Cognitive Impairment Influences Gait in Aging

目的：了解健康的衰老过程：14.感觉和运动加工。这一新的调查员奖围绕着上述主题，并借鉴了主题16：行政职能。这两个主题都呼吁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，患有痴呆症和不患有痴呆症的认知障碍患者的患病率更高，跌倒的后果更严重。这种更大的跌倒相关风险可能与高层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景需求。虽然一些研究表明阿尔茨海默病(AD)患者在复杂条件下(如并发认知任务)的平衡严重受损，但对AD患者完成任务的能力知之甚少 行走和其他任务同时进行。这项建议将确定在健康对照组和有一系列认知障碍的患者(即没有锥体外系体征的轻度AD患者和有或不有执行功能缺陷的轻度认知障碍患者)中，在更复杂的注意条件下，执行控制和注意力的哪些方面对行走很重要。首先，我们将在模拟轨迹测试的复杂步行任务中探索定势转移能力及其与移动性的关系。其次，一项由两部分组成的研究将调查在具有挑战性的人行道上行走所需的注意力资源的程度，并将评估成功完成这一任务需要哪些特定的工作记忆和注意力区域。不同类型MCI患者的纳入研究 认知缺陷是这项建议的一个独特特征，因为这将有助于描绘出注意力和记忆的执行控制对行走能力的明显贡献。这项提议将允许研究人员在包括精神病学、老年医学、神经病学和生物工程系成员在内的成熟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症患者跌倒风险增加的潜在因素。 研究不同的认知过程如何影响行动能力，将有助于更好地了解日常步行对认知障碍患者的需求，并有助于为那些最有可能摔倒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.