Brain, balance and walking...9th World Conference of the International Society for Gerontechnology (ISG), June 18-21, 2014, Taipei, Taiwan.
Purpose Falls and mobility problems are common causes of morbidity and death in elderly people, yet their causes are poorly understood. Slowing of gait is a prominent feature of human aging, even in the absence of specific diseases, and it is strongly associated with falls, dementia, and mortality....
| Publicado en: | Gerontechnology Vol. 13; no. 2; pp. 111 - 113 |
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| Formato: | abstract proceedings research Journal Article |
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International Society for Gerontechnology
2014 Special Issue
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180444743&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180444743 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15691101 904R jtl: Gerontechnology issn: 15691101 maglogo: N pubinfo: dt: 2014 Special Issue vid: 13 iid: 2 pid: 54298 pub: International Society for Gerontechnology artinfo: ui: 180444743 180444743 180444743 10.4017/gt.2014.13.02.380.00 180444743 ppf: 111 ppct: 2 formats: tig: atl: Brain, balance and walking...9th World Conference of the International Society for Gerontechnology (ISG), June 18-21, 2014, Taipei, Taiwan. aug: au: NOVAK, V. affil: Division of Gerontology, Harvard Medical School, Boston, MA, USA sug: subj: Accidental Falls Risk Factors Physical Mobility Risk Assessment Biological Markers Cerebrovascular Circulation Balance, Postural Congresses and Conferences Taiwan Taiwan Aged Aged: 65+ years ab: Purpose Falls and mobility problems are common causes of morbidity and death in elderly people, yet their causes are poorly understood. Slowing of gait is a prominent feature of human aging, even in the absence of specific diseases, and it is strongly associated with falls, dementia, and mortality. At the same time, gait and balance are dependent upon the brain's ability to maintain cerebral perfusion during standing and walking. The concept of cerebrovascular reserve has emerged as a potential biomarker for a syndrome of slow gait speed, and as an indicator of both functional decline and fall risk. Cerebrovascular reserve is brain's ability to maintain perfusion during physical activities, and to redistribute blood supply to areas with high energy demands. However, the relationship between cerebral hemodynamics, cardiovascular control, and locomotion control for standing and walking is not well understood, and has not been adequately studied. Method Cardiovascular risk factors alter brain perfusion regulation and accelerate the effects of aging on gait and balance. Hypertension and diabetes are the most prevalent risk factors. Hypertension affects more than a third of world's population. Among those who are 65 years and older, almost 75% have hypertension1,2 and 26% have diabetes3. Cerebromicrovascular disease associated with hypertension, diabetes, and other cardiovascular risk factors, including age, is linked with regional hypoperfusion, white matter hyperintensities (WMHs), and brain volume loss on MRI, as well as with neuronal degeneration, slower gait speed, and cognitive decline in elderly people4-9. Metabolic syndrome, hypertension, and stroke were each independently associated with cognitive and functional decline later in life10.The Honolulu Aging study shows that high systolic BP (120-140 and >140 mmHg) in midlife increases the risk of late-life dementia11. Both diseases have been associated with syncope (fainting) or orthostatic hypotension (blood pressure decline during standing) that account for up to 6% of hospital admissions. Up to 58% of those with dementia experienced a systolic BP decrease of ≥10 mmHg in later life11. By the age of 70, half of the population has experienced syncope or a fall at least once. With increasing age, the frequency and severity of syncope events increases, further elevating the risk for injurious falls12. Results & Discussion Diabetes is associated with regional hypoperfusion13,14, gray matter atrophy and peripheral neuropathy, slower gait speed, and worse functional outcomes. In diabetic subjects, slower walking correlates with worse perfusion in the brain and more brain volume loss. Furthermore, diabetic subjects with peripheral neuropathy that have slower and less steady gaits and increased risk of falling are dependent upon gray matter volume in the cerebellum and other brain regions to maintain balance15. Furthermore, the presence of WMHs in diabetic and hypertensive subjects worsens dynamic balance parameters16. In summary, cardiovascular risk factors accelerate brain aging and further aggravate the impact of aging on locomotion and balance, therefore increasing the risks for falls and fall related injuries. pubtype: Academic Journal doctype: abstract proceedings research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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