TY - JOUR
T1 - Lower cerebral vasoreactivity as a predictor of gait speed decline in type 2 diabetes mellitus
AU - Chung, Chen Chih
AU - Pimentel Maldonado, Daniela A.
AU - Jor’dan, Azizah J.
AU - Alfaro, Freddy J.
AU - Lioutas, Vasileios Arsenios
AU - Núñez, Maria Zunilda
AU - Novak, Vera
N1 - Funding Information:
described was supported by Harvard Clinical and Translational Science Center (Grant Number UL1 RR025758) and National Center for Research Resources (M01-RR-01032). Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R01DK103902. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Acknowledgements The work was supported by the National Institutes of Health (NIH-NIA 1R01-AG0287601A2, NIH-NIDDK 5R21 DK084463), American Diabetes Association (Clinical 1-03-CR-23 and 1-06-CR-25 to Dr. Vera Novak). The work was also in part supported NIH-NIDDK 1R01DK103902-01A1 to Dr. Novak. The project
Funding Information:
J. Alfaro, Vasileios-Arsenios Lioutas, Maria Zunilda Núñez report no disclosures. Vera Novak was funded by the National Institutes of Health (NIH-NIDDK 1R01DK103902 -03, NIH-NIA 1R01-AG0287601A2, NIH-NIDDK 5R21 DK084463), American Diabetes Association (Clinical 1-03-CR-23 and 1-06-CR-25). Azizah J. Jor’dan was funded by NIH T32 Fellowship (5T32AG023480 and HL007374-36), a Diversity Supplement Award (3R01AG041785-02S1) and a Career Development Award (K99AG051766).
Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Gait speed is an indicator of overall functional health and is correlated with survival in older adults. We prospectively evaluated the long-term association between cerebral vasoreactivity and gait speed during normal walking (NW) and dual-task walking (DTW) in older adults with and without type 2 diabetes mellitus (T2DM). 40 participants (aged 67.3 ± 8.8 years, 20 with T2DM) completed a 2-year prospective study consisting of MRI, blood sampling, and gait assessments. The whole brain vasoreactivity was quantified using continuous arterial spin labeling MRI. Gait speed during DTW was assessed by subtracting serial sevens. Dual-task cost was calculated as the percent change in gait speed from NW to DTW. In the entire cohort, higher glycemic profiles were associated with a slower gait speed. In the diabetic group, lower vasoreactivity was associated with a slower gait speed during NW (radj2 = 0.30, p = 0.019) and DTW (radj2 = 0.35, p = 0.01) and a higher dual-task cost (radj2 = 0.69, p = 0.009) at 2-year follow-up. The participants with T2DM and lower cerebral vasoreactivity had a greater decrease in gait speed during NW and DTW after the 2-year follow-up (radj2 = 0.17, p = 0.04 and radj2 = 0.28, p = 0.03, respectively). Longer diabetes duration was associated with a higher dual-task cost (radj2 = 0.19, p = 0.04) and a greater decrease in gait speed during NW (radj2 = 0.17, p = 0.02). These findings indicate that in older adults with type 2 diabetes, gait performance is highly dependent on the integrity of cerebrovascular regulation.
AB - Gait speed is an indicator of overall functional health and is correlated with survival in older adults. We prospectively evaluated the long-term association between cerebral vasoreactivity and gait speed during normal walking (NW) and dual-task walking (DTW) in older adults with and without type 2 diabetes mellitus (T2DM). 40 participants (aged 67.3 ± 8.8 years, 20 with T2DM) completed a 2-year prospective study consisting of MRI, blood sampling, and gait assessments. The whole brain vasoreactivity was quantified using continuous arterial spin labeling MRI. Gait speed during DTW was assessed by subtracting serial sevens. Dual-task cost was calculated as the percent change in gait speed from NW to DTW. In the entire cohort, higher glycemic profiles were associated with a slower gait speed. In the diabetic group, lower vasoreactivity was associated with a slower gait speed during NW (radj2 = 0.30, p = 0.019) and DTW (radj2 = 0.35, p = 0.01) and a higher dual-task cost (radj2 = 0.69, p = 0.009) at 2-year follow-up. The participants with T2DM and lower cerebral vasoreactivity had a greater decrease in gait speed during NW and DTW after the 2-year follow-up (radj2 = 0.17, p = 0.04 and radj2 = 0.28, p = 0.03, respectively). Longer diabetes duration was associated with a higher dual-task cost (radj2 = 0.19, p = 0.04) and a greater decrease in gait speed during NW (radj2 = 0.17, p = 0.02). These findings indicate that in older adults with type 2 diabetes, gait performance is highly dependent on the integrity of cerebrovascular regulation.
KW - Cognition
KW - Gait
KW - Perfusion
KW - Type 2 diabetes
KW - Vasoreactivity
KW - Vasoregulation
KW - Walking
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U2 - 10.1007/s00415-018-8981-x
DO - 10.1007/s00415-018-8981-x
M3 - Article
C2 - 30062523
AN - SCOPUS:85051084511
SN - 0340-5354
VL - 265
SP - 2267
EP - 2276
JO - Deutsche Zeitschrift fur Nervenheilkunde
JF - Deutsche Zeitschrift fur Nervenheilkunde
IS - 10
ER -
