Aging the Central Nervous System and Mobility in Older Adults

描述（由申请人提供）：本申请为为期三年的U13合作会议资助，由博士组织。Rosano， Studenski和Chen与美国老年学学会合作，强调了关注社区居住老年人中枢神经系统（CNS）与行动障碍之间相互作用的新兴领域。本系列会议旨在促进研究成果和新思想的交流，并解决相关的方法问题和研究障碍，以确定中枢神经系统在活动能力丧失中的作用。我们的长期目标是促进将研究结果转化为改善老年人行动能力的干预措施。老年人的步态和平衡问题是常见的，严重致残，并对那些在老年社区工作的人施加了紧迫的临床挑战。迄今为止，在许多明确和确定的运动相关疾病和障碍方面取得了进展，例如帕金森病和中风。然而，生活在普通社区环境中的老年人的行动障碍在很大程度上没有得到充分的研究，特别是关于中枢神经系统的作用。这些研究上的差距阻碍了病理生理学、临床术语和有效治疗策略的发展。面临身体残疾风险的老年人数量正在迅速增加，行动障碍与丧失独立性、生活质量大幅下降、住院和过早死亡有关。因此，了解这一人群中行动障碍的机制有可能大大改善老年人的临床和预防保健。最近，新出现的证据开始支持中枢神经系统和大脑可塑性在调节老年人活动能力方面的重要性，并可能为管理和治疗活动问题提供新的见解和策略。我们提出了一系列的三个相互关联的研讨会，以这些令人兴奋的发现为基础，促进系统和有效的研究中枢神经系统与老年人活动能力之间的关系。这些研讨会将汇集来自基础科学和动物模型、流行病学和临床研究等相关学科的专家，1)从基础科学、流行病学和临床角度检查现有证据，并在个体和群体水平上加强从动物研究到人类正常衰老和疾病调查的联系；2)促进相互关联学科的基础、流行病学和临床科学家之间的合作，否则他们可能没有机会在一起工作；3)通过对新兴研究成果的讨论，确定知识差距、进步障碍、替代策略和未来探究的前景。这三个研讨会都有一个独特但相互关联的科学重点：1)研讨会1将建立迄今为止中枢神经系统与流动性之间关系的最佳证据，并将确定最先进的技术来量化中枢神经系统和流动性措施；2)研讨会2将在研讨会1的基础上，确定与年龄相关的中枢神经系统损伤可能导致行动障碍的机制和原因；3)讲习班3将以讲习班1和讲习班2为基础，确定目前正在研究和/或应在未来研究中处理的最有希望的预防和干预策略。为了最大限度地实现本系列会议的长期目标，每个研讨会的科学重点都被设计成可以与下一个研讨会相结合。此外，所有三个讲习班都将讨论与行动障碍研究有关的方法学领域，包括对评估措施之间的多维和多成分相关性进行有效分析和交流的分析方法。在每次研讨会结束时，与会者将负责推荐以下内容：连接中枢神经系统和移动性的病理生理学的知识状况，新的评估技术和统计方法，最有希望的干预策略，和/或公共信息共享建议。为方便讨论，工作坊的出席人数将限制为40人，并只接受邀请。不过，讲习班的成果将如传播计划所概述的那样广泛传播。本系列会议的目的是：1)从基础、流行病学和临床角度检查现有证据，并在个体和群体水平上加强从动物研究到人类正常衰老和疾病调查的联系；2)促进相互关联学科的基础、流行病学和临床科学家之间的合作，否则他们可能没有机会一起工作；3)通过对新兴研究成果的讨论，确定知识差距、进展障碍、替代策略和未来探究的前景；4)强调中枢神经系统和移动测量的前沿方法；5)支持初级调查人员、妇女、少数民族和其他未被充分代表的群体的参与；6)通过提供充足的互动时间和使用多媒体演示格式（包括视频），鼓励研讨会参与者进行讨论和交流；7)通过GSA年度科学会议的专题讨论会向研究人员、临床医生和公众传播研究结果、讨论和建议，并向各种相关期刊（如神经病学、步态和姿势、行为和脑功能、运动障碍、老年学杂志：医学科学、衰老神经科学前沿等）提交协调的个人论文发表。

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Gait and balance problems are common and severely disabling in older adults. The number of older adults at risk for physical disability is rapidly increasing, and onset of mobility impairment is associated with loss of independence, hospitalization, and premature death. However, mobility impairments in community-dwelling older adults are largely understudied, particularly regarding the role of the central nervous system. This has hampered the development of clearly defined pathophysiology, clinical terminology, and effective treatments. Understanding the mechanisms of mobility impairment has the potential to greatly improve clinical and preventive care for older adults.