TY - JOUR
T1 - A prospective study of focal brain atrophy, mobility and fitness
AU - Tian, Q.
AU - Resnick, S. M.
AU - Davatzikos, Christos
AU - Erus, G.
AU - Simonsick, E. M.
AU - Studenski, S. A.
AU - Ferrucci, L.
N1 - Funding Information:
This research was supported by the Intramural Research Program of the National Institute on Aging. Grant number: 03-AG-0325.
Funding Information:
At each visit, participants were screened using the Blessed Information Memory Concentration (BIMC) Test [25]. If the BIMC score was four or higher, participants were evaluated using the Clinical Dementia Rating Scale (CDR) [26] or the dementia questionnaire. Additionally, participants in some substudies were evaluated using the CDR at each visit. If the BIMC was four or higher, the CDR score was 0.5 or higher, or the dementia questionnaire was abnormal, participants were reviewed at a consensus diagnostic conference. Mild cognitive impairment was determined using the Petersen criteria [27]. Diagnoses of dementia and Alzheimer’s disease were determined by the Diagnostic and Statistical Manual (DSM)-III-R [28] and the National Institute of Neurological and Communication Disorders and Stroke – Alzheimer’s Disease and Related Disorders Association criteria [29], respectively.
Publisher Copyright:
© 2019 The Association for the Publication of the Journal of Internal Medicine
PY - 2019/7
Y1 - 2019/7
N2 - Background: The parallel decline of mobility and cognition with ageing is explained in part by shared brain structural changes that are related to fitness. However, the temporal sequence between fitness, brain structural changes and mobility loss has not been fully evaluated. Methods: Participants were from the Baltimore Longitudinal Study of Aging, aged 60 or older, initially free of cognitive and mobility impairments, with repeated measures of fitness (400-m time), mobility (6-m gait speed) and neuroimaging markers over 4 years (n = 332). Neuroimaging markers included volumes of total brain, ventricles, frontal, parietal, temporal and subcortical motor areas, and corpus callosum. Autoregressive models were used to examine the temporal sequence of each brain volume with mobility and fitness, adjusted for age, sex, race, body mass index, height, education, intracranial volume and APOE ɛ4 status. Results: After adjustment, greater volumes of total brain and selected frontal, parietal and temporal areas, and corpus callosum were unidirectionally associated with future faster gait speed over and beyond cross-sectional and autoregressive associations. There were trends towards faster gait speed being associated with future greater hippocampus and precuneus. Higher fitness was unidirectionally associated with future greater parahippocampal gyrus and not with volumes in other areas. Smaller ventricle predicted future higher fitness. Conclusion: Specific regional brain volumes predict future mobility impairment. Impaired mobility is a risk factor for future atrophy of hippocampus and precuneus. Maintaining fitness preserves parahippocampal gyrus volume. Findings provide new insight into the complex and bidirectional relationship between the parallel decline of mobility and cognition often observed in older persons.
AB - Background: The parallel decline of mobility and cognition with ageing is explained in part by shared brain structural changes that are related to fitness. However, the temporal sequence between fitness, brain structural changes and mobility loss has not been fully evaluated. Methods: Participants were from the Baltimore Longitudinal Study of Aging, aged 60 or older, initially free of cognitive and mobility impairments, with repeated measures of fitness (400-m time), mobility (6-m gait speed) and neuroimaging markers over 4 years (n = 332). Neuroimaging markers included volumes of total brain, ventricles, frontal, parietal, temporal and subcortical motor areas, and corpus callosum. Autoregressive models were used to examine the temporal sequence of each brain volume with mobility and fitness, adjusted for age, sex, race, body mass index, height, education, intracranial volume and APOE ɛ4 status. Results: After adjustment, greater volumes of total brain and selected frontal, parietal and temporal areas, and corpus callosum were unidirectionally associated with future faster gait speed over and beyond cross-sectional and autoregressive associations. There were trends towards faster gait speed being associated with future greater hippocampus and precuneus. Higher fitness was unidirectionally associated with future greater parahippocampal gyrus and not with volumes in other areas. Smaller ventricle predicted future higher fitness. Conclusion: Specific regional brain volumes predict future mobility impairment. Impaired mobility is a risk factor for future atrophy of hippocampus and precuneus. Maintaining fitness preserves parahippocampal gyrus volume. Findings provide new insight into the complex and bidirectional relationship between the parallel decline of mobility and cognition often observed in older persons.
KW - brain atrophy
KW - fitness
KW - gait
KW - spatial distribution
KW - temporal sequence
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U2 - 10.1111/joim.12894
DO - 10.1111/joim.12894
M3 - Article
C2 - 30861232
AN - SCOPUS:85064487317
SN - 0954-6820
VL - 286
SP - 88
EP - 100
JO - Journal of Internal Medicine
JF - Journal of Internal Medicine
IS - 1
ER -