Neurometabolic correlates of posturography in normal aging and older adults with mild cognitive impairment: Evidence from a 1H-MRS study.

Proton magnetic resonance spectroscopy (1H-MRS) holds promise for revealing and understanding neurodegenerative processes associated with cognitive and functional impairments in aging. In the present study, we examined the neurometabolic correlates of balance performance in 42 cognitively intact older adults (healthy controls - HC) and 26 older individuals that were diagnosed with mild cognitive impairment (MCI). Neurometabolite ratios of total N-acetyl aspartate (tNAA), glutamate-glutamine complex (Glx), total choline (tCho) and myo-inositol (mIns) relative to total creatine (tCr) were assessed using single voxel 1H-MRS in four different brain regions. Regions of interest were the left hippocampus (HPC), dorsal posterior cingulate cortex (dPCC), left sensorimotor cortex (SM1), and right dorsolateral prefrontal cortex (dlPFC). Center-of-pressure velocity (Vcop) and dual task effect (DTE) were used as measures of balance performance. Results indicated no significant group differences in neurometabolite ratios and balance performance measures. However, our observations revealed that higher tCho/tCr and mIns/tCr in hippocampus and dPCC were generic predictors of worse balance performance, suggesting that neuroinflammatory processes in these regions might be a driving factor for impaired balance performance in aging. Further, we found that higher tNAA/tCr and mIns/tCr and lower Glx/tCr in left SM1 were predictors of better balance performance in MCI but not in HC. The latter observation hints at the possibility that individuals with MCI may upregulate balance control through recruitment of sensorimotor pathways.

The beneficial effects of acute strength training on sway activity and sway regularity in healthy older men: Evidence from a posturography study.

The effects of acute strength training on balance control were studied in healthy older human men (age-range 60-77y). Participants performed the Tandem Romberg Stance while completing an attention demanding cognitive task (Mathematical Counting) before and after a single acute strength training session applied to the lower limb musculature (experimental group; n = 19) or no intervention (control group; n = 18). Balance stability and the automaticity of balance control were estimated through the calculation of the center-of-pressure (CoP) velocity (Vcop) and the statistical regularity (wavelet entropy) of the CoP trajectory (WEcop), respectively. Training included 3 sets of 3 repetitions of barbell squats using Smith Machine, ranging from 90 % of one repetition maximum (1RM) to 100 % 1RM with 3 min rest between repetitions and 5 min rest between sets. Vcop and WEcop decreased after training (all time main effects, p ≤ 0.028) but group time interactions were not significant (all, p ≥ 0.056). Exploratory analyses revealed that participants in the experimental group showed a significant decrease of Vcop and WEcop in the mediolateral (ML) directions from pre to post [ML Vcop: 15.4 %; Bonferroni-corrected p = 0.048); ML WEcop: 10.5 %; Bonferroni-corrected p = 0.016]. A trend towards a decrease in Vcop and WEcop was also observed in controls, with more prominent gains in the anteroposterior than in the ML direction (Bonferroni-corrected p > 0.2). Overall, findings suggest that acute strength training may improve attentional control of balance along the narrow dimension of the support. Further studies are warranted to examine the specific mechanisms underlying these findings.

Forty-eight-hour fasting declines mental flexibility but improves balance in overweight and obese older women.

The purpose of this study was to investigate the effects of a 48-h fast on evoked stress, mood, and cognitive and motor functions in overweight and obese older women. Eleven women (body mass index >25 kg/m2) aged 63-80 years were tested under two randomly allocated conditions: 48-h zero-calorie diet with water provided ad libitum and 48-h usual diet. Autonomic function, cortisol levels, mood state, cognitive performance, visuomotor coordination, motor speed, and balance were evaluated before and after each diet. Fasting increased (P < 0.05) cortisol levels, whereas no changes were observed in heart rate and its variability. Fasting increased (P < 0.05) fatigue, prolonged (P < 0.05) reaction time in the two-choice reaction time test and decreased (P < 0.05) the velocity vector of the center of pressure with eyes closed, whereas no changes in performance were observed in the pursuit tracking and finger tapping tests. Thus, although a 48-h fast resulted in greater hypothalamic-pituitary-adrenal axis activity in overweight and obese older women, autonomic nervous system activity was not affected. Fasting increased fatigue and decreased mental flexibility, but improved balance.

Sway regularity and sway activity in older adults' upright stance are differentially affected by dual task.

Age-related changes in postural control are attributed to visual, vestibular and proprioceptive dysfunctions, muscle weakness, and reduced availability of neural resources required for efficient balance control. Concurrent performance of complex cognitive tasks while standing or walking is expected to increase balance instability due to under-recruitment of brain resources and insufficient allocation of attention to the postural task. Both balance instability and attentional control of movements can, nonetheless, be determined from the center of pressure (CoP) measurements by examining the effects of dual-task on the amount of sway activity (as measured by CoP velocity - Vcop) and the statistical regularity of the CoP trajectory (the wavelet entropy of the signal - WEcop). The abovementioned characteristics were examined in the present study in a group of 13 healthy older adults. The task involved maintaining Romberg stance for 25 s with or without performing an attention demanding cognitive tasks (word memorization or mathematical counting). A linear mixed-model study was designed to analyze the extent to which sway activity can predict sway regularity. Findings from the present study showed that, on average, Vcop and WEcop were positively correlated (p = 0.014), suggesting that older individuals who exhibited greater amounts of sway (i.e., higher Vcop) also increased sway irregularity of the posturogram - as evidenced by a higher level of wavelet entropy of the CoP trajectory. Nevertheless, results of the linear mixed model showed that significant positive associations between Vcop and WEcop were found only in dual task (R ≥ 0.67, p ≤ 0.012). Furthermore, dual-task effects (% change in performance) on both sway characteristics were not significant (p > 0.1), suggesting that none of the attention demanding cognitive tasks used in the present study was sufficient to divert a critical amount of attentional resources from the postural task. Finally, performance of the mathematical counting (but not the word memorization) task was deteriorated from sitting to standing, however this effect was marginal (p = 0.075). Taken together, we proposed that while dual task could hinder balance control, postural stability may still be maintained by allocating more attentional resources to the postural task and reducing automatized control.