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Head over heels but I forget why: Disruptive functional connectivity in older adult fallers with mild cognitive

Rachel A Crockett1, Chun Liang Hsu1, John R Best1

  • 1Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.

Behavioural Brain Research
|July 21, 2019
PubMed

Insights

Mild cognitive impairment (MCI) and faller status disrupt brain connectivity, particularly between the default mode network (DMN) and sensorimotor network (SMN). Combined MCI and falls show the most significant connectivity disruption and increased postural sway in older adults.

Area of Science:

  • Neuroscience
  • Gerontology
  • Biomedical Engineering

Background:

  • Disrupted functional connectivity is a key neural mechanism linking cognitive impairment and mobility issues in older adults with mild cognitive impairment (MCI).
  • Understanding the interplay between cognitive status (MCI) and fall history is crucial for addressing functional decline in aging populations.

Purpose of the Study:

  • To investigate the independent and combined effects of MCI and faller status on functional connectivity within the default mode network (DMN), fronto-parietal network (FPN), and sensorimotor network (SMN).
  • To compare these effects across four groups: healthy controls, MCI without falls, fallers without MCI, and fallers with MCI.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) was used to measure functional connectivity during a finger-tapping task in 66 adults aged 70-80.
  • Cognitive function was assessed using standard tests (Stroop, TMT, DSST, cognitive dual task).
  • Postural sway was measured under eyes-open conditions while standing on a floor surface.

Main Results:

  • Significant differences in DMN-SMN connectivity were observed between fallers with MCI and fallers without MCI.
  • Individuals with both MCI and a history of falls exhibited significantly greater postural sway compared to other groups.
  • A linear increase in DMN-SMN connectivity and postural sway was noted, progressing from fallers without MCI to MCI without falls, and finally to fallers with MCI. Participants with MCI also showed poorer performance on cognitive tests (DSST, TMT).

Conclusions:

  • Aberrant DMN-SMN connectivity may be a contributing factor to reduced postural stability in older adults.
  • The co-occurrence of impaired cognition (MCI) and mobility deficits (falls) is associated with more pronounced disruption in DMN-SMN connectivity and greater postural sway than either impairment alone.
Keywords:
Aberrant functional connectivityFallsMild cognitive impairmentPostural sway

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