Dual-task gait speed and mobility are positively associated with declarative memory

Abstract In the US, it is not recommended to perform routine screening assessments for cognitive function or impairment among older adults, due to the lack of effective pharmacological treatments. These common practices result in delayed identification and treatments for slowing cognitive decline progression. Thus, the purpose of the present investigation was to determine the ability to predict cognition from common measures of physical function. Seventy-five community-dwelling older adults (80.7±5.4 years) completed physical function and cognitive assessments. Physical function was assessed using the Short Physical Performance Battery (SPPB), peak velocity during a power sit-to-stand task, and dual-task walking test. Cognition (declarative memory) was assessed using a validated Visual Paired Comparison test. 38% of the variance in cognition was accounted for by the predictor variables (age, sex, education, SPPB, dual-task, peak velocity). Significant predictors included dual-task walking (p = .03), SPPB (p = .02), and education (p = .02). For each 1 second faster during the dual-task performance, cognition increased by 4 percentile units. Likewise, each 1 unit increase in SPPB resulted in an increase of 4 percentile points in cognition. The results indicate more than a third of the variance in declarative memory can be predicted by commonly assessed measures of physical function. This information is useful when identifying older adults that may have cognitive impairment before overt signs are realized. With the lack of recommended cognitive testing, using physical function declines to identify possible cognitive decline is promising. These results are preliminary in nature and longitudinal determination is warranted.

associated with higher SOC (β=0.12,SE=0.05,p<0.05).This study demonstrates that older adults in Puerto Rico who are more socially isolated have lower SOC, and that SOC increases with age.In order to promote SOC in this population, interventions should focus on reducing social isolation and may benefit from targeting young-old older adults.Future research should continue to examine these relationships and extend to other Latin American cultures.It is unknown if care and cost outcomes differ by race and ethnicity following discharge from a hospitalization involving palliative care consultation to discuss goals-of-care (PCC).In this secondary analysis of 1,390 seriously-ill patients age 18+ alive at discharge who self-identified as Black, Hispanic, Asian, white, or other race and received PCC at an urban, academic medical center, we used binomial logistic regression and multiple linear regression controlling for demographic and clinical variables to identify factors associated with care experiences and costs following discharge from a hospitalization with PCC.In adjusted analyses, discharge to hospice was associated with Medicaid (p=0.016).Thirty-day readmission was associated with age 75+ (P=0.015),Medicaid (P=0.004),admission 30 days prior (P<0.0001), and Black race compared to white (P=0.016).Number of future days hospitalized was associated with Medicaid (P=0.001),admission 30 days prior (P=0.017), and Black race compared to white (P=0.012).Having any future hospitalization cost was associated with patient ages 65-74 (P=0.022) and 75+ (P=0.023),Medicaid (P=0.014),admission 30-days prior (P<0.0001), and Black race compared to white (P=0.021).Total future hospitalization costs were associated with female gender (P=0.025),Medicaid (P=0.009),admission 30 days prior (P=0.040), and Black race compared to white (P=0.037).Race or ethnicity was not a predictor of hospice enrollment.Randomized controlled trials are needed to understand if PCC is an intervention that reduces racial disparities in end-of-life care.Qualitative insights are needed to explain how PCC and socioeconomic factors such as Medicaid may mitigate future acute care use among racial and ethnic groups.

ADULTS AGING WITH SPINAL CORD INJURY: PREVALENCE AND ASSOCIATED RISK FACTORS FOR DIAGNOSIS OF DIABETES MELLITUS Junha Park, and Lisa Bratzke, University of Wisconsin-Madison, Madison, Wisconsin, United States
With the increased life expectancy, people aging with spinal cord injury (SCI) are more likely to experience chronic conditions, including diabetes mellitus (DM).The results of previous literature related to the prevalence of DM are mixed and risk factors associated with diagnosis of DM after SCI are not well defined.This study aims to investigate the prevalence of DM and explore associated risk factors for diagnosis of DM among adults aging with long-standing spinal cord injury in the United States.This is a secondary data analysis using the National Spinal Cord Injury Model Systems Database.Participants included 516 people age 45 and older who have been living with SCI for more than 10 years.The prevalence of DM in this sample was 13.2%.Multivariate logistic regression, controlling for confounding variables, was conducted to identify risk factors associated with DM diagnosis in this sample.The multivariate logistic regression model found that the participants who responded with less severe SCI measured by the ASIA impairment scale were less likely to be diagnosed with DM (OR=0.332,p=.017).Also, DM was found to be significantly associated with BMI (OR=1.043,p=.010) and age (OR=1.038,p= .010)respectively.Duration of disability was not significantly associated with DM.Future research is needed to validate these findings and identify other common risk factors for DM such as diet/ nutrition.Further, exploration of the effect size of risk factors is also warranted.Such findings will inform interventions to aid prevention and early detection of DM.

AN INTERNATIONAL REVIEW OF MOTOR VEHICLE COLLISION RISK WITH MEDICAL CONDITIONS IN OLDER ADULTS
Mark Rapoport, 1 Joanne Wood, 2 Jamie Dow, 3 Desmond O'Neill, 4 Judith Charlton, 5 and Sjannie Koppel, 5 1.University of Toronto, Toronto, Ontario, Canada, 2. Queensland University of Technology, Brisbane City,Queensland,Australia,3. SAAQ,Quebec City,Quebec,Canada,4. Trinity College Dublin,Dublin,Dublin,Ireland,5. Monash University,Clayton,Victoria,Australia The objective was to examine the impact of seven categories of medical illness on risk of Motor Vehicle Collisions (MVC) in older adults.In late 2019, a systematic review of the MVC risk associated with alcohol use disorders, psychiatric disorders, epilepsy, diabetes, hearing loss, vision disorders and sleep disorders was conducted.A total of 64,720 titles were screened, and 138 articles were included.Of these, only thirteen pertained to older adults, only six showed increased MVC risk in at least one condition, and only seven were rated of "Good" quality.Hearing impairment was associated with MVC only if associated with visual acuity or contrast sensitivity impairments (RR 1.52, 95% CI 1. respectively).A high depression score was associated with increased MVC (RR 1.5, 95% CI 1.1-2.1) in one study, but a similar relationship was not found in two other studies.Glaucoma increased at-fault MVC risk (RR 1.65,) in one study, but no relationship was found in another.Visual field loss increased MVC risk in three of four studies (RR or HR ranging from 1.31 to 2.32).One negative study each were identified for alcohol use disorders, age-related macular degeneration, any eye disease, or any psychiatric disorder, and four negative studies were identified for reduced visual acuity.No studies of older adults were found for epilepsy or sleep disorders.Interpretation of MVC risk in older drivers with medical illness is rendered challenging by the paucity and quality of studies.

BRAIN MAGNETIC SUSCEPTIBILITY IS ASSOCIATED WITH SLOWER GAIT IN COMMUNITY-DWELLING OLDER ADULTS
Victoria Poole, 1 Robert Dawe, 1 Sue Luergans, 1 David Bennett, 1 Aron Buchman, 1 and Konstantinos Arfanakis, 2 1. Rush University, Chicago, Illinois, United States, 2. Rush University, Rush Alzheimer's Disease Center, Illinois, United States Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age.Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored.In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/-7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment.Gait speed was measured and averaged across 2 timed 8-ft walks.MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel.When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics.We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005).Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere.These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait.Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.

DIFFERENTIAL INFLUENCE OF COVID-19 PANDEMIC ON LIFE-SPACE MOBILITY OF OLDER ADULTS
Anna Zisberg, 1 Ksenya Shulyaev, 2 Nurit Gur-Yaish, 3 and Efrat Shadmi, 4 1.University of Haifa,Haifa,HaZafon,Israel,2. Faculty of Social Welfare and Health Science,University of Haifa,Haifa,Hefa,Israel,3. Oranim Academic College of Education,Haifa,HaZafon,Israel,4. University of Haifa,Mount Carmel,Israel,Haifa,Hefa,Israel Life-space mobility (LSM) is critical to aging successfully since it is essential to maintain independence, affecting the health and quality of life of older adults.During the COVID-19 pandemic older adults, who are at high-risk of serious illness and complications, are restricted by stay-at-home orders, limiting their outdoor activities.This study evaluated differences in LSM before and during the pandemic and factors related to limited pre-hospitalization mobility.We used a natural experiment design comparing LSM one month