Citation

Mahoney JR, Verghese J. J. Gerontol. A Biol. Sci. Med. Sci. 2019; ePub(ePub): ePub.

Affiliation

Department of Medicine, Division of Geriatrics Albert Einstein College of Medicine Bronx, New York, USA.

Copyright

(Copyright © 2019, Gerontological Society of America)

DOI

10.1093/gerona/glz117

PMID

31111868

Abstract

BACKGROUND: Deficits in visual-somatosensory (VS) integration are linked to poor mobility. Given that sensory, motor, and cognitive processes rely on overlapping neural circuitry that are compromised in dementia and pre-dementia stages like mild cognitive impairment (MCI), we hypothesize that cognitive impairment will be associated with reduced VS integration, which will in turn impact the relation between VS integration and mobility.

METHODS: A total of 345 older adults (mean age 76.88 ± 6.45 years; 52% female) participated in the current study. Cognitive impairment was defined as presence of MCI or dementia. Magnitude of VS integration was quantified using probability models. All participants completed assessments of general cognition (Repeatable Battery for the Assessment of Neuropsychological Status; RBANS), quantitative gait, and balance (unipedal stance).

RESULTS: The magnitude of VS integration was lower in the 40 individuals with MCI (p = 0.02) and 12 with dementia (p = 0.04), relative to the 293 individuals without cognitive impairment. In fully-adjusted models, magnitude of VS integration was only a strong predictor of performance on attention-based tests of the RBANS (β=0.161; p<0.01), regardless of cognitive status.

RESULTS from mediation analyses, however, reveal that cognitive impairment causes variation in magnitude of VS integration, which in turn causes variation in unipedal stance 95% CI [-.265, -.002] and spatial aspects of gait 95% CI [-.087, -.001].

CONCLUSIONS: Cognitive impairment influences multisensory integration, which adversely impacts balance and gait performance in aging. Future studies should aim to uncover the precise neural circuitry involved in multisensory, cognitive, and mobility processes.

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Language: en

Keywords

mobilit; ;; cognition; dementia; multisensory processing; sensorimotor integration; y