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 Gait Change Linked To Cognitive Function

New research suggests that earlier detection of Alzheimer’s disease may be possible by studying the proven link between gait and cognitive functions. At its 2012 International Conference last week, the Alzheimer’s Association (ALZ) highlighted five recent studies that explored this relation and reported similar findings.

“Observing and measuring gait changes could be a valuable tool for signaling the need for further cognitive evaluation,” said William Thies, PhD, and ALZ chief medical and scientific officer. Measuring gait changes “doesn’t require any expensive technology or take a lot of time to assess.”

The Basel Mobility Center in Switzerland separated 1,153 participants, whose average age was 77, into three groups based on their cognitive diagnosis: cognitively healthy; mild cognitive impairment (MCI); or Alzheimer’s dementia, with the last group subdivided into mild, moderate, or severe.
Researchers measured speeds of participants asked to perform one “normal” walk in comparison to a second walk in which participants also performed a cerebral task like naming animals or counting backwards out loud.

While scientists reported slower walking speeds for all groups that performed dual tasks, “those with Alzheimer’s dementia walked slower than those with MCI, who in turn walked slower than those who were cognitively healthy,” said Stephanie Bridenbaugh, MD, of the Basel Mobility Center, and lead researcher of the study.

The Mayo Clinic Study of Aging (MCSA) found comparable results in its study, which tracked more than 1,341 elderly participants’ velocity, cadence, and stride length, in addition to measuring affiliated neurological factors, including language, memory, and executive functioning. The participants were evaluated at two visits about 15 months apart. Researchers determined that those who demonstrated lower gait mobility commonly suffered from declines in cognition, memory, and executive function.

Interestingly, a research team at Erasmus MC in the Netherlands identified relationships between several gait factors, like walking pace or rhythm, and specific cognitive domains. Mohammad Ikram, MD, PhD, and his colleagues found that the speed at which participants processed information, for example, was directly associated with the rhythm aspect of their gait testing.

Oregon Health & Science University in Portland hypothesized that a disparity existed between walking strides measured on one occasion in medical offices versus everyday paces at home, monitored over time. To prove their claim, researchers utilized an in-home assessment system that continuously tracked participants’ walking speeds for one month. Lisa Silbert, MD, MCR, concluded that study participants walked more slowly in their homes, suggesting that conclusions reached over singular measurements of gait may present an inaccurate perspective of a participant’s overall cognitive function.

In Japan, The Kurihara Project measured cognitive and gait factors in 525 participants aged 75 and older. Kenichi Meguro and colleagues determined that “gait velocity was significantly decreased as the severity of dementia symptoms increased.” He concluded, “Gait should no longer be considered a simple, automatic, motor activity that is independent of cognition. They are linked.
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