Age-related changes in attention control and their relationship with gait performance in older adults with high risk of falls.


Journal

NeuroImage
ISSN: 1095-9572
Titre abrégé: Neuroimage
Pays: United States
ID NLM: 9215515

Informations de publication

Date de publication:
01 04 2019
Historique:
received: 01 08 2018
revised: 28 12 2018
accepted: 11 01 2019
pubmed: 21 1 2019
medline: 25 1 2020
entrez: 21 1 2019
Statut: ppublish

Résumé

Falls are the leading cause of injury-related deaths in the elderly worldwide. Both gait impairment and cognitive decline have been shown to constitute major fall risk factors. However, further investigations are required to establish a more precise link between the influence of age on brain systems mediating executive cognitive functions and their relationship with gait disturbances, and thus help define novel markers and better guide remediation strategies to prevent falls. Event-related functional magnetic resonance imaging (fMRI) was used to evaluate age-related effects on the recruitment of executive control brain network in selective attention task, as measured with a flanker paradigm. Brain activation patterns were compared between twenty young (21 years ± 2.5) and thirty-four old participants (72 years ± 5.3) with high fall risks. We then determined to what extend age-related differences in activation patterns were associated with alterations in several gait parameters, measured with electronic devices providing a precise quantitative evaluation of gait, as well as with alterations in several aspects of cognitive and physical abilities. We found that both young and old participants recruited a distributed fronto-parietal-occipital network during interference by incongruent distractors in the flanker task. However, additional activations were observed in posterior parieto-occipital areas in the older relative to the younger participants. Furthermore, a differential recruitment of both the left dorsal parieto-occipital sulcus and precuneus was significantly correlated with higher gait variability. Besides, decreased activation in the right cerebellum was found in the older with poorer cognitive processing speed scores. Overall results converge to indicate greater sensitivity to attention interference and heightened recruitment of cortical executive control systems in the elderly with fall risks. Critically, this change was associated with selective increases in gait variability indices, linking attentional control with gait performance in elderly with high risks of falls.

Sections du résumé

BACKGROUND
Falls are the leading cause of injury-related deaths in the elderly worldwide. Both gait impairment and cognitive decline have been shown to constitute major fall risk factors. However, further investigations are required to establish a more precise link between the influence of age on brain systems mediating executive cognitive functions and their relationship with gait disturbances, and thus help define novel markers and better guide remediation strategies to prevent falls.
METHODS
Event-related functional magnetic resonance imaging (fMRI) was used to evaluate age-related effects on the recruitment of executive control brain network in selective attention task, as measured with a flanker paradigm. Brain activation patterns were compared between twenty young (21 years ± 2.5) and thirty-four old participants (72 years ± 5.3) with high fall risks. We then determined to what extend age-related differences in activation patterns were associated with alterations in several gait parameters, measured with electronic devices providing a precise quantitative evaluation of gait, as well as with alterations in several aspects of cognitive and physical abilities.
RESULTS
We found that both young and old participants recruited a distributed fronto-parietal-occipital network during interference by incongruent distractors in the flanker task. However, additional activations were observed in posterior parieto-occipital areas in the older relative to the younger participants. Furthermore, a differential recruitment of both the left dorsal parieto-occipital sulcus and precuneus was significantly correlated with higher gait variability. Besides, decreased activation in the right cerebellum was found in the older with poorer cognitive processing speed scores.
CONCLUSIONS
Overall results converge to indicate greater sensitivity to attention interference and heightened recruitment of cortical executive control systems in the elderly with fall risks. Critically, this change was associated with selective increases in gait variability indices, linking attentional control with gait performance in elderly with high risks of falls.

Identifiants

pubmed: 30660655
pii: S1053-8119(19)30030-8
doi: 10.1016/j.neuroimage.2019.01.030
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

551-559

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Natalia B Fernandez (NB)

Laboratory of Behavioral Neurology and Imaging of Cognition, Dept. of Neurosciences, University Medical Center, University of Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Switzerland. Electronic address: natalia.fernandez@unige.ch.

Mélany Hars (M)

Division of Bone Diseases, Dept. of Internal Medicine Specialties, Geneva University Hospitals, Faculty of Medicine, Switzerland.

Andrea Trombetti (A)

Division of Bone Diseases, Dept. of Internal Medicine Specialties, Geneva University Hospitals, Faculty of Medicine, Switzerland.

Patrik Vuilleumier (P)

Laboratory of Behavioral Neurology and Imaging of Cognition, Dept. of Neurosciences, University Medical Center, University of Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Switzerland.

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