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Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition

McGough, Ellen, L., PT, PhD; Kelly, Valerie, E., PT, PhD; Weaver, Kurt, E., PhD; Logsdon, Rebecca, G., PhD; McCurry, Susan, M., PhD; Pike, Kenneth, C., PhD; Grabowski, Thomas, J., MD; Teri, Linda, PhD

American Journal of Physical Medicine & Rehabilitation: April 2018 - Volume 97 - Issue 4 - p 229–235
doi: 10.1097/PHM.0000000000000881
Original Research Articles CME Article . 2018 Series . Number 4
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Objective This study aimed to examine differences in spatiotemporal gait parameters between older adults with amnestic mild cognitive impairment and normal cognition and to examine limbic and basal ganglia neural correlates of gait and executive function in older adults without dementia.

Design This was a cross-sectional study of 46 community-dwelling older adults, ages 70–95 yrs, with amnestic mild cognitive impairment (n = 23) and normal cognition (n = 23). Structural magnetic resonance imaging was used to attain volumetric measures of limbic and basal ganglia structures. Quantitative motion analysis was used to measure spatiotemporal parameters of gait. The Trail Making Test was used to assess executive function.

Results During fast-paced walking, older adults with amnestic mild cognitive impairment demonstrated significantly slower gait speed and shorter stride length compared with older adults with normal cognition. Stride length was positively correlated with hippocampal, anterior cingulate, and nucleus accumbens volumes (P < 0.05). Executive function was positively correlated with hippocampal, anterior cingulate, and posterior cingulate volumes (P < 0.05).

Conclusions Compared with older adults with normal cognition, those with amnestic mild cognitive impairment demonstrated slower gait speed and shorter stride length, during fast-paced walking, and lower executive function. Hippocampal and anterior cingulate volumes demonstrated moderate positive correlation with both gait and executive function, after adjusting for age.

To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives Upon completion of this article, the reader should be able to: (1) discuss gait performance and cognitive function in older adults with amnestic mild cognitive impairment versus normal cognition, (2) discuss neurocorrelates of gait and executive function in older adults without dementia, and (3) recognize the importance of assessing gait speed and cognitive function in the clinical management of older adults at risk for dementia.

Level Advanced

Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

From the Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (ELM, VEK); Department of Radiology, University of Washington, Seattle, Washington (KEW, TJG); Integrated Brain Imaging Center, University of Washington, Seattle, Washington (KEW, TJG); and Psychosocial and Community Health, University of Washington, Seattle, Washington (RGL, SMM, KCP, LT).

All correspondence should be addressed to: Ellen L. McGough, PT, PhD, Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific St, Box 356490, Seattle, WA 98195.

The study was supported by National Institute of Aging at the NIH (2R01 AG14777-06A2, PI: LT), Biobehavioral Nursing Research Training Program, University of Washington (T32 NR007106), Integrated Brain Imaging Center, University of Washington (1RCA NSO73008 01, PI: TJG), and Alzheimer's Association International New Investigators Award (PI: ELM).

Previous presentations of this research (some results presented): APTA IV STEP Conference Presentation July 2016, Columbus Ohio Science in Medicine Lecture, October 2016, University of Washington.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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