NEUROPSYCHOLOGY COGNITION AND MOBILITY LAB
Legacy Projects
CENTRAL CONTROL OF MOBILITY IN AGING
(NIH Grant: R01AG036921; Institute: NIA; PI: Roee Holtzer)
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Our overarching aim is to identify brain and cognitive mechanisms of mobiity decline and disability in aging. Herein, we propose to examine the effects of executive control and cognitive fatigue on the maintenance of mobility and risk of mobility disability in older adults and their underlying brain substrates. Our overall working hypothesis is that mobility, executive control, and cognitive fatigue are closely linked through the frontal cortex-basal ganglia system in older adults. We are currently in the process of recruiting a cohort of 450 non-demented community-residing individuals age 65 years and older for baseline and annual follow-ups over the 5-year study period. Study measures are administered in each yearly evaluation to identify cross-sectional and longitudinal effects of executive control and cognitive fatigue on mobility (aim 1). Functional Near Infrared Spectroscopy (FNIRS) is used in each study visit to identify in motion PFC functional correlates of mobility (aim 2). Structural and functional MRI are administered to a subsample to augment our assessment of brain correlates of mobility (3).
COGNITIVE INTERVENTION TO IMPROVE SIMPLE AND COMPLEX WALKING
(NIH Grant: R01AG050448; Institute: NIA; PIs: Roee Holtzer & Joe Verghese)
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Given the major medical and socioeconomic consequences of disability in U.S. seniors and the low compliance with recommended treatments such as physical exercise, investigation of alternate strategies to improve mobility and locomotion is a vital need. Emerging evidence indicates that Executive Functions play an important role in maintaining locomotion in aging and preventing mobility disabilities. However, use of cognitive training programs to improve executive functions as a strategy to increase mobility has not been explored. Exciting results from our preliminary study support the efficacy and feasibility of the cognitive remediation approach to improve locomotion in older adults. We propose to conduct the first single-blind randomized clinical trial to test the efficacy of a computerized cognitive remediation intervention program on improving locomotion in sedentary seniors, a group at an especially high risk for disability. For this study, two groups of 210 sedentary seniors (420 total) will be randomized into either eight-week cognitive remediation (individualized computerized cognitive training) or health education control programs. All participants will receive gait, mobility, and cognitive assessments at baseline, post-intervention, and at six and twelve months after intervention to assess durability of effects. Our primary outcome is post intervention change in gait velocity measured during normal pace walking (simple locomotion) and walking while talking (complex locomotion) conditions as well as performance on the Short Physical Performance Battery (SPPB). Our hypothesis is that executive functions will respond to the cognitive remediation program and in turn enhance locomotion. The premise of this clinical trial is that disability among seniors is a potentially preventable chronic condition rather than an irreversible consequence of aging and disease.