Motor function in the elderly
Identifieur interne : 000D08 ( Main/Merge ); précédent : 000D07; suivant : 000D09Motor function in the elderly
Auteurs : Alexis Elbaz ; Pavla Vicente-Vytopilova ; Béatrice Tavernier ; Séverine Sabia ; Julien Dumurgier ; Bernard Mazoyer ; Archana Singh-Manoux ; Christophe TzourioSource :
- Neurology [ 0028-3878 ] ; 2013.
Abstract
The reserve hypothesis accounts for the lack of direct relationship between brain pathology and its clinical manifestations. Research has mostly focused on cognition; our objective is to examine whether the reserve hypothesis applies to motor function. We investigated whether education, a marker of reserve, modifies the association between white matter lesions (WMLs), a marker of vascular brain damage, and maximum walking speed (WS), an objective measure of motor function. We also examined the cross-sectional and longitudinal association between education and WS.
Data are from 4,010 participants aged 65–85 years in the longitudinal Three-City–Dijon Study with up to 4 WS measures over 10 years. We examined the interaction between education and WMLs for baseline WS. We studied the association between education and repeated WS measures using linear mixed models, and the role of covariates in explaining the education-WS association.
Education was strongly associated with baseline WS; the difference in mean WS between the high and low education groups (0.145 m/s, 95% confidence interval = 0.125–0.165) was equivalent to 7.4 years of age. WMLs were associated with slow WS only in the low education group (
Participants with more education were less susceptible to WMLs' effect on motor function. Higher education was associated with better motor performances but not with motor decline. These results are consistent with the passive reserve hypothesis.
Url:
DOI: 10.1212/WNL.0b013e31829d8761
PubMed: 23803317
PubMed Central: 3776533
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PMC:3776533Le document en format XML
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<author><name sortKey="Elbaz, Alexis" sort="Elbaz, Alexis" uniqKey="Elbaz A" first="Alexis" last="Elbaz">Alexis Elbaz</name>
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<author><name sortKey="Vicente Vytopilova, Pavla" sort="Vicente Vytopilova, Pavla" uniqKey="Vicente Vytopilova P" first="Pavla" last="Vicente-Vytopilova">Pavla Vicente-Vytopilova</name>
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<author><name sortKey="Tavernier, Beatrice" sort="Tavernier, Beatrice" uniqKey="Tavernier B" first="Béatrice" last="Tavernier">Béatrice Tavernier</name>
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<author><name sortKey="Sabia, Severine" sort="Sabia, Severine" uniqKey="Sabia S" first="Séverine" last="Sabia">Séverine Sabia</name>
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<author><name sortKey="Dumurgier, Julien" sort="Dumurgier, Julien" uniqKey="Dumurgier J" first="Julien" last="Dumurgier">Julien Dumurgier</name>
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<author><name sortKey="Mazoyer, Bernard" sort="Mazoyer, Bernard" uniqKey="Mazoyer B" first="Bernard" last="Mazoyer">Bernard Mazoyer</name>
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<author><name sortKey="Singh Manoux, Archana" sort="Singh Manoux, Archana" uniqKey="Singh Manoux A" first="Archana" last="Singh-Manoux">Archana Singh-Manoux</name>
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<author><name sortKey="Tzourio, Christophe" sort="Tzourio, Christophe" uniqKey="Tzourio C" first="Christophe" last="Tzourio">Christophe Tzourio</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Motor function in the elderly</title>
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<author><name sortKey="Vicente Vytopilova, Pavla" sort="Vicente Vytopilova, Pavla" uniqKey="Vicente Vytopilova P" first="Pavla" last="Vicente-Vytopilova">Pavla Vicente-Vytopilova</name>
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<author><name sortKey="Sabia, Severine" sort="Sabia, Severine" uniqKey="Sabia S" first="Séverine" last="Sabia">Séverine Sabia</name>
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<author><name sortKey="Dumurgier, Julien" sort="Dumurgier, Julien" uniqKey="Dumurgier J" first="Julien" last="Dumurgier">Julien Dumurgier</name>
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<author><name sortKey="Mazoyer, Bernard" sort="Mazoyer, Bernard" uniqKey="Mazoyer B" first="Bernard" last="Mazoyer">Bernard Mazoyer</name>
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<author><name sortKey="Singh Manoux, Archana" sort="Singh Manoux, Archana" uniqKey="Singh Manoux A" first="Archana" last="Singh-Manoux">Archana Singh-Manoux</name>
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<series><title level="j">Neurology</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>The reserve hypothesis accounts for the lack of direct relationship between brain pathology and its clinical manifestations. Research has mostly focused on cognition; our objective is to examine whether the reserve hypothesis applies to motor function. We investigated whether education, a marker of reserve, modifies the association between white matter lesions (WMLs), a marker of vascular brain damage, and maximum walking speed (WS), an objective measure of motor function. We also examined the cross-sectional and longitudinal association between education and WS.</p>
</sec>
<sec><title>Methods:</title>
<p>Data are from 4,010 participants aged 65–85 years in the longitudinal Three-City–Dijon Study with up to 4 WS measures over 10 years. We examined the interaction between education and WMLs for baseline WS. We studied the association between education and repeated WS measures using linear mixed models, and the role of covariates in explaining the education-WS association.</p>
</sec>
<sec><title>Results:</title>
<p>Education was strongly associated with baseline WS; the difference in mean WS between the high and low education groups (0.145 m/s, 95% confidence interval = 0.125–0.165) was equivalent to 7.4 years of age. WMLs were associated with slow WS only in the low education group (<italic>p</italic>
interaction = 0.026). WS declined significantly over time (−0.194 m/s/10 years, 95% confidence interval = −0.206, −0.182), but education did not influence rate of decline. Anthropometric characteristics, parental education, general health, and cognition had the strongest role in explaining the baseline education-WS association.</p>
</sec>
<sec><title>Conclusions:</title>
<p>Participants with more education were less susceptible to WMLs' effect on motor function. Higher education was associated with better motor performances but not with motor decline. These results are consistent with the passive reserve hypothesis.</p>
</sec>
</div>
</front>
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