Cognitive Impairment Influences Gait in Aging

目的：了解健康的老化过程：14.感觉和运动处理。这个新的研究者奖围绕上述主题，以及借鉴主题16。执行功能。这两个主题都要求研究与正常和病理性衰老相关的因素。在这方面，与年龄匹配的健康对照组相比，患有认知障碍伴和不伴痴呆的人显示出更高的患病率和更严重的福尔斯跌倒后果。这种更大的福尔斯相关风险可能与更高水平的执行控制和注意力过程的早期下降有关，这些过程需要重新分配和更有效地补偿感觉损失和情境需求。虽然一些研究表明阿尔茨海默病（AD）患者在复杂条件下（例如，并发认知任务）严重受损，对AD患者完成任务的能力知之甚少。 和其他任务同时进行。该提案将确定执行控制和注意力的哪些方面对于健康对照和具有一系列认知障碍的患者（即，患有轻度AD但无锥体外系体征和轻度认知障碍[MCI]伴或不伴执行功能缺陷的患者）。首先，集转移能力和它的关系，流动性将探讨在一个复杂的步行任务后，步道测试建模。第二，两部分的研究将调查的程度，必要的注意力资源行走在一个具有挑战性的人行道上，并将评估工作记忆和注意力的具体领域需要这样的成功完成。纳入具有不同模式的MCI患者， 认知缺陷是该提议的独特特征，其将有助于描绘注意力和记忆的执行控制对行走表现的独特贡献。该提案将允许研究者在包括精神病学、老年医学、神经学和生物工程系成员在内的完善的跨学科团队的帮助下，开发实验室评估技术，以评估认知障碍和痴呆患者福尔斯风险增加的潜在因素。 研究不同的认知过程如何影响移动性将有助于更好地理解日常行走对认知障碍患者的要求，并有助于为那些最有可能发生福尔斯的人制定早期识别和干预策略。

Objective: Understanding Healthy Aging Processes: 14. Sensory and Motor Processing. This new investigator award centers on the above topic, as well as drawing on topic 16. Executive Function. Both topics call for the study of factors associated with normal and pathological aging. In this regard, persons with cognitive impairment with and without dementia have been shown to have a higher prevalence and more serious consequences of falls as compared to age-matched, healthy controls. This greater falls associated risk may be linked to early decline in higher level executive control and attention processes needed to reallocate and more effectively compensate for sensory losses and situational demands. Although a few studies have suggested balance in Alzheimer's (AD) patients under complex conditions (e.g., concurrent cognitive task) is seriously compromised, little is known about AD patients' ability to accomplish ambulation and other tasks simultaneously. This proposal will determine which aspects of executive control and attention are important to walking in more complex environments under divided attention conditions in healthy controls and patients with a range of cognitive impairment (i.e., patients with mild AD without extrapyramidal signs and Mild Cognitive Impairment [MCI] with and without executive function deficits). First, set shifting ability and it's relation to mobility will be explored in a complex walking task modeled after the Trail Making Test. Second, a two part study will investigate the extent of attention resources necessary for walking on a challenging walkway and wilt evaluate which specific areas of working memory and attention are required for such successful completion. The inclusion of MCI patients with differing patterns of cognitive deficits is a unique feature of this proposal as will aid in delineating the distinct contributions of executive control of attention and memory to walking performance. This proposal will allow the investigator, with the help of a well established interdisciplinary team including members of the departments of psychiatry, geriatric medicine, neurology, and bioengineering, to develop laboratory assessment techniques for evaluating factors underlying the increased falls risk in patients with cognitive impairment and dementia. Examining how different cognitive processes affect mobility will help to better understand the demands that everyday walking places on patients with cognitive impairment, as well as help develop early identification and intervention strategies for those individuals most at risk for falls.