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      Short-latency inhibition mitigates the relationship between conscious movement processing and overly cautious gait

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          Abstract

          Background

          Overly cautious gait is common in older adults. This is characterised by excessively slow gait, shortened steps, broadened base of support and increased double limb support. The current study sought to (1) evaluate if overly cautious gait is associated with attempts to consciously process walking movements, and (2) explore whether an individual’s ability to rapidly inhibit a dominant motor response serves to mitigate this relationship.

          Methods

          A total of 50 older adults walked at a self-selected pace on an instrumented walkway containing two raised wooden obstacles (height = 23 cm). Trait conscious movement processing was measured with the Movement-Specific Reinvestment Scale. Short-latency inhibitory function was assessed using a validated electronic go/no-go ruler catch protocol. We used linear regressions to explore the relationship between these variables and gait parameters indicative of overly cautious gait.

          Results

          When controlling for general cognitive function (MoCA), and functional balance (Berg Balance Scale), the interaction between trait conscious movement processing and short-latency inhibition capacity significantly predicted gait velocity, step length and double limb support. Specifically, older adults with higher trait conscious movement processing and poorer inhibition were more likely to exhibit gait characteristics indicative of cautious gait (i.e. reduced velocity, shorter step lengths and increased double limb support). Neither conscious movement processing nor inhibition independently predicted gait performance.

          Conclusion

          The combination of excessive movement processing tendencies and poor short-latency inhibitory capacity was associated with dysfunctional or ‘overly cautious’ gait. It is therefore plausible that improvement in either factor may lead to improved gait and reduced fall risk.

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          Most cited references30

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          The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.

          To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. Validation study. A community clinic and an academic center. Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
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            Moderation in Management Research: What, Why, When, and How

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              The relations among inhibition and interference control functions: a latent-variable analysis.

              This study used data from 220 adults to examine the relations among 3 inhibition-related functions. Confirmatory factor analysis suggested that Prepotent Response Inhibition and Resistance to Distractor Interference were closely related, but both were unrelated to Resistance to Proactive Interference. Structural equation modeling, which combined Prepotent Response Inhibition and Resistance to Distractor Interference into a single latent variable, indicated that 1 aspect of random number generation performance, task-switching ability, and everyday cognitive failures were related to Response-Distractor Inhibition, whereas reading span recall and unwanted intrusive thoughts were related to Resistance to Proactive Interference. These results suggest that the term inhibition has been overextended and that researchers need to be more specific when discussing and measuring inhibition-related functions. ((c) 2004 APA, all rights reserved)
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                Author and article information

                Contributors
                Journal
                Age Ageing
                Age Ageing
                ageing
                Age and Ageing
                Oxford University Press
                0002-0729
                1468-2834
                May 2021
                18 November 2020
                18 November 2020
                : 50
                : 3
                : 830-837
                Affiliations
                College of Health , Medicine and Life Sciences, Brunel University London, UK
                Centre for Cognitive Neuroscience, Brunel University London , UK
                College of Health , Medicine and Life Sciences, Brunel University London, UK
                Centre for Cognitive Neuroscience, Brunel University London , UK
                Department of Physical Medicine and Rehabilitation, University of Michigan , USA
                School of Sport and Health Sciences, University of Exeter , UK
                College of Health , Medicine and Life Sciences, Brunel University London, UK
                Author notes
                Address correspondence to: Toby Ellmers, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK. Email: toby.ellmers@ 123456brunel.ac.uk
                Article
                afaa230
                10.1093/ageing/afaa230
                8099234
                33206968
                ebb1aeee-dae3-4642-aac3-9d30c5dbac68
                © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 March 2020
                : 13 September 2020
                Page count
                Pages: 8
                Categories
                Research Paper
                AcademicSubjects/MED00280

                Geriatric medicine
                conscious movement processing,inhibition,reinvestment,cautious gait,older people

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