Changes in executive function and gait in people with mild cognitive impairment and Alzheimer disease.

Natália Oiring De Castro Cezar,Danielle Chagas Pereira Da Silva,Juliana Hotta Ansai,Francisco Assis Carvalho Vale,Larissa Pires De Andrade,Marcos Paulo Braz De Oliveira,Anielle Cristhine De Medeiros Takahashi

doi:10.1590/1980-57642021dn15-010006

Abstract

ABSTRACT.Changes in executive function and motor aspects can compromise the prognosis of older adults with mild cognitive impairment (MCI) and favor the evolution to dementia.Objectives:The aim of this study was to investigate the changes in executive function and gait and to determine the association between changes in these variables.Methods:A 32-month longitudinal study was conducted with 40 volunteers: 19 with preserved cognition (PrC), 15 with MCI and 6 with Alzheimer disease (AD). Executive function and gait speed were assessed using the Frontal Assessment Battery, the Clock-Drawing test and the 10-meter walk test. For data analysis, the Pearson product-moment correlation, two-way repeated-measures ANOVA, and chi-square were conducted.Results:After 32 months, an improvement in the executive function was found in all groups (p=0.003). At baseline, gait speed was slower in individuals with MCI and AD compared to those with PrC (p=0.044), that was maintained after the follow-up (p=0.001). There was significant increase in number of steps in all groups (p=0.001). No significant association was found between changes in gait speed and executive function.Conclusions:It should be taken into account that gait deteriorates prior to executive function to plan interventions and health strategies for this population.

Highlights

Older adults with mild cognitive impairment (MCI) and Alzheimer disease (AD) experience changes in executive function (EF),[1,2] which are more pronounced in the latter group.[3]
One hundred and twenty-four volunteers were evaluated at baseline: 46 with preserved cognition (PrC), 40 with MCI, and 38 with mild AD
After a 32-month follow-up, the dropout rate was 67.74% (n=84) due to deaths (15.47%), lack of willingness to participate in the follow-up evaluation (21.43%), change of address to a different city (4.76%), having become bedridden (2.39%), having become wheelchair-bound (2.39%), claimed disease (15.47%), disinterest (21.43%), and loss of contact via telephone or residence (16.66%)

Summary

Introduction

Older adults with mild cognitive impairment (MCI) and Alzheimer disease (AD) experience changes in executive function (EF),[1,2] which are more pronounced in the latter group.[3] EF is a broad term related to planning, working memory, cognitive flexibility, monitoring, decision-making, and the ability to solve novel problems.[4]. A relationship has been found between changes in gait and EF in older adults with cognitive impairment[9,10] and those with AD in the mild and moderate phases.[6] A poorer performance regarding EF measures is associated with a shorter step length and width as well as slower gait.[11] In a study with a 23-month follow-up, reductions in cadence (number of steps per minute) and gait speed (GS) were associated with global cognitive decline and diminished EF in older adults with PrC.[12]

Objectives

Methods

Results

Conclusion