Aging the Central Nervous System and Mobility in Older Adults

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PROGRAM SUMMARY/ABSTRACT This application for a three-year U13 cooperative conference grant, organized by Drs. Rosano, Studenski, and Chen in partnership with the Gerontological Society of America, highlights the emerging field focusing on the interplay between the central nervous system (CNS) and mobility impairment in community-dwelling older adults. This conference series intends to foster the exchange of research findings and new ideas, as well as address related methodological issues and research barriers, in order to identify the role of the CNS in mobility loss. Our long-term goal is to facilitate the translation of research results into interventions that improve mobility for older adults. Gait and balance problems in older adults are common and severely disabling, and impose pressing clinical challenges among those in and working with the geriatric community. To date, advances have been made in a number of well-defined and established movement-related diseases and disorders, such as Parkinson's disease and stroke. However, mobility impairments in older adults living in general community settings are largely understudied, particularly regarding the role of the CNS. These gaps in research have hampered the development of clearly defined pathophysiology, clinical terminology, and effective treatment strategy. The number of older adults at risk for physical disability is rapidly increasing, and mobility impairment is associated with loss of independence, substantially reduced quality of life, hospitalization, and premature death. Thus, understanding the mechanisms of mobility impairment in this population has the potential to greatly improve clinical and preventive care for older adults. Recently, emerging evidence has begun to support the importance of CNS and brain plasticity in regulating mobility in older adults and may provide new insights and strategies for managing and treating mobility problems. We propose a series of three interrelated workshop that build on these exciting findings and promote systematic and effective studies on the relationship between the CNS and mobility in aging. These workshops will bring together experts from interrelated disciplines in basic science and animal models, epidemiology, and clinical research to 1) examine existing evidence from basic science, epidemiological, and clinical perspectives and enhance links from animal studies to human investigation of both normal aging and disease at the individual and population level; 2) promote collaboration between basic, epidemiological, and clinical scientists of interrelated disciplines who might not otherwise have an opportunity to work together; and 3) identify knowledge gaps, barriers to progress, alternative strategies, and prospects for future inquiry through discussions of emerging research findings. Each of these three workshops has a distinct but interrelated scientific focus: 1) Workshop 1 will establish the best evidence to date for a relationship between the CNS and mobility and will identify state-of-the-art technology to quantify CNS and mobility measures; 2) Workshop 2 will build on Workshop 1 and ascertain the mechanisms and causes by which age-related CNS impairment may cause mobility impairment; and 3) Workshop 3 will build on Workshops 1 and 2 to identify the most promising prevention and intervention strategies that are currently being studied and/or should be addressed in future studies. To maximize the possibility of achieving the long-term goal of this conference series, the scientific focus of each workshop is designed so that one builds into the next. In addition, all three workshops will address methodological areas related to the study of mobility impairment, including analytical approaches to implement effective analysis and communication of multidimensional and multicomponent correlations between assessed measures. At the end of each workshop, the attendees will be charged with recommending the following: state of knowledge on the pathophysiology linking the CNS and mobility, new assessment technologies and statistical approaches, most promising intervention strategies, and/or public information sharing proposals. To facilitate discussion, workshop attendance will be limited to 40 participants and will be by invitation only. However, the outcomes of the workshops will be broadly disseminated as outlined in the dissemination plan. The aims of this conference series are to 1) examine existing evidence from basic, epidemiological, and clinical perspectives and enhance links from animal studies to human investigation of both normal aging and disease at the individual and population level; 2) promote collaborations between basic, epidemiological, and clinical scientists of interrelated disciplines who might not otherwise have an opportunity to work together; 3) identify knowledge gaps, barriers to progress, alternative strategies, and prospects for future inquiry through discussions of emerging research findings; 4) emphasize cutting-edge methodologies for CNS and mobility measures; 5) support involvement from junior investigators, women, minorities, and other underrepresented groups; 6) encourage discussions and exchanges of ideas from workshop participants by providing ample time for interactions and using multimedia presentation formats, including videos; and 7) disseminate findings, discussions, and recommendations to investigators, clinicians, and the public through symposia at the GSA Annual Scientific Meeting, as well as submit coordinated individual papers to a variety of related journals (e.g., Neurology, Gait & Posture, Behavioral and Brain Functions, Movement Disorders, Journal of Gerontology: Medical Sciences, Frontiers in Aging Neuroscience, etc.) for publication.