# The influence of asthma on walking in older adults: brain predictors, medication adherence and asthma control

> **NIH NIH R01** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2024 · $755,336

## Abstract

The increased prevalence of asthma among older adults and its associations with multiple adverse health
outcomes including poor cognition are of significant public health concern. Walking is a robust measure of health
across healthy and disease populations. Mobility impairments are common, debilitating and predictive of poor
health outcomes. Scarce literature suggests that asthma is associated with self-reported and performance-based
mobility limitations among older adults but putative mechanisms that may underlie this relationship have not
been identified. The current proposal aims to address this critical gap in knowledge by examining neurological
(e.g., gray matter volume and thickness, white matter integrity) and behavioral processes (e.g., medication
adherence) involved in the influence of asthma on walking. Specifically, we aim to focus on asthma-related
modifiable factors that are amenable to biobehavioral interventions. The fronto-striatal circuitry, critical for brain
control of locomotion, is disrupted in asthma suggesting its key role in asthma-related mobility impairments. Poor
controller medication adherence and reduced asthma control are proposed as mechanistic targets implicated in
mobility impairments in older persons with asthma (OPWA). We aim to use a validated dual-task walking
paradigm predictive of health outcomes, a burst measurement (i.e., repeated trials) design, and functional-near-
infrared spectroscopy (fNIRS) to determine the influence of asthma on brain activation levels and trajectories of
walking in 120 OPWA (age 60-80 years) and 120 controls without asthma. We will use multiple MRI methods to
determine disruptions in the fronto-striatal circuitry to identify mechanisms of brain control of walking in OPWA.
Furthermore, we will examine the impact of a 30-day medication adherence protocol and repeated asthma
control assessments (pulmonary function, self-report) on walking performance and its associated brain activation
patterns and learning trajectories. Brain activation patterns and learning trajectories of walking and
improvements in their efficiency due to practice may be novel biomarkers to identify OPWA at risk of developing
mobility impairments as they survive into older age. Such findings, their underlying asthma-specific fronto-striatal
circuitry disruptions, and variability in controller medication adherence and asthma control will inform bio-
behavioral interventions to improve walking, prevent mobility impairments, and improve related health outcomes
among OPWA.

## Key facts

- **NIH application ID:** 10879508
- **Project number:** 1R01HL169316-01A1
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** JONATHAN M. FELDMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $755,336
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10879508

## Citation

> US National Institutes of Health, RePORTER application 10879508, The influence of asthma on walking in older adults: brain predictors, medication adherence and asthma control (1R01HL169316-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10879508. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*