Predictors of gait speed and its change over three years in community-dwelling older people

Abstract

We aimed to assess whether and how changes in brain volume and increases in white matter hyperintensity (WMH) volume over three years predict gait speed and its change independently of demographics, vascular risk factors and physical status. We analyzed 443 individuals from the Lothian Birth Cohort 1936, at mean age 73 and 76 years. Gait speed at age 76 was predicted by age, grip strength and body mass index at mean age 73, three-year brain volume decrease and WMH volume increase, explaining 26.1% of variance. Decline in gait speed to age 76 was predicted by the same five variables explaining 40.9% of variance. In both analyses, grip strength and body mass index explained the most variance. A clinically significant decline in gait speed (≥ 0.1 m/s per year) occurred in 24.4%. These individuals had more structural brain changes. Brain volume and WMH changes were independent predictors of gait dysfunction and its three-year change, but the impact of malleable physical factors such as grip strength or body mass index was greater.

Grip strength from midlife as an indicator of later-life brain health and cognition: evidence from a British birth cohort

“…That said, there was no evidence that individuals with below- or above-average grip strength from midlife differed in WMHV compared to those with average trajectories; nor any evidence of a positive association between grip strength at age 69 and WMHV. However, above-average decline in grip strength was weakly associated with higher WMHV, which is consistent with studies reporting longitudinal associations between declines in other physical function measures (e.g., gait speed, chair rises) and increased WMHV [ 50 – 52 ]. Studies are needed in other cohorts across a range of ages to examine this discrepancy.…”

A prospective study of focal brain atrophy, mobility and fitness

“…For example, recent cross‐sectional studies demonstrate that grey matter areas, such as cortical areas of precuneus, motor, prefrontal regions and subcortical areas of hippocampus, thalamus and caudate, are associated with mobility in older adults, but the temporal sequence of this association remains unknown . A few longitudinal studies show brain structural changes, such as changes in total brain volume and white matter hyperintensities, predict gait decline, but the spatial distribution is undetermined . Recent longitudinal studies have shown prior mobility performance is associated with future volumes of hippocampus and superior parietal lobe , which are involved with spatial navigation.…”

“…Whether maintaining fitness counteracts brain ageing in community‐dwelling older adults remains unclear because of the limited availability of longitudinal studies adequate to test this hypothesis. The specific cortical and subcortical structure implicated in the protection has not been identified . Only a few cross‐sectional neuroimaging studies show higher fitness is associated with neuroimaging markers mostly localized in prefrontal and medial temporal lobes .…”

Efficacy of remote ischemic conditioning on improving WMHs and cognition in very elderly patients with intracranial atherosclerotic stenosis

“…In addition, a group of aging-related vascular changes, such as increased tortuous arterioles, thickened vascular walls due to collagen deposition, decreased vascular density and impaired cerebral blood flow (CBF) autoregulation could further exacerbate WM damage [3, 4]. Clinically, a high WMH burden is considered to be associated with progressive cognitive impairment, increased risk of stroke and dementia, gait disturbance, depression and even death [2, 5, 6].…”