- Gait speed
- Psychomotor speed
- Elderly community dwellers
- Cognitive decline
Background/Aims: Gait speed is cross-sectionally associated with attention and psychomotor speed in older community dwellers. It is unclear if gait speed predicts decline in these cognitive domains over time. Methods: Usual gait speed (m/s) over 6 m was measured at baseline in 2,776 Health, Aging and Body Composition Study participants (mean age ± SD 73.5 ± 2.8 years, 53% women, 37% blacks). The Digit Symbol Substitution Test (DSST) was administered at baseline and after 5 years to assess attention and psychomotor speed. We used multivariate logistic regression models to calculate the risk of DSST 5-year decline [>1 SD from mean change (9 points)] across quartiles of gait speed, adjusting for demographics, weight, physical activity, comorbidities, depression and Modified Mini-Mental State Examination. Results: After 5 years, 389 (17.1%) participants declined in DSST. Compared to those in the highest quartile of gait speed (>1.35 m/s), participants in the lowest quartile (<1.05 m/s) were more likely to decline in DSST independently of the considered covariates (OR 1.74, 95% CI 1.21–2.51, adjusted p for trend across quartiles = 0.006). Conclusions: In this cohort of older community dwellers, gait speed independently predicted a decline in DSST after 5 years.
Copyright © 2007 S. Karger AG, Basel
- Rosano C, Simonsick EM, Harris TB, Kritchevsky SB, Brach J, Visser M, Yaffe K, Newman AB: Association between physical and cognitive function in healthy elderly: the health, aging and body composition study. Neuroepidemiology 2005;24:8–14.
- Richards M, Stern Y, Mayeux R: Subtle extrapyramidal signs and incident dementia: a follow-up analysis. Neurology 1995;45:1942.
- Verghese J, Lipton RB, Hall CB, Kuslansky G, Katz MJ, Buschke H: Abnormality of gait as a predictor of non-Alzheimer’s dementia. N Engl J Med 2002;347:1761–1768.
- Scarmeas N, Albert M, Brandt J, Blacker D, Hadjigeorgiou G, Papadimitriou A, Dubois B, Sarazin M, Wegesin D, Marder K, Bell K, Honig L, Stern Y: Motor signs predict poor outcomes in Alzheimer disease. Neurology 2005;64:1696–1703.
- Wang L, Larson EB, Bowen JD, van Belle G: Performance-based physical function and future dementia in older people. Arch Intern Med 2006;166:1115–1120.
- Camicioli R, Howieson D, Oken B, Sexton G, Kaye J: Motor slowing precedes cognitive impairment in the oldest old. Neurology 1998;50:1496–1498.
- Marquis S, Moore MM, Howieson DB, Sexton G, Payami H, Kaye JA, Camicioli R: Independent predictors of cognitive decline in healthy elderly persons. Arch Neurol 2002;59:601–606.
- Elkins JS, Knopman DS, Yaffe K, Johnston SC: Cognitive function predicts first-time stroke and heart disease. Neurology 2005;64:1750–1755.
- Rapp MA, Reischies FM: Attention and executive control predict Alzheimer disease in late life: results from the Berlin Aging Study (BASE). Am J Geriatr Psychiatry 2005;13:134–141.
- Fried LP, Kronmal RA, Newman AB, Bild DE, Mittelmark MB, Polak JF, Robbins JA, Gardin JM: Risk factors for 5-year mortality in older adults: the cardiovascular health study. JAMA 1998;279:585–592.
- Pavlik VN, de Moraes SA, Szklo M, Knopman DS, Mosley TH Jr, Hyman DJ: Relation between cognitive function and mortality in middle-aged adults: the atherosclerosis risk in communities study. Am J Epidemiol 2003;157:327–334.
- Longstreth WT Jr, Arnold AM, Beauchamp NJ Jr, Manolio TA, Lefkowitz D, Jungreis C, Hirsch CH, O’Leary DH, Furberg CD: Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly: The Cardiovascular Health Study. Stroke 2005;36:56–61.
- Kuo HK, Leveille SG, Yu YH, Milberg WP: Cognitive function, habitual gait speed, and late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999–2002. Gerontology 2006;53:102–110.
- Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB: Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55:M221–M231.
- Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, Fox M, Guralnik JM: Physical performance measures in the clinical setting. J Am Geriatr Soc 2003;51:314–322.
- Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, Mayorga LM: Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci 2005;60:1304–1309.
- Wechsler D (ed): Wechsler Adult Intelligence Scale – Revised. San Antonio, Psychological Corporation, 1981.
- Rooks RN, Simonsick EM, Miles T, Newman A, Kritchevsky SB, Schulz R, Harris T: The association of race and socioeconomic status with cardiovascular disease indicators among older adults in the health, aging, and body composition study. J Gerontol B Psychol Sci Soc Sci 2002;57:S247–S256.
- Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS: Compendium of physical activities: an update of activity codes and met intensities. Med Sci Sports Exerc 2000;32:S498–504.
- Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K: A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med 2001;161:1703–1708.
- Andresen EM, Malmgren JA, Carter WB, Patrick DL: Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 1994;10:77–84.
- Wilson RS, Mendes De Leon CF, Bennett DA, Bienias JL, Evans DA: Depressive symptoms and cognitive decline in a community population of older persons. J Neurol Neurosurg Psychiatry 2004;75:126–129.
- Kuo HK, Sorond F, Iloputaife I, Gagnon M, Milberg W, Lipsitz LA: Effect of blood pressure on cognitive functions in elderly persons. J Gerontol A Biol Sci Med Sci 2004;59:1191–1194.
- Kuo HK, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, Lipsitz LA: Effect of blood pressure and diabetes mellitus on cognitive and physical functions in older adults: a longitudinal analysis of the advanced cognitive training for independent and vital elderly cohort. J Am Geriatr Soc 2005;53:1154–1161.
- Newman AB, Arnold AM, Naydeck BL, Fried LP, Burke GL, Enright P, Gottdiener J, Hirsch C, O’Leary D, Tracy R: ‘Successful aging’: effect of subclinical cardiovascular disease. Arch Intern Med 2003;163:2315–2322.
- Stuss DT, Peterkin I, Guzman DA, Guzman C, Troyer AK: Chronic obstructive pulmonary disease: effects of hypoxia on neurological and neuropsychological measures. J Clin Exp Neuropsychol 1997;19:515–524.
- Teng EL, Chui HC: The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987;48:314–318.
- Lopez OL, Kuller LH, Fitzpatrick A, Ives D, Becker JT, Beauchamp N: Evaluation of dementia in the cardiovascular health cognition study. Neuroepidemiology 2003;22:1–12.
- Verghese J, Wang C, Holtzer R, Lipton R, Xue X: Quantitative gait dysfunction and risk of cognitive decline and dementia. J Neurol Neurosurg Psychiatry 2007;78:929–935.
- Inzitari M, Baldereschi M, Di Carlo A, Di Bari M, Marchionni N, Scafato E, Farchi G, Inzitari D: Impaired attention predicts motor performance decline in older community-dwellers with normal baseline mobility: results from the Italian Longitudinal Study On Aging (ILSA). J Gerontol A Biol Sci Med Sci 2007;62:837–843.
- Tabbarah M, Crimmins EM, Seeman TE: The relationship between cognitive and physical performance: MacArthur Studies of Successful Aging. J Gerontol A Biol Sci Med Sci 2002;57:M228–M235.
- Proust-Lima C, Amieva H, Dartigues JF, Jacqmin-Gadda H: Sensitivity of four psychometric tests to measure cognitive changes in brain aging-population-based studies. Am J Epidemiol 2007;165:344–350.
Marco Inzitari, MD
Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh
130 N Bellefield St, Room 518
Pittsburgh, PA 15213 (USA)
Tel. +1 412 383 1305, Fax +1 412 383 1308, E-Mail email@example.com
Published online: November 27, 2007
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 2, Number of References : 32
Vol. 29, No. 3-4, Year 2007 (Cover Date: February 2008)
Journal Editor: Feigin, V.L. (Auckland)
ISSN: 0251–5350 (Print), eISSN: 1423–0208 (Online)
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