This protocol describes the Super Movers Study, which will enroll 350 adults aged 65 and older to identify the structural, functional, neurophysiological, and molecular brain characteristics that distinguish exceptional-mobility older adults (fast movers, and Super Movers aged 80 and older) from usual and slow movers, and whether these characteristics predict cognitive and physical decline.
Key Findings
Background
The paper is a study protocol, so no outcome data are reported; the study aims to shift focus from the biology of gait decline to the biology of gait resilience.
Gait dysfunction is described as a preclinical marker of Alzheimer disease and related dementias (ADRD), often emerging years before clinical diagnosis.
The neural and biological substrates that confer resilience against motor and cognitive decline are described as poorly understood.
Individuals who maintain exceptional gait performance into advanced age are termed 'Super Movers' and represent a phenotype of resilient aging.
Background
The study's aim is to identify brain characteristics that distinguish older adults with exceptional mobility from usual and slow-moving peers and to determine whether they predict cognitive and physical decline over time.
Characteristics examined are structural, functional, neurophysiological, and molecular.
The hypothesis is that interplay between protective and pathological aging mechanisms produces brain changes along a continuum from resilient gait to gait dysfunction.
Methods
The study plans to enroll 350 adults aged 65 and older from community and clinic settings and classify them by gait speed using age- and sex-specific thresholds.
Participants are classified as fast, usual, or slow movers.
Fast movers aged 80 years and older are designated as Super Movers.
Enrollment is currently underway.
Methods
The baseline assessment battery is comprehensive, covering imaging, mobile EEG during walking, multisensory integration, blood profiling, biomarkers, aging clocks, and cognitive testing.
Baseline assessments include brain imaging, mobile EEG recorded during walking, and multisensory integration (MSI).
Blood measures include comprehensive blood profiling, blood-based markers of neurodegeneration, and epigenetic and proteomic aging clocks.
Detailed cognitive testing is also performed at baseline.
Methods
Follow-up is planned annually in person and every 6 months by telephone to assess cognitive and physical decline.
In-person assessments are annual.
Telephone assessments occur every 6 months.
Methods
The study is funded by the National Institute on Aging and approved by the Stony Brook University IRB.
Funding grant: R01AG089096; PI: Joe Verghese.
IRB approval was received from Stony Brook University.
Conclusions
The investigators expect Fast and Super Movers to show distinct neural substrates, EEG activation signatures, and favorable biomarker profiles relative to usual and slow movers.
This is an expected outcome (hypothesis), not an observed result.
The protocol is positioned to advance understanding of healthy aging and inform dementia prevention strategies.
What This Means
This paper describes the plan for a study, not its results. The Super Movers Study will look at older adults who keep walking quickly well into old age, especially those aged 80 and older, to understand what is different about their brains and bodies. Slower walking is known to be an early warning sign of memory and thinking problems such as Alzheimer disease, but much less is known about what helps some people stay mobile and resilient.
The researchers plan to enroll 350 adults aged 65 and older and sort them into fast, usual, and slow walkers based on age- and sex-specific speed cutoffs. Participants will have brain scans, brain activity recordings while walking, tests of how the senses work together, blood tests for markers of brain disease and biological aging, and detailed thinking tests. They will be followed with yearly visits and phone calls every six months to see who experiences declines in thinking or physical function.
This research suggests a shift in approach: studying what protects people rather than only what goes wrong. The researchers expect fast walkers and Super Movers to show distinct brain features and healthier biological markers, but this remains to be tested. If confirmed, the findings could help guide future strategies for preventing dementia. Enrollment is underway, so no conclusions can be drawn yet.
Shafeeque C, Cotton K, Sathyan S, Ayers E, Nunez V, Marusic U, et al.. (2026). An Exceptional Mobility Group Among Older Adults: Protocol for the Super Movers Study.. JMIR research protocols. https://doi.org/10.2196/104520