Motor Imagery Intervention for Improving Gait and Cognition in the Elderly

The proposed research aims to establish the efficacy of an imagined gait protocol for
improving gait and cognition in the elderly. This imagined gait protocol involves imagined
gait in single (imagined walking; iW) and dual-task (imagined walking while talking; iWWT)
situations. A single-blind randomized clinical trial of 58 cognitively-healthy elderly with
pre-post measures of gait, cognition, and functional Magnetic Resonance Imaging (fMRI) during
imagined gait is proposed. The overall hypothesis is that imagined gait can be used as a
rehabilitative tool for improving gait and cognition in the elderly because it engages and
strengthens similar neural systems as actual gait and cognition. The first aim of this study
is to establish the efficacy of our imagined gait protocol to improve gait and cognition in
the elderly. We predict that our imagined gait intervention will improve gait velocity during
actual walking and walking-while-talking conditions to a greater extent than the active
control (visual imagery) intervention. We also predict that our imagined gait intervention
will cognitive performance during dual-task walking conditions. The second aim of this study
is to determine neuroplasticity changes in response to our imagined gait protocol. We predict
that the neural systems engaged during imagined gait will change following our imagined gait
intervention.

Inclusion Criteria:

- Adults between 65 and 85 years and older, residing in the community.

- Able to speak English at a level sufficient to undergo study procedures.

- Plan to be in the area for the next 3 months.

Exclusion Criteria:

- Presence of dementia (telephone-based memory impairment screen < 5 or Ascertain
Dementia 8-item Informant Questionnaire score > 1)

- Presence of gait disorder diagnosed by clinician (e.g. neuropathy).

- Any medical condition or chronic medication use (e.g. neuroleptics) that will
compromise safety or affect cognitive functioning.

- Terminal illness with life expectancy <12 months.

- Progressive, degenerative neurologic disease (e.g. Parkinson's disease, ALS).

- Major psychiatric disorders such as Schizophrenia.

- Pacemaker or any permanent metal implants like hip prosthesis (other than tooth
fillings) and claustrophobia.