{ "abstract": "Background\n\nGait dysfunction is a preclinical marker of Alzheimer disease (AD) and related dementias (ADRD), often emerging years before clinical diagnosis. While much of the existing literature has focused on the pathological mechanisms driving motor and cognitive decline, the neural and biological substrates that confer resilience against such decline remain poorly understood. Individuals who maintain exceptional gait performance into advanced age, termed Super Movers, represent a unique phenotype of resilient aging. Understanding the biological profile of these individuals offers a unique and largely untapped window into the mechanisms underlying healthy aging and resilience to dementia.Objective\n\nThis study aims to identify the structural, functional, neurophysiological, and molecular brain characteristics that distinguish older adults with exceptional mobility from their usual and slow-moving peers, and to determine whether these characteristics predict cognitive and physical decline over time. We hypothesize that the interplay between protective and pathological mechanisms in aging gives rise to structural, functional, neurophysiological, and molecular brain changes that manifest along a continuum from resilient gait to gait dysfunction.Methods\n\nWe aim to enroll 350 adults aged 65 years and older from community and clinic settings. Participants will be classified by gait speed into fast, usual, and slow movers using age- and sex-specific thresholds; fast movers aged 80 years and older will be designated as Super Movers. All participants will undergo comprehensive assessments at baseline, including brain imaging, mobile electroencephalogram (EEG) recorded during walking, multisensory integration (MSI), comprehensive blood profiling, blood-based markers of neurodegeneration, epigenetic and proteomic aging clocks, and detailed cognitive testing. Follow-up assessments will be conducted annually in person and every 6 months by telephone.Results\n\nThis study was funded by the National Institute on Aging (R01AG089096; PI: Joe Verghese) and has received Institutional Review Board (IRB) approval from Stony Brook University. Enrollment is currently underway.Conclusions\n\nFast and Super Movers are expected to demonstrate distinct neural substrates, EEG activation signatures, and favorable biomarker profiles relative to usual and slow movers. By shifting the scientific focus from the biology of gait decline toward the biology of gait resilience, this protocol is uniquely positioned to advance our understanding of healthy aging and inform novel strategies for dementia prevention.", "abstract_shown": true, "affiliations": [ "Department of Neurology, Renaissance School of Medicine, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY, 11794, United States, 1 631-216-9370.", "Department of Molecular Biology, Kannur University, Kannur, Keralam, India.", "Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.", "Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia.", "Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.", "Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States.", "Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States." ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Chathathayil Mohammedali Shafeeque", "orcid": "0000-0003-2795-8086" }, { "affs": [ 0 ], "name": "Kelly Cotton", "orcid": "0000-0001-9014-9762" }, { "affs": [ 1 ], "name": "Sanish Sathyan", "orcid": "0000-0002-8127-1835" }, { "affs": [ 0 ], "name": "Emmeline I Ayers", "orcid": "0000-0002-5061-3708" }, { "affs": [ 0 ], "name": "Valerie Nunez", "orcid": "0000-0001-9267-072X" }, { "affs": [ 2, 3 ], "name": "Uros Marusic", "orcid": "0000-0002-7420-2137" }, { "affs": [ 4 ], "name": "Erica F Weiss", "orcid": "0000-0002-0726-7547" }, { "affs": [ 5 ], "name": "Daliah Ross", "orcid": "0000-0002-0577-7578" }, { "affs": [ 6 ], "name": "Jie Yang", "orcid": "0000-0003-3469-5931" }, { "affs": [ 0 ], "name": "Helena M Blumen", "orcid": "0000-0002-0275-6616" }, { "affs": [ 0 ], "name": "Jeannette R Mahoney", "orcid": "0000-0003-1079-787X" }, { "affs": [ 0 ], "name": "Joe Verghese", "orcid": "0000-0003-4252-2547" } ], "bibtex": "https://research.draconitic.com/paper/62zkj7859zr2g.bib", "cited_by": 0, "doi": "10.2196/104520", "fulltext_url": "https://europepmc.org/articles/PMC13722142", "id": "62zkj7859zr2g", "issns": [ "1929-0748" ], "landing_url": "https://europepmc.org/article/MED/42962081", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Advancements in Neuroimaging" ], [ "heading", "Dementia and Cognitive Decline" ], [ "heading", "Frailty Detection, Assessment and Prediction" ], [ "heading", "NIH funded proposals with peer-review reports (USA)" ], [ "heading", "Participatory Research Protocols and Proposals" ], [ "heading", "Physical Activity for Older People" ], [ "heading", "Protocol" ], [ "heading", "Signal Processing" ], [ "lcc", "R" ], [ "lcc", "R858-859.7" ], [ "openalex", "3612|Balance, Gait, and Falls Prevention" ] ], "openalex": "W7214744126", "pdf_url": "https://europepmc.org/articles/PMC13722142?pdf=render", "pmcid": "PMC13722142", "pmid": "42962081", "published": "2026-10-01", "publisher": "JMIR Publications Inc.", "ris": "https://research.draconitic.com/paper/62zkj7859zr2g.ris", "sources": [ { "first_seen": "2026-11-02T03:21:21Z", "native_id": "MED:42962081", "source": "europepmc", "url": "https://europepmc.org/article/MED/42962081" }, { "first_seen": "2026-11-03T12:22:42Z", "native_id": "PMC13722142", "source": "pmc", "url": "https://doi.org/10.2196/104520" }, { "first_seen": "2026-11-07T14:21:03Z", "native_id": "97436740d9ce444ba5913a0515b8bab2", "source": "doaj", "url": "https://doi.org/10.2196/104520" } ], "subjects": [ { "field": "medicine", "origin": "lcc:R", "subfield": "general" } ], "title": "An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.", "title_text": "An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.", "type": "peer-reviewed", "updated_at": "2026-11-08T14:20:31Z", "url": "https://research.draconitic.com/paper/62zkj7859zr2g", "venue": "JMIR research protocols", "versions": [] }