Here - American Geriatrics Society

P OSTER
A BSTRACTS
CONCLUSIONS: These results lend support to the idea of “accelerated
aging” of organ systems in persons growing older with longstanding
physical disabilities. Health care providers should be aware
of the special medical needs associated with organ system decline in
these individuals.
D157
Brain Grey Matter Volume of the Putamen and Clinical Correlates
of Motor Skill in Walking.
J. M. VanSwearingen, 1 S. Perera, 2 C. Rosano, 3 H. J. Azenstein, 4
J. S. Brach, 1 S. A. Studenski. 2 1. Physical Therapy, University of
Pittsburgh, Pittsburgh, PA; 2. Geriatric Medicine, University of
Pittsburgh, Pittsburgh, PA; 3. Epidemiology, University of Pittsburgh,
Pittsburgh, PA; 4. Psychiatry, University of Pittsburgh, Pittsburgh, PA.
Supported By: Pittsburgh Older American’s Independence Center, 1
P30 AG024827; K23 AG026766
Background: Grey matter volume (GMV) of the whole brain
and regions has been associated with age-related changes in gait and
motor sequence learning. It is unclear if whole brain or regional
GMV relates to motor skill of walking. We examined the relation of
GMV in the putamen, involved in selection, timing and automaticity
of well-learned motor sequences, with clinical correlates of motor
skill in walking in older adults with mobility limitations.
Methods: We used baseline data from a RCT of exercise interventions
in older adults with slow gait who also completed structural
brain imaging (n=41, mean age 76.7±5.6).Automatic labeling pathway
method was used to determine total brain volume, whole brain GMV
and GMV of the putamen and additional brain regions associated
with age-related changes in gait from the structural MRI. The GMV
in the additional regions was included to determine if a relation to the
putamen was unique or generalized. Motor skill in walking (energy
cost of walking, stance time variability [STV] and the Figure of 8 Walk
[F8W] cadence) and gait speed were recorded in a different session.
Partial correlations, controlling for age, gait speed and total brain volume
(GMV+WMV+CSF) were used to determine the adjusted correlations
(r) between brain GMV and motor skill in walking.
Results: Controlling for age, gait speed and total brain volume,
putamen GMV was related to all measures of motor skill in walking:
energy cost of walking (r=-.33, p=.040), STV (r=.37, p=.020), and
F8Wcadence (r=-.44, p=.005). Whole brain GMV was related only to
F8W cadence (r=-.38, p=.016). The only other regions associated with
motor skill in walking were the precentral region related to STV
(r=.33, p=.029), and the hippocampus related to F8W cadence (r=-.33,
p=.046).
Conclusion: GMV in the putamen was associated with most clinical
measures of motor skill in walking. Age-related changes in brain
circuits for motor sequence task performance may be a central contributor
to the timing and coordination difficulties in gait of older
adults. The putamen may be an important brain region of interest in
future studies to determine whether interventions that improve
motor skill in walking also change the brain.
D158
Aging with Longstanding Physical Disability: A Focus Group Study.
K. Yorkston, A. Verrall, K. L. Johnson. Rehabilitation Medicine,
University of Washington, Seattle, WA.
Supported By: This project was funded by a grant from the
Department of Education, NIDRR grant number H133B080024.
Background: People aging with longstanding physical disability
must deal with competing trajectories. Physical function is declining
while confidence in the ability to cope is improving. Social support is
likely to decline with retirement & aging significant others while
medical management is improving thus increasing life expectancy.
Methods: Four focus groups were conducted soliciting advice for
health care teams seeing patients aging with a longstanding disability.
Participants included people with spinal cord injury (N = 7), postpolio
syndrome (N = 7), multiple sclerosis (N = 5), and muscular dystrophy
(N = 4). All were at least 45 years of age and living with their
disability for at least 8 years. Focus groups transcripts were reviewed
and coded using Atlas.ti and a framework of themes was developed.
Results: Four major themes emerged which are described in
Table 1.
Conclusions: Health care providers should acknowledge the
skills that people with longstanding disability bring to the task of prioritizing
their goals and managing their condition. Healthcare
providers can assist them in developing individualized self-management
interventions that help to maintain function and independence
as they age.
Table 1. Focus Group Themes
D159
Motor Learning Ability in Walking Relates to Physical Function in
Older Adults.
M. Zaldana, 2 J. M. VanSwearingen, 1 S. A. Studenski, 2 J. S. Brach. 1 1.
Physical Therapy, University of Pittsburgh, Pittsburgh, PA; 2.
Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA.
Supported By: Research/Grant Support: Pittsburgh Older
American’s Independence Center, 1 P30 AG024827; Pitt Clinical
Research Training- Geriatrics/Gerontology T32 AG021885; K23
AG026766
Background: Motor learning is important in the recovery or
adaptation of performance in daily life after age-related changes in
neuromotor function. Backward walking is a motor task with a similar
motor sequence and complexity as forward walking but less practiced
(ie less skilled). We examined the relation of changes in gait
variability, an indicator of motor skill learning, over repeated trials of
backward walking to physical function in older adults.
Methods: Community-dwelling older adults (77.1 years±6.1,
n=67) independent in ambulation performed 4 repeated trials of
straight path backward walking and usual walking over a computerized
walkway. Mean backward and usual walking gait speed and
mean gait variability (stance time standard deviation, STV) for the
first two and last two trials of backward walking were calculated.
Mean percent change in STV between the first and last two trials of
backward walking represented motor learning ability. Physical function
in daily life, the Late-Life Function and Disability Instrument
overall functioning (LLFDI total) was recorded in the same session.
A linear regression model was used to examine the contribution of
motor learning in walking ability to physical function in daily life,
controlling for age, usual gait speed and backward walking gait speed.
Results: Motor learning ability in walking independently contributed
to physical function, while controlling for age, usual and
backward gait speed. The mean percent change in STV contributed
(β=-.22, p=.03) to the variance in LLFDI total beyond age and usual
gait speed (β=.53, p