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. 2013 Nov;68(11):1379-86.
doi: 10.1093/gerona/glt089. Epub 2013 Jul 10.

Aging, the central nervous system, and mobility

Andrea L Rosso  1 , Stephanie A Studenski, Wen G Chen, Howard J Aizenstein, Neil B Alexander, David A Bennett, Sandra E Black, Richard Camicioli, Michelle C Carlson, Luigi Ferrucci, Jack M Guralnik, Jeffrey M Hausdorff, Jeff Kaye, Lenore J Launer, Lewis A Lipsitz, Joe Verghese, Caterina Rosano
Affiliations

Aging, the central nervous system, and mobility

Andrea L Rosso et al. J Gerontol A Biol Sci Med Sci. 2013 Nov.

Abstract

Background: Mobility limitations are common and hazardous in community-dwelling older adults but are largely understudied, particularly regarding the role of the central nervous system (CNS). This has limited development of clearly defined pathophysiology, clinical terminology, and effective treatments. Understanding how changes in the CNS contribute to mobility limitations has the potential to inform future intervention studies.

Methods: A conference series was launched at the 2012 conference of the Gerontological Society of America in collaboration with the National Institute on Aging and the University of Pittsburgh. The overarching goal of the conference series is to facilitate the translation of research results into interventions that improve mobility for older adults.

Results: Evidence from basic, clinical, and epidemiological studies supports the CNS as an important contributor to mobility limitations in older adults without overt neurologic disease. Three main goals for future work that emerged were as follows: (a) develop models of mobility limitations in older adults that differentiate aging from disease-related processes and that fully integrate CNS with musculoskeletal contributors; (b) quantify the contribution of the CNS to mobility loss in older adults in the absence of overt neurologic diseases; (c) promote cross-disciplinary collaboration to generate new ideas and address current methodological issues and barriers, including real-world mobility measures and life-course approaches.

Conclusions: In addition to greater cross-disciplinary research, there is a need for new approaches to training clinicians and investigators, which integrate concepts and methodologies from individual disciplines, focus on emerging methodologies, and prepare investigators to assess complex, multisystem associations.

Keywords: Central nervous system; Mobility.; Motor control.

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Figures

Figure 1.
Figure 1.
Model of current gaps in knowledge of central nervous system (CNS) involvement in mobility of older adults: 1) what is the CNS contribution to mobility; 2) what are the mechanisms of brain reserve in mobility; 3) when do neurologic changes related to mobility decline occur; and 4) what aspects of CNS are modifiable and amenable to interventions?
Figure 2.
Figure 2.
Model of central nervous system involvement in mobility of older adults. Summary model from those developed by workshop participants (November 2012).
See this image and copyright information in PMC

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