"Mind in Motion": Multimodal Imaging of Brain Activity to Investigate Walking and Mobility Decline in Older Adults

This study is a longitudinal, prospective cohort study with a follow-up period of 1.2 - 3.5
years, dependent on when the participant enrolls. Participants will be assessed at baseline,
and then every six months for 3.5 years or until the study ends, whichever comes first.

The investigators plan to enroll 200 community-dwelling men and women age 70+ years.

Inclusion Criteria for Older Adults:

- Community dwelling men and women 70+ years old

- Short Physical Performance Battery (SPPB) <10

- Able to complete the 400 m walk test within 15 minutes without sitting or the help of
another person and without a walker, a cane is allowed

- Willingness to undergo all testing procedures

- English speaking

- Willingness to be enrolled for 1.25 to 3.5 years, depending on enrollment date.

Inclusion Criteria for Young Adults:

- Healthy men and women aged 20-40 years old

- Willingness to undergo all testing procedures

- English speaking

Exclusion Criteria for all participants:

- Significant medical event requiring hospitalization in the past 6 months that has the
potential to contaminate data being collected (fracture, hospitalization etc.);

- Severe visual impairment or corrected visual acuity less than 20/40, which would
preclude completion of the assessments;

- Not meeting MRI eligibility (e.g. metal implants, pacemaker, etc.)

- Clinically diagnosed vestibular dysfunction;

- Unwilling or unable to do an over-ground version of the uneven terrain task without
assistive device;

- Develops chest pain or severe shortness of breath during physical stress;

- History of stroke;

- Any history of clinically diagnosed traumatic brain injury;

- Diagnosis of dementia or taking cholinesterase inhibitors (Aricept, Exelon, Razadyne,
Namenda, or Namzaric);

- Significant cognitive impairment defined as a score of 17 on the modified Telephone
Inventory for Cognitive Status (TICS-M).

- Any major ADL disability (unable to feed, dress, bath, use the toilet, or transfer);

- Report of lower extremity pain due to osteoarthritis that significantly limits
mobility;

- Diagnosis or treatment for rheumatoid arthritis;

- Lives in a nursing home; persons living in assisted or independent housing will not be
excluded;

- Receiving physical therapy for gait, balance, or other lower extremity training;

- Known neuromuscular disorder or overt neurological disease (e.g. Multiple Sclerosis,
Rhabdomyolysis, Myasthenia Gravis, Ataxia, Apraxia, post-polio syndrome, mitochondrial
myopathy, Parkinson's Disease, ALS etc.)

- Unable to communicate because of severe hearing loss or speech disorder;

- Planned surgical procedure or hospitalization in the next 12 months (e.g., joint
replacement, CABG);

- Severe pulmonary disease, requiring the use of supplemental oxygen;

- Terminal illness, as determined by a physician;

- Severe cardiac disease, including NYHA Class III or IV congestive heart failure,
clinically significant aortic stenosis, recent history of cardiac arrest, use of a
cardiac defibrillator, or uncontrolled angina;

- Is planning to move out of the area in next year or leave the area for >6 mos during
follow-up;

- Other significant conditions that would impact safety and/or compliance to the
protocol (e.g. renal failure on hemodialysis, psychiatric disorder—bipolar,
schizophrenia, excessive alcohol intake etc.);

- Use of walker or wheel chair;

- Artificial hair covering the scalp such as a wig or toupee

- Failure to provide informed consent;

- Transaminases >twice upper limit of normal;

- Hemoglobin <10 g/dL;

- Investigator discretion based on safety or compliance concerns