Poole Victoria N, Oveisgharan Shahram, Yu Lei, Dawe Robert J, Leurgans Sue E, Zhang Shengwei, Arfanakis Konstantinos, Buchman Aron S, Bennett David A
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States.
Front Aging Neurosci. 2023 Oct 4;15:1194986. doi: 10.3389/fnagi.2023.1194986. eCollection 2023.
To determine the extent to which the regional brain volumes associated with slow gait speed can inform subsequent cognitive decline in older adults from the Rush Memory and Aging Project.
We utilized deformation-based morphometry (DBM) in a whole-brain exploratory approach to identify the regional brain volumes associated with gait speed assessed over a short distance during an in-home assessment. We created deformation scores to summarize the gait-associated regions and entered the scores into a series of longitudinal mixed effects models to determine the extent to which deformation predicted change in cognition over time, controlling for associations between gait and cognition.
In 438 older adults (81 ± 7; 76% female), DBM revealed that slower gait speed was associated with smaller volumes across frontal white matter, temporal grey matter, and subcortical areas and larger volumes in the ventricles during the same testing cycle. When a subset was followed over multiple (5 ± 2) years, slower gait speed was also associated with annual declines in global cognition, executive functioning, and memory abilities. Several of the gait-related brain structures were associated with these declines in cognition; however, larger ventricles and smaller medial temporal lobe volumes proved most robust and attenuated the association between slow gait and cognitive decline.
Regional brain volumes in the ventricles and temporal lobe associated with both slow gait speed and faster cognitive decline have potential to improve risk stratification for cognitive decline in older adults.
确定来自拉什记忆与衰老项目的老年人中，与步态速度缓慢相关的脑区体积能在多大程度上提示随后的认知衰退。
我们采用基于变形的形态测量法（DBM）进行全脑探索性研究，以识别在居家评估期间短距离步态速度相关的脑区体积。我们创建了变形分数来总结与步态相关的区域，并将这些分数纳入一系列纵向混合效应模型，以确定变形在控制步态与认知关联的情况下，随时间预测认知变化的程度。
在438名老年人（81±7岁；76%为女性）中，DBM显示，在同一测试周期内，步态速度较慢与额叶白质、颞叶灰质和皮质下区域体积较小以及脑室体积较大有关。当对一个子集进行长达（5±2）年的随访时，步态速度较慢还与整体认知、执行功能和记忆能力的年度下降有关。一些与步态相关的脑结构与这些认知下降有关；然而，脑室较大和内侧颞叶体积较小最为显著，并减弱了步态缓慢与认知衰退之间的关联。
脑室和颞叶的脑区体积与步态速度缓慢和认知衰退加快均相关，这有可能改善老年人认知衰退的风险分层。
