Abstract
BackgroundGait is thought to have a cognitive component, but the current evidence in healthy elderly is mixed. We studied the association between multiple gait and cognitive measures in a cohort of older people. MethodsOne hundred and seventy-eight cognitively healthy participants from the Whitehall II Imaging Sub-study had a detailed clinical and neuropsychological assessment, as well as an MRI scan. Spatiotemporal and variability gait measures were derived from two 10 m walks at self-selected speed. We did a linear regression analysis, entering potential confounders with backwards elimination of variables with p ≥ 0.1. The remaining variables were then entered into a second regression before doing a stepwise analysis of cognitive measures, entering variables with p < 0.05 and removing those with p ≥ 0.1. ResultsAmongst absolute gait measures, only greater stride length was associated with better performance on the Trail Making Test A (p = 0.023) and the Boston Naming Test (p = 0.042). The stride time variability was associated with performance on the Trail Making Test A (p = 0.031). Age was associated with poorer walking speed (p = 0.014) and stride time (p = 0.011), female sex with shorter stride time (p = 0.000) and shorter double stance (p = 0.005). Length of full-time education was associated with faster walking speed (p = 0.012) and shorter stride time (p = 0.045), and a history of muscular-skeletal disease with slower walking speed (p = 0.01) and shorter stride length (p = 0.015). Interestingly, volume of white matter hyperintensities (WMH) on FLAIR MRI images did not contribute independently to any of the gait measures (p > 0.05). ConclusionsNo strong relationship between gait and non-motor cognition was observed in a cognitively healthy, high functioning sample of elderly. Nevertheless, we found some relationships with spatial, but not temporal gait which warrant further investigation. WMH made no independent contributionto gait.
Highlights
Gait disorders and cognitive impairment are common in people over the age of 65
We examined the association between cognitive domains and gait parameters in a population-based sample of 241 older adults
The log-transformed coefficient of variation for stride time was associated with performance in the Trail Making Test A, in that greater variability of stride time was associated with longer time needed to complete the trails test
Summary
Gait disorders and cognitive impairment are common in people over the age of 65. There is considerable heterogeneity in cognitive ageing [1], and about 20% of even very old people walk well [2]. There is evidence suggesting that gait measures are differentially related to distinct cognitive processes [4,5,6]. Studying the gait –cognition relationship can provide further insights into shared cognitive and motor networks and identify targets for intervention [5,7,8]. We studied the association between multiple gait and cognitive measures in a cohort of older people. Results: Amongst absolute gait measures, only greater stride length was associated with better performance on the Trail Making Test A (p = 0.023) and the Boston Naming Test (p = 0.042).
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