Gerontology最新文献

{"title":"Comparing Cognitive-Motor Interference Across Younger, Middle-Aged, and Older Adults During Dual-task Walking.","authors":"Shatha Abdulaziz Aldraiwiesh, Robert S Gailey, James G Moore, Jennifer C Britton, Neva Jillaine Kirk-Sanchez","doi":"10.1159/000552128","DOIUrl":"https://doi.org/10.1159/000552128","url":null,"abstract":"<p><strong>Introduction: </strong>Walking while listening or talking is a functionally relevant cognitive-motor dual-task (DT) activity that may challenge attentional capacity. DT activity alters gait and increases falls risk. The aging process may magnify challenges in DT performance. This study compared cognitive-motor interference (CMI) and DT performance across younger, middle-aged, and older adults during walking under varying memory task types.</p><p><strong>Methods: </strong>A cross-sectional sample of 32 younger (mean age=25),18 middle-aged (mean age=56), and 19 older (mean age=73.6) healthy adults completed walking trials under single-task (ST) and four DT conditions with different memory-based tasks, two auditory encoding (story memory and list encoding), and two verbal retrieval (verbal fluency and list retrieval). Participants wore sensors that transmitted spatiotemporal walking data to a mobile iOS device. Gait parameters (speed (m/s), stride time (s), stride time variability (%CoV)) and memory performances were measured under ST and DT conditions. DT effects (DTE) were calculated for all measures to quantify CMI, the percent change in performance under DT relative to ST. Statistical analyses included ANOVAs with post hoc tests and correlations with age.</p><p><strong>Results: </strong>We found a decreasing trend in DTgait performance and worsening CMI across conditions with advancing age (for example, DT verbal fluency gait speed: younger= 1.10m/s DTE= -15%; middle-aged= 0.98m/s DTE= -18%, older= 0.82m/s DTE= -24%). ANOVA showed differences between the 3 age groups in the DTE of all memory tasks on the gait measures (p<0.05), with the DTE being consistently higher (worse) in older than younger adults. Middle-aged and older adults did not differ in DTE on speed or stride variability under memory retrieval tasks, but the latter had greater DTE on speed under memory encoding tasks. Middle-aged adults had similar DTE on gait measures to younger adults under encoding tasks, but greater on stride time and variability under retrieval tasks. Groups had similar DTE on memory tasks.</p><p><strong>Conclusion: </strong>Age-related differences in CMI were more prominent for gait than for memory tasks. Findings support that DT performance incrementally declines with age. Middle-aged and older adults had similar gait destabilization in different DT walking demands, but older adults had higher interference with DT walking of auditory processing demands. Retrieval tasks during walking expose early deficits in middle-aged adults that differentiate them from younger adults. Results further suggest assessing DT walking of different demands and beginning from middle age to reduce fall risk and enhance DT ability early in life via education or cognitive-motor training.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of reactive balance training program characteristics on reactive balance control and fall risk: a systematic review and meta-regression.","authors":"Hadas Nachmani, Laura Kathleen Langer, Augustine Joshua Devasahayam, Avril Mansfield","doi":"10.1159/000552354","DOIUrl":"https://doi.org/10.1159/000552354","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Introduction- Reactive Balance Training (RBT) programs have been developed to address age-related deterioration in reactive balance control and increased fall risk. Despite the demonstrated effectiveness of those programs, there is significant variability in intervention characteristics (e.g., perturbation type, total volume and intensity of training) and in study findings. It is likely that intervention effectiveness depends on the intervention features; however, little is known about the optimal way to deliver RBT. The purpose of this systematic review and meta-analysis is to determine the optimal intervention characteristics for RBT for improving reactive balance control and preventing falls in daily life. Methods- We searched MEDLINE ALL (July 2023), Embase (July 2023), Physiotherapy Evidence Database (August 2023) and Cochrane (July 2023) for randomized controlled trials of RBT that reported measures of reactive balance control and/or falls in daily life. Results were screened by two reviewers independently to determine eligibility. The following details were extracted: study population; intervention characteristics (number, frequency and duration of sessions, type, intensity and number of perturbations; description of the control), number of participants in each group; reactive balance outcomes pre- and post-intervention, and number of falls post-intervention. Risk of bias (RoB) and certainty of evidence (GRADE) were assessed. Meta-regressions were performed to explore the influence of different study components on reactive balance control and falls. Results- After screening 7,677 records, 32 studies were included; 25 reported a reactive balance outcome, and 19 reported falls in daily life. RoB of reactive balance control revealed main concerns arising from selection of reported results. RoB of falls in daily life had high or some concerns in the measurements of the outcome and selection of reported results. RBT programs that included manual perturbations were associated with reduced fall rates compared to waist pull perturbations (rate ratio: 0.45; 95% confidence interval: [0.22, 0.91], p=0.042). There were no other significant relationships between any other training parameters and falls in daily life or reactive balance control. Quality of evidence (GRADE) was low for reactive balance control and very low for falls in daily life. Discussion- Optimal RBT training characteristics remain unclear due to substantial variability in training protocols and underreporting of key intervention details across studies, which limited meaningful synthesis and interpretation of findings. Although programs incorporating manual perturbations were associated with reduced fall rates, no other training parameters showed consistent relationships with reactive balance control or falls in daily life. Future RBT studies should provide more detailed and standardized descriptions of RBT protocols, include head-to-head comparisons of training parameters. and ","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-25"},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of pain with self-reported hearing difficulty among adults aged 50 years or older in six prospective cohorts.","authors":"Xueyuan Xu, Deyi Luo, Erjie Xie","doi":"10.1159/000551972","DOIUrl":"https://doi.org/10.1159/000551972","url":null,"abstract":"<p><p>Background Pain is highly prevalent in older adults and linked to hyperacusis, yet evidence on its relationship with self-reported hearing difficulty (HD) remains limited. The aim of this study was to investigate the associations of pain with incident HD. Methods Adults aged ≥50 from six nationally-representative aging cohorts were included: the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the Mexican Health and Ageing Study (MHAS), the China Health and Retirement Longitudinal Study (CHARLS), and the Korean Longitudinal Study of Aging (KLoSA). Pain trajectories were derived from four consecutive biennial assessments of pain severity. Logistic regression was applied to examine cross-sectional associations between pain and HD. Cox proportional hazards models assessed longitudinal associations of pain with HD. Primary analyses adjusted for age, sex, education, marital status, smoking, alcohol consumption, hypertension, and diabetes; sensitivity analyses additionally included depressive symptoms as a covariate. Results Cross-sectional and longitudinal analyses included 130,521 participants (mean age 62.8 years; range 50-106) and 11,067 participants (mean age 60.9 years; range 50-87), respectively. Frequent pain was associated with higher odds of HD, with dose-response gradients for severity (P-trend<0.001). Five distinct pain trajectories were defined. Participants in the persistent moderate-severe pain trajectory group had the highest risk of HD (Pooled HR=1.62, 1.38-1.90), followed by the increasing group (Pooled HR=1.31, 1.07-1.59) and the fluctuating group (Pooled HR=1.25, 1.14-1.38), while decreasing pain trajectories showed no significant associations. The persistent no-mild pain group served as the reference group. In sensitivity analyses, Group-Based Trajectory Modeling (GBTM) further identified three distinct pain trajectories. Conclusion Pain status and dynamic trajectories significantly impact HD risk. Standardized pain management should be integrated into future HD prevention strategies.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-15"},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Artery Disease, Aging, and Falls: Forecasting a Looming Challenge for Older Adults.","authors":"Min Wang, Bijan Najafi, Min He","doi":"10.1159/000552232","DOIUrl":"https://doi.org/10.1159/000552232","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of oral tacrolimus induction therapy in elderly patients with ulcerative colitis: A subanalysis of a large multicenter retrospective cohort study.","authors":"Toshihiro Inokuchi, Sakiko Hiraoka, Naoki Oshima, Ryohei Hayashi, Sakuma Takahashi, Hiroshi Matsumoto, Shinichi Hashimoto, Kazuo Yashima, Ken Yamashita, Tomoki Inaba, Kousaku Kawashima, Taro Takami, Hajime Isomoto, Akiko Shiotani, Shiro Oka, Shunji Ishihara, Motoyuki Otsuka","doi":"10.1159/000551622","DOIUrl":"https://doi.org/10.1159/000551622","url":null,"abstract":"<p><strong>Introduction: </strong>We previously reported the findings of a multicenter retrospective cohort study investigating the efficacy of oral tacrolimus induction therapy in patients with ulcerative colitis (UC). In this subanalysis, we specifically evaluated the efficacy and safety of tacrolimus in elderly patients.</p><p><strong>Methods: </strong>Patients with moderate-to-severe UC treated with tacrolimus between 2009 and 2017 were stratified into the elderly (≥60 years, n=34) and non-elderly (<60 years, n=182) groups. We compared the clinical remission rate at week 12, the colectomy-free survival at week 52, and the incidence of adverse events leading to treatment discontinuation between the two groups.</p><p><strong>Results: </strong>Despite the higher comorbidity burden and lower baseline hemoglobin and albumin levels in the elderly group, clinical remission rates at week 12 were comparable, at 58.8% in the elderly group and 56.6% in the non-elderly group. Colectomy-free survival at week 52 did not differ significantly between elderly and non-elderly patients (91.2% vs 90.7%). Among elderly patients, those who did not achieve clinical remission demonstrated significantly higher disease activity and lower hemoglobin levels at baseline compared with those who achieved remission. The incidence of adverse events did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>Oral tacrolimus therapy demonstrated comparable efficacy and safety between elderly and non-elderly patients, indicating its feasibility as a treatment option for the elderly.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying reactive dynamic balance in older adults: an exploratory lag-plot-based approach towards fall risk estimation.","authors":"Lea Feld, Michel Hackbarth, Laura Himmelmann, Elisa-Marie Speckmann, Jessica Koschate-Storm, Tim Stuckenschneider, Tania Zieschang","doi":"10.1159/000551583","DOIUrl":"https://doi.org/10.1159/000551583","url":null,"abstract":"<p><strong>Introduction: </strong>Reactive dynamic balance in older adults has become a focus of research and targeted falls prevention inter-ventions. However, an accurate and reliable measure to assess an individual's reactive dynamic balance per-formance is lacking. While the Margin of Stability (MoS) is commonly used in laboratory settings, its practical applicability for fall risk assessment is limited. This study proposes exploratory perturbation-based reactive balance measures based on lag plot analysis of acceleration data from a single inertial measurement unit worn at the lower back and evaluates their predictive value for future falls.</p><p><strong>Method: </strong>Sixty-four older adults (>60 years), all of whom had recently experienced a fall resulting in an emergency department visit, participated in a treadmill-based perturbation protocol including acceleration (right/left), deceleration (right/left), full-stop, sway (right/left), and pitch perturbations. Besides age, Short Physical Performance Battery (SPPB), gait speed, cognition, and concerns about falling were assessed. Reactive dynamic balance responses were quantified, using an exploratory approach with individual lag plot ellipses derived from acceleration data in mediolateral (ML) and anteroposterior (AP) direction. Four unperturbed gait variability measures were calculated per participant, and four exploratory perturbation-based parameters as well as two MoS parameters were calculated per participant and perturbation type. Stepwise logistic regressions were performed to evaluate the predictive value of this exploratory approach for prospective falls, reporting odds ratio (OR), and McFaddens pseudo R^2.</p><p><strong>Results: </strong>While the SPPB showed predictive relevance (OR=0.65, p=0.029, R^2=0.14), unperturbed gait variability and MoS did not improve model performance, when controlling for age. In contrast, exploratory perturbation-based parameters for the acceleration right perturbation significantly contributed to fall prediction. In particular, an effect was observed for the parameter associated with short-term variability (LMS_SD2^norm; OR=0.39, p=0.010, R^2=0.20). These results indicate that older adults with higher short-term (stride-to-stride) variability in trunk acceleration during right-leg acceleration perturbations are less prone to falls. When allowing for an additional predictive parameter, the proportion of acceleration data deviating from unperturbed walking during the perturbation phase (POE) showed also a predictive value (OR=1.13, p=0.020, R^2=0.28).</p><p><strong>Conclusion: </strong>The findings provide first evidence, that the proposed exploratory perturbation-based acceleration parameters, especially LMS_SD2^norm, may quantify aspects of reactive dynamic balance performance relevant to fall risk. These measures hold promise for integration into wearable technologies for long-term monitoring and real-world fall risk assessment.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between cardiovascular risk factors and cognitive function: a cross-sectional study of twins in the United Kingdom.","authors":"Swarna Vishwanath, Ellen J Thompson, Rose S Penfold, Ruth C E Bowyer, Cristina Menni, Ingrid Hopper, Joanne Ryan, Claire J Steves","doi":"10.1159/000551944","DOIUrl":"https://doi.org/10.1159/000551944","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular risk factors (CVRF) have been associated with cognitive impairment; however, the underlying mechanisms remain unclear. This study used twins modelling, to investigate whether shared twin factors contribute to the associations between CVRFs and cognitive function.</p><p><strong>Methods: </strong>This study used a cross-sectional design and participants were from the UK adult twin registry. Clinically validated cognitive tests were administered during routine clinical research visits between 2013 and 2016, measuring overall global cognition, recall, verbal fluency, processing speed, episodic memory and learning. CVRFs were total cholesterol (TC), high-density lipoprotein (HDL), systolic blood pressure (SBP), type 2 diabetes (T2D), and smoking status.</p><p><strong>Results: </strong>Participants were between 1300-2300 twins (depending on the cognitive test) and the mean age of twins was approximately 56 years. Cholesterol levels (both TC and HDL) were significantly associated (p<0.05) with overall global cognition, recall, and verbal fluency with effect sizes (standardised) ranging from 0.5 to 0.11. In the twins modelling, after adjusting for genetic and shared environmental factors, the associations disappeared. Similarly, higher SBP levels were associated with poorer verbal fluency performance (-0.05 [-0.10 to 0.00]), and while between-pair effects were significant found (-0.09 [-0.15 to -0.03]), within-pair effects (after adjusting of shared environmental factors) were not.</p><p><strong>Conclusion: </strong>Higher TC, HDL, and lower SBP were all associated with better performance on a range of validated cognitive tests. However, findings suggest that the association between CVRFs and cognitive function is predominantly explained by shared twin-pair factors which may be genetic or shared environment.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Hospital-at-Home (HaH) Versus Traditional Hospital Care in older Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Hongyao He, Yajie Li, Yaqin Li, Xiaomin Xu, Qiuyan Fu, Xuemei Peng, Gang Yuan, Wen He, Ling Zhang, Zhexin Lin, Miaohong Chen","doi":"10.1159/000551394","DOIUrl":"https://doi.org/10.1159/000551394","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of the Hospital-at-Home (HaH) model compared to traditional hospital care for older patients.</p><p><strong>Methods: </strong>We comprehensively searched PubMed, Embase, Medline, Cochrane Library, SinoMed, Scopus, and ClinicalTrials.gov for randomized controlled trials (RCTs) published up to April 15, 2024. The primary outcomes were length of stay (LOS) and readmission rates. Secondary outcomes included total cost, mortality, adverse events, and instrumental activities of daily living (IADL).</p><p><strong>Results: </strong>Eleven RCTs involving 3,301 patients were included. The HaH group demonstrated a significantly shorter LOS (SMD -0.45; 95% CI -0.62 to -0.28; p < 0.01) and lower total healthcare costs (SMD -0.40; 95% CI -0.52 to -0.28; p < 0.0001) than the traditional care group. HaH was also associated with a reduced risk of readmission, with subgroup analyses showing consistent benefits at one, three, and nine months. Additionally, patients receiving HaH showed modest but significant improvements in IADL scores (SMD -0.15; 95% CI -0.26 to -0.04; p < 0.0001). However, no significant differences were found between the two groups in terms of mortality (RR 1.03; 95% CI 0.49 to 2.18; p = 0.93) or adverse event rates (RR 1.01; 95% CI 0.43 to 2.36; p = 0.084).</p><p><strong>Conclusion: </strong>For a selected group of older patients, HaH appears to be a viable alternative to traditional hospitalization, offering advantages in reducing length of stay, healthcare costs, and readmission rates, while potentially improving functional recovery without increasing risks to patient safety. Further research is warranted to confirm these findings and refine implementation strategies.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-22"},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motoric cognitive risk syndrome among community-dwelling older adults in China: Prevalence, associated factors, and adverse outcomes.","authors":"Hongtao Cheng, Hexiao Ding, Shuangni Huang, Jingyang Zhang, Tianxu Miao, Siyu Zhang, June Zhang","doi":"10.1159/000551825","DOIUrl":"https://doi.org/10.1159/000551825","url":null,"abstract":"<p><strong>Introduction: </strong>Motoric cognitive risk syndrome (MCR) is a screening syndrome that has been associated with increased dementia risk in prior studies. This study aimed to investigate the prevalence, associated factors, and adverse outcomes of MCR among community-dwelling older adults in China.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted among 5,242 CHARLS participants aged ≥60 years to examine factors associated with prevalent MCR, and prospective outcomes were evaluated over a 3-year follow-up. The Boruta algorithm was used for feature selection. Multivariate logistic regression analysis was employed to assess associations, while XGBoost was applied as a complementary baseline classification approach to rank feature importance for distinguishing prevalent MCR.</p><p><strong>Results: </strong>The prevalence of MCR was 12.9% among the study population, with higher rates in unmarried, illiterate, and older participants. Physical performance measures emerged as the strongest associated factors, with five-time sit-to-stand test (OR=1.05, 95%CI: 1.03-1.07), handgrip strength (OR=0.98, 95%CI: 0.97-0.99), and mobility score (OR=1.12, 95%CI: 1.04-1.19) showing significant associations. Higher education level (OR=0.67, 95%CI: 0.51-0.89) and social activity participation (OR=0.69, 95%CI: 0.58-0.82) were inversely associated with prevalent MCR, while stroke (OR=2.18, 95%CI: 1.43-3.24), visual impairment (OR=1.40, 95%CI: 1.08-1.84), and poor self-reported health status (OR=1.50, 95%CI: 1.13-2.00) were associated with higher odds of prevalent MCR. MCR was prospectively associated with ADL disability (adjusted OR=1.40, 95% CI: 1.12-1.73) but not hospitalization (adjusted OR=1.08, 95% CI: 0.87-1.34).</p><p><strong>Conclusion: </strong>These findings underscore the importance of incorporating physical performance measures and social factors in MCR screening protocols and may inform screening and risk stratification in aging populations.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Associations Between Reactive-Balance Stepping Responses, Self-Induced Stepping and Gray Matter Volume.","authors":"Inbal Paran, Moti Salti, Hadas Nachmani, Yuliya Berdichevsky, Ilan Shelef, Itshak Melzer","doi":"10.1159/000551973","DOIUrl":"https://doi.org/10.1159/000551973","url":null,"abstract":"<p><strong>Background: </strong>The distinction between reactive and proactive balance control mechanisms in terms of age-related structural neural correlates is still scarce. From a biomechanical perspective, reactive stepping is a rapid response to sudden loss of stability, whereas proactive self-induced stepping requires anticipatory postural adjustments and longer duration. This study aims to explore how cortical and sub-cortical gray matter volume correlates with variables of reactive and proactive stepping responses among older and young adults; and whether these stepping responses can be distinguished from one another in terms of their structural neural correlates (i.e., cortical and sub-cortical gray matter volume).</p><p><strong>Methods: </strong>Twenty-six older adults and nine young adults underwent structural MRI brain scanning. Self-induced stepping variables were derived from ground reaction force data, while kinematic parameters of reactive stepping, including step thresholds, were obtained using a three-dimensional motion capture system. Age-related differences in ground reaction force measures, stepping kinematics, and gray-matter volume in ten regions of interest were examined, followed by partial correlation analyses.</p><p><strong>Results: </strong>Age-related impairments in reactive and proactive stepping performance were accompanied by significantly smaller gray-matter volume among older adults across all regions of interest (p≤0.003), except for the brainstem (p=0.026; post-correction significance level: p<0.005). Partial correlation analyses including both older and young adults revealed significant associations whereby longer balance recovery durations and lower stepping thresholds were associated with lower gray-matter volume in prefrontal and cortical regions, and in the putamen and amygdala (r=-0.41 to -0.60, p≤0.037; and r=0.38 to 0.43, p≤0.048, respectively). In self-induced stepping performance, longer preparation and step durations were significantly associated with lower pre-central, cerebellar and amygdala gray-matter volume (r=-0.51 - -0.56, p≤0.006).</p><p><strong>Conclusion: </strong>Age-related differences in reactive stepping deficits were primarily associated with lower gray-matter volume in prefrontal, cortical, putamen, and amygdala regions, whereas self-induced stepping impairments were associated with precentral, cerebellar, and amygdala gray matter volumes. These findings suggest distinct neural substrates underlying reactive versus self-initiated balance control. Further investigation needs to explore whether intervention programs in older adults may change gray matter volume in these regions.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}