Differential relationships between brain structure and dual task walking in young and older adults

Abstract

Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when performing a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underly dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18-34 years) and 23 older adults (66-86 years). We also collected T1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: 1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and 2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations. CONTRIBUTION TO THE FIELDOlder age is associated with poorer mobility, including difficulties in performing a cognitive task while walking (i.e., dual task walking). Our work contributes to the field by examining multimodal structural neuroimaging data to characterize how brain structure relates to dual task walking in young versus older adults. We extracted multiple indices from T1-weighted and diffusion-weighted magnetic resonance imaging (MRI) scans that describe morphological characteristics of brain gray matter, white matter, and cerebrospinal fluid. We analyzed MRI and gait data from 37 young (18-34 years) and 23 older (66-86 years) adults. We identified multiple relationships between regional brain atrophy and greater dual task costs (DTcosts) to gait, i.e., greater slowing of gait speed and greater increases in gait variability from single to dual task walking. Specifically, for the older adults only, thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices were associated with larger DTcosts to walking. Additionally, for the older adults only, ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity were associated with larger DTcosts. These findings illustrate that temporal, frontoparietal and sensorimotor brain structures are associated with walking DTcosts in older adults, highlighting potential targets for interventions.