Feasibility and Safety of Sequential Transcranial Direct Current Stimulation and Physical Therapy in Older Adults at Risk of Falling: A Randomized Pilot Study.

Objective: To establish the feasibility and safety of administering transcranial direct current stimulation (tDCS) immediately prior to physical therapy (PT) sessions in older adults at risk of falls.

Design: A pilot randomized controlled study.

Setting: Outpatient geriatric physical therapy clinic.

The age-related contribution of cognitive function to dual-task gait in middle-aged adults in Spain: observations from a population-based study.

Background: Poor dual-task gait performance is associated with a risk of falls and cognitive decline in adults aged 65 years or older. When and why dual-task gait performance begins to deteriorate is unknown. This study aimed to characterise the relationships between age, dual-task gait, and cognitive function in middle age (ie, aged 40-64 years).

Brain activity during dual-task standing in older adults.

Background: In older adults, the extent to which performing a cognitive task when standing diminishes postural control is predictive of future falls and cognitive decline. The neurophysiology of such "dual-tasking" and its effect on postural control (i.e.

Network-Based Transcranial Direct Current Stimulation May Modulate Gait Variability in Young Healthy Adults.

Purpose: Previous studies have linked gait variability to resting-state functional connectivity between the dorsal attention network (DAN) and the default network (DN) in the brain. The purpose of this study was to examine the effects of a novel transcranial direct current stimulation (tDCS) paradigm designed to simultaneously facilitate the excitability of the DAN and suppress the excitability of the DN (i.e.

Transcranial Direct Current Stimulation May Reduce Prefrontal Recruitment During Dual Task Walking in Functionally Limited Older Adults - A Pilot Study.

Introduction: Transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (dlPFC) improves dual task walking in older adults, when tested just after stimulation. The acute effects of tDCS on the cortical physiology of walking, however, remains unknown.

Methods: In a previous study, older adults with slow gait and executive dysfunction completed a dual task walking assessment before and after 20 min of tDCS targeting the left dlPFC or sham stimulation.

Evidence for a Specific Association Between Sustained Attention and Gait Speed in Middle-to-Older-Aged Adults.

Although cognitive decline has previously been associated with mobility limitations and frailty, the relationship between sustained attention and gait speed is incompletely characterized. To better quantify the specificity of the sustained attention and gait speed association, we examined the extent to which this relationship is unique rather than accounted for by executive functioning and physical health characteristics. 58 middle-to-older-aged community-dwelling adults without overt evidence of cognitive impairment (45-90 years old; 21 females) participated in the study.

Gait Variability Is Associated With the Strength of Functional Connectivity Between the Default and Dorsal Attention Brain Networks: Evidence From Multiple Cohorts.

Background: In older adults, elevated gait variability when walking has been associated with both cognitive impairment and future falls. This study leveraged 3 existing data sets to determine relationships between gait variability and the strength of functional connectivity within and between large-scale brain networks in healthy older adults, those with mild-to-moderate functional impairment, and those with Parkinson's disease (PD).

Method: Gait and resting-state functional magnetic resonance imaging data were extracted from existing data sets on: (i) 12 older adults without overt disease yet with slow gait and mild executive dysfunction; (ii) 12 older adults with intact cognitive-motor function and age- and sex-matched to the first cohort; and (iii) 15 individuals with PD.

Targeted tDCS Mitigates Dual-Task Costs to Gait and Balance in Older Adults.

Objective: Among older adults, the ability to stand or walk while performing cognitive tasks (ie, dual-tasking) requires coordinated activation of several brain networks. In this multicenter, double-blinded, randomized, and sham-controlled study, we examined the effects of modulating the excitability of the left dorsolateral prefrontal cortex (L-DLPFC) and the primary sensorimotor cortex (SM1) on dual-task performance "costs" to standing and walking.

Methods: Fifty-seven older adults without overt illness or disease completed 4 separate study visits during which they received 20 minutes of transcranial direct current stimulation (tDCS) optimized to facilitate the excitability of the L-DLPFC and SM1 simultaneously, or each region separately, or neither region (sham).

Recovery from Coronavirus Disease 2019 among Older Adults in Post-Acute Skilled Nursing Facilities.

Objectives: To examine functional outcomes of post-acute care for coronavirus disease 2019 (COVID-19) in skilled nursing facilities (SNFs).

Design: Retrospective cohort.

Setting And Participants: Seventy-three community-dwelling adults ≥65 years of age admitted for post-acute care from 2 SNFs from March 15, 2020, to May 30, 2020.

The functional implications and modifiability of resting-state brain network complexity in older adults.

The dynamics of the resting-state activity in brain functional networks are complex, containing meaningful patterns over multiple temporal scales. Such physiologic complexity is often diminished in older adults. Here we aim to examine if the resting-state complexity within functional brain networks is sensitive to functional status in older adults and if repeated exposure to transcranial direct current stimulation (tDCS) would modulate such complexity.

Self-Reported Head Trauma Predicts Poor Dual Task Gait in Retired National Football League Players.

Objective: Symptomatic head trauma associated with American-style football (ASF) has been linked to brain pathology, along with physical and mental distress in later life. However, the longer-term effects of such trauma on objective metrics of cognitive-motor function remain poorly understood. We hypothesized that ASF-related symptomatic head trauma would predict worse gait performance, particularly during dual task conditions (ie, walking while performing an additional cognitive task), in later life.

Multiscale Dynamics of Spontaneous Brain Activity Is Associated With Walking Speed in Older Adults.

Background: In older adults, compromised white matter tract integrity within the brain has been linked to impairments in mobility. We contend that poorer integrity disrupts mobility by altering the processing of sensorimotor and cognitive and attentional resources in neural networks. The richness of information processing in a given network can be quantified by calculating the complexity of resting-state functional MRI time series.

Motor-Cognitive Neural Network Communication Underlies Walking Speed in Community-Dwelling Older Adults.

While walking was once thought to be a highly automated process, it requires higher-level cognition with older age. Like other cognitive tasks, it also becomes further challenged with increased cognitive load (e.g.

A Cluster Randomized Trial of Tai Chi vs Health Education in Subsidized Housing: The MI-WiSH Study.

Objectives: Tai Chi (TC) may benefit older adults with a variety of diseases and disabilities. We tested the hypothesis that TC improves physical function in older adults living in low-income housing facilities.

Design: Cluster randomized controlled trial.

Effects of transcranial direct current stimulation over right posterior parietal cortex on attention function in healthy young adults.

Attention involves three distinct networks for alerting, orienting, and executive control. Interventions targeting the specific attentional networks remain lacking. Transcranial direct current stimulation (tDCS) has been shown to modulate cortical excitability, which potentially serves as an interventional tool to treat individuals with attention impairment.

In the Eyes of Those Who Were Randomized: Perceptions of Disadvantaged Older Adults in a Tai Chi Trial.

Background And Objectives: Older adults living in subsidized housing have typically been excluded from exercise intervention studies. We conducted a qualitative study to explore the perceived physical, psychological, social, and economic factors that influenced participation in and adherence to a year-long Tai Chi intervention within an ongoing cluster-randomized controlled trial (RCT) for older adults living within subsidized housing facilities.

Research Design And Methods: Focus groups were held with participants of the RCT who were allocated to the trial's Tai Chi intervention.

Transcranial Direct Current Stimulation May Improve Cognitive-Motor Function in Functionally Limited Older Adults.

Objective: To determine the effects of a transcranial direct current stimulation (tDCS) intervention with the anode placed over the left dorsolateral prefrontal cortex (dlPFC) and cathode over the right supraorbital region, on cognition, mobility, and "dual-task" standing and walking in older adults with mild-to-moderate motor and cognitive impairments.

Methods: A double-blinded, block-randomized, sham-controlled trial was conducted in 18 nondemented, ambulatory adults aged ⩾65 years with slow walking speed (⩽1.0 m/s) and "executive" dysfunction (Trail Making Test B score ⩽25th percentile of age- and education-matched norms).

Concurrent phone texting alters crossing behavior and induces gait imbalance during obstacle crossing.

Texting during walking has become a very common daily activity and could alter gait performance, especially during locomotion when additional visual attention is demanded, such as obstacle crossing. The purpose of this study was to examine biomechanical changes in obstructed gait characteristics while engaging in a phone texting activity. Gait analyses were performed on ten young healthy adults under the following two tasks: 1) walking and crossing an obstacle set at a 10% of the subject's height and 2) walking and crossing an obstacle while responding to a text message.