Walking energetics and white matter hyperintensities in mid-to-late adulthood

Ryan J. Dougherty, Amal A. Wanigatunga, Yang An, Qu Tian, Eleanor M. Simonsick, Marilyn S. Albert, Susan M. Resnick, Jennifer A. Schrack

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: White matter hyperintensities (WMHs) increase with age and contribute to cognitive and motor function decline. Energy costs for mobility worsen with age, as the energetic cost of walking increases and energetic capacity declines. We examined the cross-sectional associations of multiple measures of walking energetics with WMHs in mid- to late-aged adults. METHODS: A total of 601 cognitively unimpaired adults (mean age 66.9 ± 15.3 years, 54% women) underwent brain magnetic resonance imaging scans and completed standardized slow- and peak-paced walking assessments with metabolic measurement (V̇O2). T1-weighted scans and fluid-attenuated inversion recovery images were used to quantify WMHs. Separate multivariable linear regression models examined associations adjusted for covariates. RESULTS: Lower slow-paced V̇O2 (B = 0.07; P = 0.030), higher peak-paced V̇O2 (B = –0.10; P = 0.007), and lower cost-to-capacity ratio (B =.12; P < 0.0001) were all associated with lower WMH volumes. DISCUSSION: The cost-to-capacity ratio, which describes the percentage of capacity required for ambulation, was the walking energetic measure most strongly associated with WMHs.

Original languageEnglish (US)
Article numbere12501
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Issue number4
StatePublished - Oct 1 2023


  • cardiorespiratory fitness
  • cerebral small vessel disease
  • cerebral vascular health
  • gait
  • magnetic resonance imaging
  • metabolic cost of walking
  • motor control
  • neuroimaging
  • physical fitness
  • physical function
  • walking economy
  • walking efficiency

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health


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