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003 ENHANCING COGNITION: DOES IT IMPROVE GAIT?
Parkinsonism and Related Disorders 16S1 (2010) S1–S9
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Oral presentations
Plenary Session I 001 MINDING AND MINING OUR BEHAVIORAL MARKERS: TOWARDS AN INDEPENDENCE INDUSTRY S. Agritelley. Director of Product Research and Innovation, Intel Digital Health Group, Hillsboro, OR, USA While there has been much media, political, and business attention to building new industries to address Global Warming, there has been far too little conversation about how to do the same for Global Aging. We face age-related epidemics of cognitive, mobility, and sociability impairments, yet most nations, and especially the United States, are stuck in a reactive model of care that waits for these conditions to manifest in the hospital for extreme, emergency, expensive intervention. We must shift towards a home-based, consumer-enabled, prevention-oriented care paradigm. But what will it take for us to invent an “independence industry” that helps people to live with dignity, support, and purpose from wherever they choose? How can we use disruptive technologies to help prevent, predict, and detect declines in cognition and balance before they become an emergency room visit? What are the barriers to these kinds of innovations coming to the marketplace? In this talk, I will explore these questions – using case studies and examples from Intel’s research on fall prevention and cognitive assistance – with a particular focus on how technologies may help us to discover “behavioral markers” for disease in important new ways. And I will look at these innovations through the lens of healthcare reform and what it takes to make this vision real. 002 HEALTHY BODY, HEALTHY MIND?: FITNESS TRAINING EFFECTS ON MIND AND BRAIN A. Kramer. University of Illinois at Urbana Champaign, Urbana, IL, USA In my brief presentation I will critically review research conducted over the past decade that has examined whether fitness training enhances cognition and brain function of older adults. The presentation will cover both cross-sectional and intervention studies of fitness differences and fitness training. Studies which assess cognition via both behavioral measures and non-invasive neuroimaging measures will be reviewed and discussed. Finally, I will discuss the gaps in the literature and the manner in which they can be addressed. 003 ENHANCING COGNITION: DOES IT IMPROVE GAIT? J. Hausdorff1,2 . 1 Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, 2 Physical Therapy, Tel Aviv University, Ramat Aviv, Israel Background and Aims: Although it was long believed that gait is largely an automatic process that does not rely on cognitive function, numerous studies in man and in animal models have 1353-8020/$ – see front matter © 2010 Elsevier Ltd. All rights reserved.
now documented the relationship between these two seemingly disconnected and disparate abilities. Methods: Here, we briefly review exciting recent evidence in human studies that extends this idea further. Not only is the ability in one area related to the other, but enhancing cognition apparently also improves gait. Although the evidence is still scant, several lines of research support this notion. Results: Prospective studies have demonstrated that enhanced executive function is protective for falls. Pharmacologic interventions have shown that cognitive therapy gains may transfer to gait. Cognitive training programs have reported carryover effects to activities of daily living related to mobility. Moreover, interventions that combined motor and cognitive training have observed improvement in gait including an augmented ability to respond to the challenges of dual tasks. Conclusions: While many questions remain, there is increasing evidence to support the cause and effect relationship between cognition and gait.
Plenary Session II 004 RELATION OF RISK FACTORS AND NEUROPATHOLOGY TO COGNITIVE AND MOTOR IMPAIRMENT D. Bennett. Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Background: Loss of cognitive and motor function are two of the most common consequences of aging. Methods: Risk factor data, longitudinal cognitive and motor and disability data, and post-mortem data come from two cohort studies of aging that include organ donation at death: The Religious Orders Study and the Rush Memory and Aging Project. Together, more than 2,400 persons have been examined annually for up to 15 years and brain autopsied have been performed on more than 750 persons. Cox proportional hazards models and mixed models were used to examine the relation of risk factors to clinical outcomes over time, and logistic and linear regression were used to examine the relation of neuropathologic indices to cognitive and motor function proximate to death and to risk factors. Results: Several risk factors including APOE, diabetes, olfactory identification, physical activity, and social engagement were related to cognitive and motor outcomes, and neuropathologic indices of Alzheimer’s disease, cerebrovascular disease, and Lewy bodies were shown to be related to cognitive and motor function, and to one or more of the risk factors. Conclusions: The data suggest that cognitive and motor impairment in the elderly share common risk factors and neuropathologic indices.
Contents lists available at ScienceDirect
Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis
Oral presentations
Plenary Session I 001 MINDING AND MINING OUR BEHAVIORAL MARKERS: TOWARDS AN INDEPENDENCE INDUSTRY S. Agritelley. Director of Product Research and Innovation, Intel Digital Health Group, Hillsboro, OR, USA While there has been much media, political, and business attention to building new industries to address Global Warming, there has been far too little conversation about how to do the same for Global Aging. We face age-related epidemics of cognitive, mobility, and sociability impairments, yet most nations, and especially the United States, are stuck in a reactive model of care that waits for these conditions to manifest in the hospital for extreme, emergency, expensive intervention. We must shift towards a home-based, consumer-enabled, prevention-oriented care paradigm. But what will it take for us to invent an “independence industry” that helps people to live with dignity, support, and purpose from wherever they choose? How can we use disruptive technologies to help prevent, predict, and detect declines in cognition and balance before they become an emergency room visit? What are the barriers to these kinds of innovations coming to the marketplace? In this talk, I will explore these questions – using case studies and examples from Intel’s research on fall prevention and cognitive assistance – with a particular focus on how technologies may help us to discover “behavioral markers” for disease in important new ways. And I will look at these innovations through the lens of healthcare reform and what it takes to make this vision real. 002 HEALTHY BODY, HEALTHY MIND?: FITNESS TRAINING EFFECTS ON MIND AND BRAIN A. Kramer. University of Illinois at Urbana Champaign, Urbana, IL, USA In my brief presentation I will critically review research conducted over the past decade that has examined whether fitness training enhances cognition and brain function of older adults. The presentation will cover both cross-sectional and intervention studies of fitness differences and fitness training. Studies which assess cognition via both behavioral measures and non-invasive neuroimaging measures will be reviewed and discussed. Finally, I will discuss the gaps in the literature and the manner in which they can be addressed. 003 ENHANCING COGNITION: DOES IT IMPROVE GAIT? J. Hausdorff1,2 . 1 Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, 2 Physical Therapy, Tel Aviv University, Ramat Aviv, Israel Background and Aims: Although it was long believed that gait is largely an automatic process that does not rely on cognitive function, numerous studies in man and in animal models have 1353-8020/$ – see front matter © 2010 Elsevier Ltd. All rights reserved.
now documented the relationship between these two seemingly disconnected and disparate abilities. Methods: Here, we briefly review exciting recent evidence in human studies that extends this idea further. Not only is the ability in one area related to the other, but enhancing cognition apparently also improves gait. Although the evidence is still scant, several lines of research support this notion. Results: Prospective studies have demonstrated that enhanced executive function is protective for falls. Pharmacologic interventions have shown that cognitive therapy gains may transfer to gait. Cognitive training programs have reported carryover effects to activities of daily living related to mobility. Moreover, interventions that combined motor and cognitive training have observed improvement in gait including an augmented ability to respond to the challenges of dual tasks. Conclusions: While many questions remain, there is increasing evidence to support the cause and effect relationship between cognition and gait.
Plenary Session II 004 RELATION OF RISK FACTORS AND NEUROPATHOLOGY TO COGNITIVE AND MOTOR IMPAIRMENT D. Bennett. Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Background: Loss of cognitive and motor function are two of the most common consequences of aging. Methods: Risk factor data, longitudinal cognitive and motor and disability data, and post-mortem data come from two cohort studies of aging that include organ donation at death: The Religious Orders Study and the Rush Memory and Aging Project. Together, more than 2,400 persons have been examined annually for up to 15 years and brain autopsied have been performed on more than 750 persons. Cox proportional hazards models and mixed models were used to examine the relation of risk factors to clinical outcomes over time, and logistic and linear regression were used to examine the relation of neuropathologic indices to cognitive and motor function proximate to death and to risk factors. Results: Several risk factors including APOE, diabetes, olfactory identification, physical activity, and social engagement were related to cognitive and motor outcomes, and neuropathologic indices of Alzheimer’s disease, cerebrovascular disease, and Lewy bodies were shown to be related to cognitive and motor function, and to one or more of the risk factors. Conclusions: The data suggest that cognitive and motor impairment in the elderly share common risk factors and neuropathologic indices.