44). Running meta‐analyses separately for simple and difficult mental tracking task showed similar odds ratios. Conclusion:  The mental tracking task yielded significant dual‐task‐related changes for fall prediction. Most studies successively used an appropriate level of task complexity specific to the specified population of interest. More research is required for definite conclusions regarding the effect of task type and complexity. Geriatr Gerontol Int 2013; 13: 289–297.

Diffusion spectrum imaging (DSI) of MRI can detect neural fiber tract changes. We investigated integrity of cingulum bundle (CB) in patients with mild cognitive impairment (MCI) and early Alzheimer's disease (EAD) using DSI tractography and explored its relationship with cognitive functions. We recruited 8 patients with MCI, 9 with EAD and 15 healthy controls (HC). All subjects received a battery of neuropsychological tests to access their executive, memory and language functions. We used a 3.0-tesla MRI scanner to obtain T1- and T2-weighted images for anatomy and used a pulsed gradient twice-refocused spin-echo diffusion echo-planar imaging sequence to acquire DSI. Patients with EAD performed significantly poorer than the HC on most tests in executive and memory functions. Significantly smaller general fractional anisotropy (GFA) values were found in the posterior and inferior segments of left CB and of the anterior segment of right CB of the EAD compared with those of the HC. Spearman's correlation on the patient groups showed that GFA values of the posterior segment of the left CB were significantly negatively associated with the time used to complete Color Trails Test Part II and positively correlated with performance of the logical memory and visual reproduction. GFA values of inferior segment of bilateral CB were positively associated with the performance of visual recognition. DSI tractography demonstrates significant preferential degeneration of the CB on the left side in patients with EAD. The location-specific degeneration is associated with corresponding declines in both executive and memory functions.

There is a clear hierarchical structure of mobility disability that correlates differently with IADL and BADL disabilities. These results suggest that different mobility tasks should be included in disability assessments to suit specific purposes.

Low-level laser therapy (LLLT), widely used in physiotherapy, has been known to enhance wound healing and stimulate cell proliferation, including fibroblast and endothelial cells. Applying LLLT can increase cell proliferation in many kinds of cells including fibroblasts and endothelial cells. However, the protective mechanisms of LLLT on endothelial apoptosis remain unclear. We hypothesized LLLT can protect endothelial cells from inflammation-induced apoptosis. Human endothelial cell line, EA.hy926 cells, and TNF-α/cycloheximide (TNF/CHX) were used to explore the protective effects of LLLT (660 nm) on inflammation-induced endothelial apoptosis. Cell viability, apoptosis, caspase-3/7/8/9 activity, MAPKs signaling, NF-κB activity, and inducible/endothelial nitric oxide synthase (iNOS/eNOS) expression were measured. Our results showed that LLLT increased EA.hy926 cell proliferation, attenuated the TNF/CHX-induced apoptosis, and reduced the TNF/CHX-mediated caspase-3/7/8/9 activation. In addition, LLLT increased ERK MAPK phosphorylation and suppressed the TNF/CHX-increased p38 MAPK, JNK, IKK phosphorylation, NF-κB translocation, and iNOS expression. The caspases-3 cleavage and cell death were not increased in cells treating with ERK inhibitor U0126, which implicated that ERK is not to be responsible for the protective effects of LLLT. After treating with p38 mitogen-activated protein kinase (MAPK) activator, the protection of LLLT in cell apoptosis was no longer existed, showing that LLLT protected the endothelial cells by suppressing p38 MAPK signaling. Our results provide a new insight into the possible molecular mechanisms in which LLLT protects against inflammatory-induced endothelial dysfunction.