Consensus on Shared Measures of Mobility and Cognition: From the Canadian Consortium on Neurodegeneration in Aging (CCNA)

Montero‐Odasso, Manuel; Almeida, Quincy J.; Bherer, Louis; Burhan, Amer M.; Camicioli, Richard; Doyon, Julien; Fraser, Sarah; Hunter, Susan; Li, Karen; Liu-Ambrose, Teresa; McIlroy, William E.; Middleton, Laura; Morais, José A.; Sakurai, Ryota; Speechley, Mark; Vasudev, Akshya; Beauchet, Olivier; Hausdorff, Jeffrey M.; Rosano, Caterina; Studenski, Stephanie A.; Verghese, Joe

doi:10.1093/gerona/gly148

Cited by 121 publications

(115 citation statements)

References 130 publications

(147 reference statements)

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“…Assessment of walking provides clinically meaningful insights into cognitive-motor function and underlying brain health. 4 In addition to the peripheral and spinal neuromuscular systems, the complex task of walking depends upon "higher-level" sensory-motor integration and various cognitive functions. 5 Moreover, in daily life, walking is almost always performed in the context of cognitive tasks such as talking, reading signs, or making decisions.…”

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confidence: 99%

Self‐Reported Head Trauma Predicts Poor Dual Task Gait in Retired National Football League Players

Manor

Zhou

et al. 2019

Annals of Neurology

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Objective Symptomatic head trauma associated with American‐style football (ASF) has been linked to brain pathology, along with physical and mental distress in later life. However, the longer‐term effects of such trauma on objective metrics of cognitive–motor function remain poorly understood. We hypothesized that ASF‐related symptomatic head trauma would predict worse gait performance, particularly during dual task conditions (ie, walking while performing an additional cognitive task), in later life. Methods Sixty‐six retired professional ASF players aged 29 to 75 years completed a health and wellness questionnaire. They also completed a validated smartphone‐based assessment in their own homes, during which gait was monitored while they walked normally and while they performed a verbalized serial‐subtraction cognitive task. Results Participants who reported more symptomatic head trauma, defined as the total number of impacts to the head or neck followed by concussion‐related symptoms, exhibited greater dual task cost (ie, percentage increase) to stride time variability (ie, the coefficient of variation of mean stride time). Those who reported ≥1 hit followed by loss of consciousness, compared to those who did not, also exhibited greater dual task costs to this metric. Relationships between reported trauma and dual task costs were independent of age, body mass index, National Football League career duration, and history of musculoskeletal surgery. Symptomatic head trauma was not correlated with average stride times in either walking condition. Interpretation Remote, smartphone‐based assessments of dual task walking may be utilized to capture meaningful data sensitive to the long‐term impact of symptomatic head trauma in former professional ASF players and other contact sport athletes. ANN NEUROL 2020;87:75–83

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confidence: 99%

Self‐Reported Head Trauma Predicts Poor Dual Task Gait in Retired National Football League Players

Manor

Zhou

et al. 2019

Annals of Neurology

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“…Low performance in TMTs and SDST is a predictor of increased risk of falls incidence and mobility decline . Thus, those tests are included in the core battery as useful cognitive indicators to assess motor–cognitive interaction . SDST measures several cognitive mechanisms, including visual information processing such as visual attention and visuoperceptual and visuospatial ability .…”

Section: Discussionmentioning

confidence: 99%

“…Scales related to motor and cognitive functions were used to evaluate the concurrent validity, as there is no gold standard for the dual‐task testing method currently available. Thus, we selected the relevant measurements with reference to an international consensus on the interaction between motor and cognitive functions …”

Section: Methodsmentioning

confidence: 99%

“…Motor and cognitive functions are regulated through a common brain area and networks, and they mutually influence each other in a mechanism often termed “motor–cognitive interactions,” particularly when motor and cognitive reserves are limited . Emerging evidence suggests that the decline in such interactions based on aging and neurodegeneration is associated with an increased risk of dementia and falls .…”

Section: Introductionmentioning

confidence: 99%

“…However, there are few validated motor–cognitive dual‐task tests and those that have been validated are limited to verbal and calculation tasks (e.g. naming items/animals, serial sevens subtraction and reciting alphabet letters while walking) …”

Section: Introductionmentioning

confidence: 99%

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Reliability and construct validity of a novel motor–cognitive dual‐task test: A Stepping Trail Making Test

Osuka

Kojima

Sakurai

et al. 2020

Geriatrics Gerontology Int

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Aim This study aimed to examine the reliability and construct validity of the Stepping Trail Making Test (S‐TMT) in community‐dwelling older adults. Methods This study comprised a cross‐sectional study based on a population sample. Participants comprised 1224 community‐dwelling older Japanese women aged 65–81 years without functional disability, dementia, depression, Parkinson's disease, or cognitive and visual impairments. The S‐TMT measured the time taken to step on a sequence of numbers (1–16) positioned on a mat (1 m2). Participants were instructed to step as quickly and accurately as possible. Motor functions were assessed by walking speed and knee extensor strength tests, while cognitive functions were assessed by the Symbol Digit Substitution Task (SDST) test, verbal and logical memory test, and TMT‐A and ‐B. Results As a result of test–retest reliability over 6 months, the intraclass correlation coefficients of the S‐TMT was 0.82 (95% confidence interval, 0.68–0.90). An adjusted multiple regression model indicated that the S‐TMT was significantly associated with walking speed for motor function, and associated with the SDST, TMT‐A and TMT‐B for cognitive functions (P < 0.001). Conclusions These results suggest that the S‐TMT is a reliable dual‐task test comprising mobility for motor function and a visual‐dependent execution function for cognitive function in older women. Geriatr Gerontol Int 2020; 20: 291–296.

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Association of Neurocognitive and Physical Function With Gait Speed in Midlife

et al. 2019

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IMPORTANCE Gait speed is a well-known indicator of risk of functional decline and mortality in older adults, but little is known about the factors associated with gait speed earlier in life. OBJECTIVES To test the hypothesis that slow gait speed reflects accelerated biological aging at midlife, as well as poor neurocognitive functioning in childhood and cognitive decline from childhood to midlife. DESIGN, SETTING, AND PARTICIPANTS This cohort study uses data from the Dunedin Multidisciplinary Health and Development Study, a population-based study of a representative 1972 to 1973 birth cohort in New Zealand that observed participants to age 45 years (until April 2019). Data analysis was performed from April to June 2019. EXPOSURES Childhood neurocognitive functions and accelerated aging, brain structure, and concurrent physical and cognitive functions in adulthood. MAIN OUTCOMES AND MEASURES Gait speed at age 45 years, measured under 3 walking conditions: usual, dual task, and maximum gait speeds. RESULTS Of the 1037 original participants (91% of eligible births; 535 [51.6%] male), 997 were alive at age 45 years, of whom 904 (90.7%) had gait speed measured (455 [50.3%] male; 93% white). The mean (SD) gait speeds were 1.30 (0.17) m/s for usual gait, 1.16 (0.23) m/s for dual task gait, and 1.99 (0.29) m/s for maximum gait. Adults with more physical limitations (standardized regression

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Consensus on Shared Measures of Mobility and Cognition: From the Canadian Consortium on Neurodegeneration in Aging (CCNA)

Cited by 121 publications

References 130 publications

Self‐Reported Head Trauma Predicts Poor Dual Task Gait in Retired National Football League Players

Self‐Reported Head Trauma Predicts Poor Dual Task Gait in Retired National Football League Players

Reliability and construct validity of a novel motor–cognitive dual‐task test: A Stepping Trail Making Test

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

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