1 Department of Medicine, Division of Geriatric Medicine, University of Western Ontario, London, Canada.
2 Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada.
3 Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.
4 Department of Kinesiology and Physical Education, Sun Life Financial Movement Disorders Research Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada.
5 Department of Psychology and PERFORM Centre, Concordia University, Montréal, Quebec, Canada.
6 Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Quebec, Canada.
7 Department of Medicine, University of Montreal, Quebec, Canada.
8 Montreal Heart Institute, Research Centre, Quebec, Canada.
9 Department of Psychiatry, Geriatric Psychiatry, Schulich School of Medicine, University of Western Ontario, London, Canada.
10 Lawson Health Research Institute, London, Ontario, Canada.
11 Department of Medicine, Geriatric and Cognitive Neurology, University of Alberta, Edmonton, Canada.
12 Functional Neuroimaging Unit, University of Montreal, Quebec, Canada.
13 Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
14 Faculty of Health Sciences, School of Physical Therapy, University of Western Ontario, London, Canada.
15 Department of Physical Therapy, Centre for Hip Health and Mobility, University of British Columbia, Canada.
16 Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Research Institute, University of British Columbia, Canada.
17 Division of Neurology and Department of Medicine, University of Toronto, Ontario, Canada.
18 Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Ontario, Canada.
19 Department of Kinesiology, University of Waterloo, Ontario, Canada.
20 Department of Medicine, Division of Geriatrics and Centre of Excellence in Aging and Chronic Disease, McGill University, Montréal, Quebec, Canada.
21 Department of Medicine, Division of Clinical Pharmacology, University of Western Ontario, London, Canada.
22 Department of Medicine, Division of Geriatric Medicine, McGill University, Montréal, Quebec, Canada.
23 Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quebec, Canada.
24 RUIS McGill Centre of Excellence on Aging and Chronic Disease - CEViMaC, Montréal, Quebec, Canada.
25 Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.
26 Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Israel.
27 Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois.
28 Department of Epidemiology, University of Pittsburgh, Pennsylvania.
29 Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pennsylvania.
30 Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.

Consensus on Shared Measures of Mobility and Cognition: From the Canadian Consortium on Neurodegeneration in Aging (CCNA).

J Gerontol A Biol Sci Med Sci. 2019 May 16;74(6):897-909

Authors: Montero-Odasso M, Almeida QJ, Bherer L, Burhan AM, Camicioli R, Doyon J, Fraser S, Muir-Hunter S, Li KZH, Liu-Ambrose T, McIlroy W, Middleton L, Morais JA, Sakurai R, Speechley M, Vasudev A, Beauchet O, Hausdorff JM, Rosano C, Studenski S, Verghese J, Canadian Gait and Cognition Network

Abstract

BACKGROUND: A new paradigm is emerging in which mobility and cognitive impairments, previously studied, diagnosed, and managed separately in older adults, are in fact regulated by shared brain resources. Deterioration in these shared brain mechanisms by normal aging and neurodegeneration increases the risk of developing dementia, falls, and fractures. This new paradigm requires an integrated approach to measuring both domains. We aim to identify a complementary battery of existing tests of mobility and cognition in community-dwelling older adults that enable assessment of motor-cognitive interactions.

METHODS: Experts on mobility and cognition in aging participated in a semistructured consensus based on the Delphi process. After performing a scoping review to select candidate tests, multiple rounds of consultations provided structured feedback on tests that captured shared characteristics of mobility and cognition. These tests needed to be sensitive to changes in both mobility and cognition, applicable across research studies and clinics, sensitive to interventions, feasible to perform in older adults, been previously validated, and have minimal ceiling/floor effects.

RESULTS: From 17 tests appraised, 10 tests fulfilled prespecified criteria and were selected as part of the "Core-battery" of tests. The expert panel also recommended a "Minimum-battery" of tests that included gait speed, dual-task gait speed, the Montreal Cognitive Assessment and Trail Making Test A&B.

CONCLUSIONS: A standardized assessment battery that captures shared characteristics of mobility and cognition seen in aging and neurodegeneration may increase comparability across research studies, detection of subtle or common reversible factors, and accelerate research progress in dementia, falls, and aging-related disabilities.

PMID: 30101279 [PubMed - in process]