Journal Article

Age-related changes in attention control and their relationship with gait performance in older adults with high risk of falls

Trombetti, Andrea, Vuilleumier, Patrik, Fernandez, Natalia B., Hars, Mélany

2019

Overview

Falls are the leading cause of injury-related deaths in the elderly worldwide. Both gait impairment and cognitive decline have been shown to constitute major fall risk factors. However, further investigations are required to establish a more precise link between the influence of age on brain systems mediating executive cognitive functions and their relationship with gait disturbances, and thus help define novel markers and better guide remediation strategies to prevent falls. Event-related functional magnetic resonance imaging (fMRI) was used to evaluate age-related effects on the recruitment of executive control brain network in selective attention task, as measured with a flanker paradigm. Brain activation patterns were compared between twenty young (21 years ± 2.5) and thirty-four old participants (72 years ± 5.3) with high fall risks. We then determined to what extend age-related differences in activation patterns were associated with alterations in several gait parameters, measured with electronic devices providing a precise quantitative evaluation of gait, as well as with alterations in several aspects of cognitive and physical abilities. We found that both young and old participants recruited a distributed fronto-parietal-occipital network during interference by incongruent distractors in the flanker task. However, additional activations were observed in posterior parieto-occipital areas in the older relative to the younger participants. Furthermore, a differential recruitment of both the left dorsal parieto-occipital sulcus and precuneus was significantly correlated with higher gait variability. Besides, decreased activation in the right cerebellum was found in the older with poorer cognitive processing speed scores. Overall results converge to indicate greater sensitivity to attention interference and heightened recruitment of cortical executive control systems in the elderly with fall risks. Critically, this change was associated with selective increases in gait variability indices, linking attentional control with gait performance in elderly with high risks of falls. •Gait performance in elderly with high risks of falls is partly linked to executive control abilities.•Over-recruitment of posterior cortices might reflect compensatory processes mitigating age-related executive control decline.•Study links higher gait variability with greater increases in both frontal and parieto-occipital areas in elderly.•Gait variability assessment using pressure-sensitive walkways is sensitive to identify neural changes in attentional network.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Accidental Falls / Adult / Age / Aged / Aging / Aging - physiology / Attention - physiology / Attention task / Brain mapping / Cerebellum / Cerebral Cortex - diagnostic imaging / Cerebral Cortex - physiology / Cognitive ability / Cognitive aging / Cognitive Aging - physiology / Cortex (parietal) / Electronic equipment / Executive function / Executive Function - physiology / Fall risks / Falls / Female / Functional magnetic resonance imaging / Gait / Gait - physiology / Geriatrics / Humans / Information processing / Nerve Net - diagnostic imaging / Nerve Net - physiology / Neuroimaging / Older people / Parieto-occipital sulcus / Risk factors / Walking / Young Adult / Young adults