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Peer-reviewedCC BYJMIR research protocols

An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.

7 affiliations
  1. 1Department of Neurology, Renaissance School of Medicine, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY, 11794, United States, 1 631-216-9370.
  2. 2Department of Molecular Biology, Kannur University, Kannur, Keralam, India.
  3. 3Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.
  4. 4Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia.
  5. 5Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.
  6. 6Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States.
  7. 7Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States.

Abstract

Background

Gait 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

This 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

We 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

This 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

Fast 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.

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BibTeX
@article{shafeeque2026exceptional,
  title = {{An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.}},
  author = {Chathathayil Mohammedali Shafeeque and Kelly Cotton and Sanish Sathyan and Emmeline I Ayers and Valerie Nunez and Uros Marusic and Erica F Weiss and Daliah Ross and Jie Yang and Helena M Blumen and Jeannette R Mahoney and Joe Verghese},
  journal = {JMIR research protocols},
  year = {2026},
  month = oct,
  doi = {10.2196/104520},
  url = {https://europepmc.org/article/MED/42962081},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.
AU  - Chathathayil Mohammedali Shafeeque
AU  - Kelly Cotton
AU  - Sanish Sathyan
AU  - Emmeline I Ayers
AU  - Valerie Nunez
AU  - Uros Marusic
AU  - Erica F Weiss
AU  - Daliah Ross
AU  - Jie Yang
AU  - Helena M Blumen
AU  - Jeannette R Mahoney
AU  - Joe Verghese
PY  - 2026
DA  - 2026/10/01
JO  - JMIR research protocols
DO  - 10.2196/104520
UR  - https://europepmc.org/article/MED/42962081
AB  - Background  Gait 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  This 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  We 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  This 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  Fast 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.
SN  - 1929-0748
ER  -