Multiple linear regression model assessing the contribution of fat and lean mass composition to trial completion Stroop test performance.

*<p> = significance at p<0.05.</p><p>Δ in Sub-total fat mass = Baseline fat mass subtracted by Final fat mass; Δ in Sub-total lean mass = Final lean mass subtracted by Baseline lean mass.</p

Descriptive statistics for variables of interest.

<p>BAT = Balance and Tone; 1× RT = once-weekly resistance training; 2× RT = twice- weekly resistance training; BMI = weight in kilograms/height in square meters; Baseline Stroop and Trial completion Stroop performance = Stroop color words condition subtracted by Stroop coloured x's condition; Δ in Stroop = Stroop Baseline subtracted by Trial completion Stroop; Δ in Sub-total fat mass = Final fat mass subtracted by Baseline fat mass (a positive number represents an increase in fat mass and a negative number represents a decrease in fat mass); Δ in Sub-total lean mass = Final lean mass subtracted by Baseline lean mass (a positive number represents an increase in lean mass and a negative number represents a decrease in lean mass).</p

Disruptions in Brain Networks of Older Fallers Are Associated with Subsequent Cognitive Decline: A 12-Month Prospective Exploratory Study

<div><p>Cognitive impairment and impaired mobility are major public health concerns. There is growing recognition that impaired mobility is an early biomarker of cognitive impairment and dementia. The neural basis for this association is currently unclear. We propose disrupted functional connectivity as a potential mechanism. In this 12-month prospective exploratory study, we compared functional connectivity of four brain networks– the default mode network (DMN), fronto-executive network (FEN), fronto-parietal network (FPN), and the primary motor sensory network (SMN) – between community-dwelling older adults with ≥ two falls in the last 12 months and their non-falling counterparts (≤ one fall in the last 12 months). Functional connectivity was examined both at rest and during a simple motor tapping task. Compared with non-fallers, fallers showed more connectivity between the DMN and FPN during right finger tapping (<i>p</i> = 0.04), and significantly less functional connectivity between the SMN and FPN during rest (<i>p</i>≤0.05). Less connectivity between the SMN and FPN during rest was significantly associated with greater decline in both cognitive function and mobility over the12-month period (r = −0.32 and 0.33 respectively; <i>p</i>≤0.04). Thus, a recent history of multiple falls among older adults without a diagnosis of dementia may indicate sub-clinical changes in brain function and increased risk for subsequent decline.</p></div

Graphical Representations of Between-Network Connectivity Significantly Different Between Fallers and Non-Fallers.

<p>Graphical Representations of Between-Network Connectivity Significantly Different Between Fallers and Non-Fallers.</p

Neural Networks and Regions of Interests Included in the Analysis.

†<p>PCC = posterior cingulate cortex; FMC = frontal medial cortex; RMTG/LMTG = right/left middle temporal gyrus; RPHG/LPHG = right/left parahippocampal gyrus; LMFG =  left middle frontal gyrus; RLOC/LLOC = right/left parietal cortex; RALPFC = right anterior lateral prefrontal cortex; RINS/LINS =  right/left insular sulcus; RPFC/LPFC =  right/left prefrontal cortex; RIFG/LIFG =  right/left inferior frontal gyrus; CING =  cingulate; RIPS = right inferior parietal sulcus; RVV/LVV =  right/left ventral visual; RSMG = right supramarginal gyrus; RSLOC/LSLOC =  right/left occipital cortex; RFEF/LFEF =  right/left frontal eye field; LPCG = left precentral gyrus; RPCG = right precentral gyrus; LCB = left cerebellum; RCB = right cerebellum; LPM = left premotor; RPM = right premotor; SMA = supplementary motor area.</p

Correlations of Behavioural Performances and Functional Connectivity.

<p>Correlations of Behavioural Performances and Functional Connectivity.</p

Correlations Between Change in Performance Measures and Baseline Functional Connectivity.

†<p>MMSE, Mini Mental State Examination; MoCA, Montreal Cognitive Assessment; Stroop Test = Stroop 3– Stroop 2, units in seconds; Trail Making = Trail Making B – Trail Making A, units in seconds; Digits Forward/Backward = Digits Backward – Digits Forward; m/s = meters/second; MCI, Mild Cognitive Impairment.</p><p>Change calculated as: 12-month value minus baseline value.</p><p>Negative value represents improvement for: ΔStroop Test, ΔTrail Making Test, ΔTimed Up and Go, ΔDigits Forward and Backward Test, ΔPhysiological Profile Assessment.</p><p>Positive value represents improvement for: ΔMoCA, ΔMMSE, ΔShort Physical Performance Battery, Δ4-Meter Gait Speed.</p><p>*<i>p</i>≤0.04.</p

Group Functional Connectivity Map.

<p>Group Functional Connectivity Map.</p

Twelve-Month Follow-Up Description of Participants.

†<p>m, male; f, female; MMSE, Mini Mental State Examination; MoCA, Montreal Cognitive Assessment; Stroop Test = Stroop 3– Stroop 2, units in seconds; Trail Making = Trail Making B – Trail Making A, units in seconds; Digits Forward/Backward = Digits Backward – Digits Forward; m/s = meters/second; MCI, Mild Cognitive Impairment.</p><p>Number of falls during study ranged from 0–7 in the Fallers group; 0–4 in the Non-Fallers group.</p

Baseline Description of Participants.

†<p>m, male; f, female; MMSE, Mini Mental State Examination; MoCA, Montreal Cognitive Assessment; Stroop Test = Stroop 3– Stroop 2, units in seconds; Trail Making = Trail Making B – Trail Making A, units in seconds; Digits Forward/Backward = Digits Backward – Digits Forward; m/s = meters/second; MCI, Mild Cognitive Impairment.</p><p>Number of falls 12-month prior to study ranged from 2–20 in the Fallers group; 0–1 in the Non-Fallers group.</p><p>*Statistical analysis included one outlier with 816.94 seconds on the Trail Making; after removal of this individual same relationships persist across the variables (<i>p</i><0.01 for Falls in previous 12 months; <i>p</i>>0.05 for other variables).</p