Gait and cognition decline with advancing age, and presage the onset of dementia. Yet, the relative trajectories of gait and cognitive decline in aging are poorly understood—particularly among those with the motoric cognitive risk (MCR) syndrome. This study compared changes in simple and complex gait performance and cognition, as a function of age and MCR. We examined gait and cognitive functions of 1 095 LonGenity study participants (mean age = 75.4 ± 6.7 years) with up to 12 years of annual follow-up. Participants were of Ashkenazi Jewish descent, free of dementia, ambulatory, and had a 12.2% MCR prevalence at baseline. Gait speed was measured at usual pace walking (single-task walking, STW-speed) and walking while talking (WWT-speed). Eleven neuropsychological test scores were examined separately, and as a global cognition composite. Linear mixed-effects models adjusted for baseline sex, education, parental longevity, cognitive impairment, and global health were used to estimate changes in gait and cognition, as a function of age and MCR. STW-speed, WWT-speed, and cognitive tests performance declined in a nonlinear (accelerating) fashion with age. STW-speed declined faster than WWT-speed and cognitive test scores. People with MCR showed faster rates of decline on figure copy and phonemic fluency. Gait declines at a faster rate than cognition in aging. People with MCR are susceptible to faster decline in visuospatial, executive, and language functions. This study adds important knowledge of trajectories of gait and cognitive decline in aging, and identifies MCR as a risk factor for accelerated cognitive decline.

Background: Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Method: Participants (n = 350, mean age 71.9 ± 7.1) were randomly selected from the electoral roll. Variability in step time, step length, step width, and double support time (DST) were calculated as the standard deviation of each measure, obtained from the GAITRite walkway. Magnetic resonance imaging (MRI) scans were processed through FreeSurfer to obtain cortical thickness of 68 regions. Bayesian regression was used to determine regional associations of mean cortical thickness and thickness ratio (regional thickness/overall mean thickness) with gait variability. Results: Smaller global cortical thickness was only associated with greater step width and step time variability. Smaller mean thickness in widespread regions important for sensory, cognitive, and motor functions were associated with greater step width and step time variability. In contrast, smaller thickness in a few frontal and temporal regions were associated with DST variability and the right cuneus was associated with step length variability. Smaller thickness ratio in frontal and temporal regions important for motor planning, execution, and sensory function and greater thickness ratio in the anterior cingulate was associated with greater variability in all measures. Conclusions: Examining individual cortical regions is important in understanding the relationship between gray matter and gait variability. Cortical thickness ratio highlights that smaller regional thickness relative to global thickness may be important for the consistency of gait.

Background: Although gait speed typically declines with age, some individuals manage to maintain higher walking speeds well into older age. To better understand healthy longevity, we propose a novel exceptional aging phenotype of super movers, individuals 80 years or older with walking speeds comparable to individuals 3 decades younger. Methods: We conducted a retrospective cohort study to examine the epidemiology and determinants of super mover status as well as mortality, biological aging and gait speed trajectories of super movers compared to age peers identified from 15 aging cohort studies across 24 countries. Results: In a pooled cohort of data from multicountry population-based surveys, prevalence of super movers ranged from 4.9% to 11.1% in individuals 80 and older, with an average overall prevalence of 7.3%. Compared to age peers, super movers exhibited lower disease prevalence, healthier lifestyles and had lower mortality rates (hazard ratios: 0.38, 95% CI: 0.09–0.66). In 2 smaller samples with gait and biological aging data and longitudinal gait assessments, compared to age-matched peers, super movers had younger biological age and showed faster gait speed from their seventh to tenth decades, respectively. Conclusions: Super movers are an exceptional aging phenotype enriched with unique biological and clinical profiles that can provide valuable insights into healthy longevity.