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Deep white matter hyperintensities, microstructural integrity and dual task walking in older people

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Abstract

To examine neural, physiological and cognitive influences on gait speed under single and dual-task conditions. Sixty-two community-dwelling older people (aged 80.0 ± 4.2 years) participated in our study. Gait speed was assessed with a timed 20-meter walk under single and dual-task (reciting alternate letters of the alphabet) conditions. Participants also underwent tests to estimate physiological fall risk based on five measures of sensorimotor function, cognitive function across five domains, brain white matter (WM) hyperintensities and WM microstructural integrity by measuring fractional anisotropy (FA). Univariate linear regression analyses showed that global physiological and cognitive measures were associated with single (β = 0.594 and β=-0.297, respectively) and dual-task gait speed (β = 0.306 and β=-0.362, respectively). Deep WMHs were associated with dual-task gait speed only (β = 0.257). Multivariate mediational analyses showed that global and executive cognition reduced the strength of the association between deep WMHs and dual-task gait speed by 27% (β = 0.188) and 44% (β = 0.145) respectively. There was a significant linear association between single-task gait speed and mean FA values of the genu (β=-0.295) and splenium (β=-0.326) of the corpus callosum, and between dual-task gait speed and mean FA values of Superior Cerebellar Peduncle (β=-0.284), splenium of the Corpus Callosum (β=-0.286) and Cingulum (β=-0.351). Greater deep WMH volumes are associated with slower walking speed under dual-task conditions, and this relationship is mediated in part by global cognition and executive abilities specifically. Furthermore, both cerebellum and cingulum are related to dual-task walking due to their role in motor skill performance and attention, respectively.

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Acknowledgements

We would like to thank participants from the Sydney Memory and Ageing Study for volunteering their time to take part in this study. We would also like to thank Dr Jacqueline Zheng for collecting the gait test data for this study.

Funding

This study was funded by the Australian National Health and Medical Research Council, grants 350833 and 400941. Professor Lord and Associate Professor Delbaere are currently supported by the Australian National Health and Medical Research Council.

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Authors and Affiliations

  1. Department of Physiotherapy Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran

    Tabassom Ghanavati

  2. Neuroscience Research Australia, University of New South Wales, NeuRA, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia

    Myriam Sillevis Smitt, Stephen R. Lord & Kim Delbaere

  3. Centre for Healthy Brain Ageing (CHeBA) School of Psychiatry UNSW Medicine, University of New South Wales, Sydney, Australia

    Perminder Sachdev, Wei Wen, Nicole A. Kochan & Henry Brodaty

  4. Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia

    Perminder Sachdev & Nicole A. Kochan

  5. Dementia Collaborative Research Centre UNSW Medicine, University of New South Wales, Sydney, Australia

    Henry Brodaty

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Author S. L. The Physiological Profile Assessment is commercially available through Neuroscience Research Australia.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ghanavati, T., Smitt, M.S., Lord, S.R. et al. Deep white matter hyperintensities, microstructural integrity and dual task walking in older people. Brain Imaging and Behavior 12, 1488–1496 (2018). https://doi.org/10.1007/s11682-017-9787-7

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