Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: The HUNT study

Sverdrup, Karen; Selbæk, Geir; Bergh, Sverre; Strand, Bjørn Heine; Thingstad, Pernille; Skjellegrind, Håvard Kjesbu; Skjerve, Kjerstin Næss; Tangen, Gro Gujord

doi:10.1016/j.archger.2021.104400

Cited by 25 publications

(17 citation statements)

References 46 publications

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“…Additionally, some gait parameters could identify patients with PSD, as evidenced by the moderate AUCs. Previous studies have revealed that patients with VaD walked with a slower velocity and shorter stride length than patients with AD ( Tanaka et al, 1995 ; Sverdrup et al, 2021 ). However, we did not find a difference in the pace domain between the PSD and AD groups, even though PSD is a subtype of VaD.…”

Section: Discussionmentioning

confidence: 93%

Pathological Gait Signatures of Post-stroke Dementia With Toe-Off and Heel-to-Ground Angles Discriminate From Alzheimer’s Disease

Sun

et al. 2021

Front. Aging Neurosci.

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Given the limited power of neuropsychological tests, there is a need for a simple, reliable means, such as gait, to identify mild dementia and its subtypes. However, gait characteristics of patients with post-stroke dementia (PSD) and Alzheimer’s disease (AD) are unclear. We sought to describe their gait signatures and to explore gait parameters distinguishing PSD from post-stroke non-dementia (PSND) and patients with AD. We divided 3-month post-stroke patients into PSND and PSD groups based on the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the activity of daily living (ADL). Thirty-one patients with AD and thirty-two healthy controls (HCs) were also recruited. Ten gait parameters in one single and two dual-task gait tests (counting-backward or naming-animals while walking) were compared among the groups, with adjustment for baseline demographic covariates and the MMSE score. The area under the receiver operating characteristic curve (AUC) was used to identify parameters discriminating PSD from individuals with PSND and AD. Patients with PSD and patients with AD showed impaired stride length, velocity, stride time, and cadence while patients with PSD had altered stance and swing phase proportions (all p ≤ 0.01, post hoc). Patients with AD had smaller toe-off (ToA) and heel-to-ground angles (HtA) (p ≤ 0.01) than HCs in dual-task gait tests. Individuals with PSD had a shorter stride length, slower velocity, and altered stance and swing phase percentages in all tests (p ≤ 0.01), but a higher coefficient of variation of stride length (CoVSL) and time (CoVST) only in the naming animals-task gait test (p ≤ 0.001) than individuals with PSND. ToA and HtA in the naming animals-task gait test were smaller in individuals with AD than those with PSD (p ≤ 0.01). Statistical significance persisted after adjusting for demographic covariates, but not for MMSE. The pace and the percentage of stance or swing phase in all tests, CoVST in the dual-task paradigm, and CoVSL only in the naming animals-task gait test (moderate accuracy, AUC > 0.700, p ≤ 0.01) could distinguish PSD from PSND. Furthermore, the ToA and HtA in the naming animals-task gait paradigm discriminated AD from PSD (moderate accuracy, AUC > 0.700, p ≤ 0.01). Thus, specific gait characteristics could allow early identification of PSD and may allow non-invasive discrimination between PSD and AD, or even other subtypes of dementia.

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Section: Discussionmentioning

confidence: 93%

Pathological Gait Signatures of Post-stroke Dementia With Toe-Off and Heel-to-Ground Angles Discriminate From Alzheimer’s Disease

Sun

et al. 2021

Front. Aging Neurosci.

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“…Canon and Crimmins 33 showed that muscle quality of the knee extensors, assessed using an isokinetic device, was closely related to cognitive decline. Sverdrup et al 34 found an association with dementia for poor performances in the Timed Up and Go (TUG) test, the STS test and gait speed.…”

Section: Discussionmentioning

confidence: 99%

Sit to stand muscle power reference values and their association with adverse events in Colombian older adults

Ramírez‐Vélez

Izquierdo

García-Hermoso

et al. 2022

Sci Rep

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Recently, a valid method to assess lower-body muscle power based on a sit-to-stand field test (STS) has been published. Our study aimed to describe lower-body muscle power in older individuals aged ≥ 60 years and examine the relationship of muscle weakness with adverse events according to gender- and age-specific muscle weakness cut-off points. A total of 3689 Colombian older adults (57.6% women, age 69.1 ± 6.9 years) from the 2015 Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE) participated in this study. Lower-body muscle power normalized to body mass was estimated by the five-repetitions STS test. Anthropometric, physical performance and clinical characteristics were collected. Age-specific percentiles using the LMS method, cut-off points and association with adverse events were calculated. Lower-body muscle power was greater in men than among women (2.2 ± 0.7 vs. 1.6 ± 0.5 W·kg−1, respectively; p < 0.001) at all ages. Muscle power ranked in the 50th percentile between 2.38 and 1.30 W·kg−1 in men, whereas women ranked between 1.79 and 1.21 W·kg−1. According to the cut-off points, lower-limb muscle power < 1 standard deviation in men was associated with having dynapenia, poor gait speed, cognitive impairment and mental, visual, hearing and memory problems. While, women were associated with having sarcopenia, dynapenia, poor gait speed, cognitive impairment, mental, hearing and memory problems, dementia and hospitalizations of > 24 h in the last year. Overall, participants with poor lower-limb muscle power had a significantly higher risk of adverse events [in men: odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.19–1.91, p < 0.001; in women: OR = 1.52, 95% CI = 1.27–1.87, p = 0.001] than their stronger counterparts. This study is the first to describe lower-limb muscle power values and cut-off points among a nationally representative sample of Colombian older adults. In men, 7 of the 14 adverse events studied were associated with lower muscle strength, whereas in women, it was 9 of the 14 adverse events.

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“…15 Analyses of HUNT4 have further shown that shift work is associated with higher levels of C-reactive protein and chronic musculoskeletal pain, 16 and that cognitive impairment is associated with lower physical performance. 17 The new focus on genetic and molecular epidemiology has resulted in e.g. genome-wide association studies (GWAS) identifying new genetic variants associated with atrial fibrillation, 18 serum lipids, 19 thyroid stimulating hormone (TSH) 20 and bone mineral density.…”

Section: What Has It Found? Key Findings and Publicationsmentioning

confidence: 99%

Cohort Profile Update: The HUNT Study, Norway

Åsvold

Rehn

Kjelvik³

et al. 2021

Preprint

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In the HUNT Study, all residents aged ≥20 years in the Nord-Trøndelag region, Norway have been invited to repeated surveys since 1984-86. The study data may be linked to local and national health registries. The HUNT4 survey in 2017-19 included 56 042 participants in Nord-Trøndelag and 107 711 participants in the neighboring Sør-Trøndelag region. The HUNT4 data enable more long-term follow-up, studies of life-course health trajectories, and within-family studies. New measures include body composition analysis using bioelectrical impedance; a one-week accelerometer recording; physical and cognitive testing in older adults; measurements of hemoglobin and blood cell counts, HbA1c and phosphatidylethanol; and genotyping. Researchers can apply for HUNT data access from HUNT Research Centre if they have obtained project approval from the Regional Committee for Medical and Health Research Ethics, see www.ntnu.edu/hunt/data.

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Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: The HUNT study

Cited by 25 publications

References 46 publications

Pathological Gait Signatures of Post-stroke Dementia With Toe-Off and Heel-to-Ground Angles Discriminate From Alzheimer’s Disease

Pathological Gait Signatures of Post-stroke Dementia With Toe-Off and Heel-to-Ground Angles Discriminate From Alzheimer’s Disease

Sit to stand muscle power reference values and their association with adverse events in Colombian older adults

Cohort Profile Update: The HUNT Study, Norway

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