The association between cognition and gait in a representative sample of very old people – the influence of dementia and walking aid use

Abstract Background Cognition has been related with gait speed in older adults; however, studies involving the oldest age group, where many have mobility disability and cognitive impairment, are few. The aim was to investigate the association between global cognitive function and gait speed in a representative sample of very old people, and whether the association was affected by dementia, and walking aid use. Method This cross-sectional study included 1317 participants, mean age 89.4 years, and 68% women, from the Umeå85+/Gerontological Regional Database. Self-paced gait speed was measured over 2.4 m, with or without walking aids, and global cognitive function with the Mini-Mental State Examination (MMSE). The association between cognition and gait speed was analyzed using multiple linear regression and stratified according to dementia. The influence of missing gait speed values was explored using multiple imputation. An interaction analysis was performed to investigate the influence of walking aid use. Results In comprehensively adjusted analyses, MMSE associated with gait speed (unstandardized β (β) 0.011 m/s, 95% Confidence Interval [CI] = 0.009, 0.013, p < 0.001) in the total sample. No association was found in people with dementia (β 0.003 m/s, 95%CI = 0.000, 0.006, p = 0.058), until missing gait speed values were compensated for by multiple imputation (β 0.007 m/s, 95% [CI] = 0.002, 0.011, p = 0.002). In interaction analysis the use of walking aids attenuated the association between cognition and gait speed (β − 0.019 m/s, 95%CI = − 0.024, − 0.013, p < 0.001). Conclusion Global cognitive function appears to associate with gait speed in very old people. However, in people with dementia selection bias was indicated since unless missing gait speed values were accounted for no association was observed. Walking aid use attenuated cognitive load, which may not apply to walking in daily activities, and requires further investigation.

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Age-specific differences in gait domains and global cognitive function in older women: gait characteristics based on gait speed modification

PeerJ ◽

10.7717/peerj.8820 ◽

2020 ◽

Vol 8 ◽

pp. e8820 ◽

Cited By ~ 6

Author(s):

Byungjoo Noh ◽

Changhong Youm ◽

Myeounggon Lee ◽

Hwayoung Park

Keyword(s):

Cognitive Function ◽

Older Women ◽

Gait Speed ◽

Measurement Unit ◽

Gait Characteristics ◽

Global Cognitive Function ◽

Age Related ◽

Data Loggers ◽

Type Data ◽

All Speeds

Background Several studies have reported the association between gait and global cognitive function; however, there is no study explaining the age-specific gait characteristics of older women and association between those characteristics and global cognitive function by age-specific differences and gait speed modification. The aim of this study was to examine age-specific differences in gait characteristics and global cognitive function in older women as well as identify gait domains strongly associated with global cognitive function in older women based on gait speed modification. Methods One hundred sixty-four female participants aged 65–85 years were examined. Participants were assessed for global cognitive function through the mini-mental state examination. They also performed three trials of the overground walking test along a straight 20 m walkway. Inertial measurement unit sensors with shoe-type data loggers on both the left and right outsoles were used to measure gait characteristics. Results The pace at all speeds and the variability and phase at faster speeds were altered in women aged >75 years (all pace domain parameters, p < 0.05); variability and phase highly depended on age (all p < 0.05). Variability at slower speeds (β = −0.568 and p = 0.006) and the phase at the preferred (β = −0.471 and p = 0.005) and faster speeds (β = −0.494 and p = 0.005) were associated with global cognitive function in women aged >75 years. Discussion The variability and phase domains at faster speeds were considered to identify gait changes that accompany aging. In addition, the decreases in global cognitive function are associated with increased variability and phase domains caused by changes in gait speed in older women. Conclusion Our results are considered useful for understanding age-related gait characteristics with global cognitive function in old women.

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Tea consumption and measures of attention and psychomotor speed in the very old: the Newcastle 85+ longitudinal study

BMC Nutrition ◽

10.1186/s40795-020-00361-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Edward Jonathan Okello ◽

Nuno Mendonça ◽

Blossom Stephan ◽

Graciela Muniz-Terrera ◽

Keith Wesnes ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Function ◽

Sustained Attention ◽

Community Dwelling ◽

Tea Consumption ◽

Psychomotor Speed ◽

Very Old ◽

Old Adults ◽

Global Cognitive Function ◽

Over Time

Abstract Background A number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old, defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed. Method Longitudinal (5-years), population-based cohort study of individuals aged 85+ years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n = 676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function were assessed. Linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline. Results Tea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time. Conclusions In this cohort study of non-demented very old adults we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group. These findings need to be confirmed in a sufficiently powered and well-designed RCT with non-demented very old adults.

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Usual Gait Speed Independently Predicts Mortality in Very Old People: A Population-Based Study

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2013.04.006 ◽

2013 ◽

Vol 14 (7) ◽

pp. 529.e1-529.e6 ◽

Cited By ~ 32

Author(s):

Annika Toots ◽

Erik Rosendahl ◽

Lillemor Lundin-Olsson ◽

Peter Nordström ◽

Yngve Gustafson ◽

...

Keyword(s):

Gait Speed ◽

Population Based ◽

Old People ◽

Population Based Study ◽

Very Old ◽

Usual Gait Speed

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Tea consumption and measures of attention and psychomotor speed in the very old: The Newcastle 85+ Longitudinal Study

10.21203/rs.3.rs-22144/v1 ◽

2020 ◽

Author(s):

Edward Jonathan Okello ◽

Nuno Mendonça ◽

Blossom Stephan ◽

Graciela Muniz-Terrera ◽

Keith Wesnes ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Function ◽

Sustained Attention ◽

Community Dwelling ◽

Tea Consumption ◽

Psychomotor Speed ◽

Very Old ◽

Global Cognitive Function ◽

Co Morbidity ◽

Over Time

Abstract Background A number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed. Method: Longitudinal (5-years), population-based cohort study of individuals aged 85 + years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n = 676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function, linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline. Results Tea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time. Conclusions In this cohort study of the very old and non-demented (85 + years) we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group.

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Walking Aids Moderate Exercise Effects on Gait Speed in People With Dementia: A Randomized Controlled Trial

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2016.09.003 ◽

2017 ◽

Vol 18 (3) ◽

pp. 227-233 ◽

Cited By ~ 16

Author(s):

Annika Toots ◽

Håkan Littbrand ◽

Henrik Holmberg ◽

Peter Nordström ◽

Lillemor Lundin-Olsson ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Gait Speed ◽

Controlled Trial ◽

Moderate Exercise ◽

Randomized Controlled ◽

People With Dementia ◽

Walking Aids

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Cognitive function among physically independent very old people in an urban community in Japan: The Itabashi Oldest-Old Study II

Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics ◽

10.3143/geriatrics.42.214 ◽

2005 ◽

Vol 42 (2) ◽

pp. 214-220 ◽

Cited By ~ 2

Author(s):

Hajime Iwasa ◽

Yasuyuki Gondo ◽

Taketo Furuna ◽

Erika Kobayashi ◽

Hiroki Inagaki ◽

...

Keyword(s):

Cognitive Function ◽

Urban Community ◽

Oldest Old ◽

Old People ◽

Very Old

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Low or Declining Gait Speed is Associated With Risk of Developing Dementia Over 5 Years Among People Aged 85 Years and Over

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0266 ◽

2020 ◽

pp. 1-8

Author(s):

Jerry Öhlin ◽

Yngve Gustafson ◽

Håkan Littbrand ◽

Birgitta Olofsson ◽

Annika Toots

Keyword(s):

Nursing Home ◽

Cognitive Decline ◽

Gait Speed ◽

Daily Living ◽

Population Aging ◽

Old People ◽

Very Old ◽

Dementia Screening ◽

Screening Procedures

Improving dementia screening procedures beyond simple assessment of current cognitive performance is timely given the ongoing phenomenon of population aging. A slow or declining gait speed (GS) is a potential early indicator of cognitive decline scarcely investigated in very old people. Here, we investigated the 5-year associations of baseline GS, change in GS, and cognitive function with subsequent dementia development in people aged 85 years and older (n = 296) without dementia at baseline. Declining and a slow baseline GS were associated with higher odds of dementia development after adjusting for confounders (e.g., age, sex, and dependency in activities of daily living) and missing GS values at follow-up. The GS decline was associated with cognitive decline in participants who developed dementia. The results support the potential of GS tests to predict future cognitive decline among community- and nursing home-dwelling very old people.

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Cognitive function among physically independent very old people in an urban Japanese community

Geriatrics and Gerontology International ◽

10.1111/j.1447-0594.2005.00315.x ◽

2005 ◽

Vol 5 (4) ◽

pp. 248-253 ◽

Cited By ~ 3

Author(s):

Hajime Iwasa ◽

Yasuyuki Gondo ◽

Taketo Furuna ◽

Erika Kobayashi ◽

Hiroki Inagaki ◽

...

Keyword(s):

Cognitive Function ◽

Old People ◽

Very Old

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Heterogeneity in Association Between Cognitive Function and Gait Speed Among Older Adults: An Integrative Data Analysis Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa211 ◽

2020 ◽

Cited By ~ 1

Author(s):

Elizabeth P Handing ◽

Stephen R Rapp ◽

Shyh-Huei Chen ◽

W Jack Rejeski ◽

Marie Wiberg ◽

...

Keyword(s):

Older Adults ◽

Data Analysis ◽

Cognitive Function ◽

African Americans ◽

Gait Speed ◽

Multilevel Regression ◽

Race And Gender ◽

Global Cognitive Function ◽

And Gender ◽

The Relationship

Abstract Background Increasing evidence shows that cognition and gait speed are associated and are important measures of health among older adults. However, previous studies have used different methods to assess these 2 outcomes and lack sufficient sample size to examine heterogeneity among subgroups. This study examined how the relationship between global cognitive function and gait speed are influenced by age, gender, and race utilizing an integrated data analysis approach. Method Data on cognition (Montreal Cognitive Assessment [MoCA], Mini-Mental Status Examination [MMSE], and Modified Mini-Mental State Examination [3MSE]) and gait speed (range: 4–400 m) were acquired and harmonized from 25 research studies (n = 2802) of adults aged 50+ from the Wake Forest Older American Independence Center. Multilevel regression models examined the relationship between predicted values of global cognitive function (MoCA) and gait speed (4-m walk), including heterogeneity by age, race, and gender. Results Global cognitive function and gait speed exhibited a consistent positive relationship among whites with increasing age, while this was less consistent for African Americans. That is, there was a low correlation between global cognitive function and gait speed among African Americans aged 50–59, a positive correlation in their 60s and 70s, then a negative correlation thereafter. Conclusion Global cognition and gait speed exhibited a curvilinear U-shaped relationship among whites; however, the association becomes inverse in African Americans. More research is needed to understand this racial divergence and could aid in identifying interventions to maintain cognitive and gait abilities across subgroups.

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Tea consumption and measures of attention and psychomotor speed in the very old: The Newcastle 85+ Longitudinal Study

10.21203/rs.3.rs-22144/v2 ◽

2020 ◽

Author(s):

Edward Jonathan Okello ◽

Nuno Mendonça ◽

Blossom Stephan ◽

Graciela Muniz-Terrera ◽

Keith Wesnes ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Function ◽

Sustained Attention ◽

Community Dwelling ◽

Tea Consumption ◽

Psychomotor Speed ◽

Very Old ◽

Old Adults ◽

Global Cognitive Function ◽

Over Time

Abstract Background: A number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old, defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed.Method: Longitudinal (5-years), population-based cohort study of individuals aged 85+ years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n=676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function were assessed. Linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline.Results: Tea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time.Conclusions: In this cohort study of non-demented very old adults we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group. These findings need to be confirmed in a sufficiently powered and well-designed RCT with non-demented very old adults.

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