Functional parameters indicative of mild cognitive impairment: a systematic review using instrumented kinematic assessment

Iván José Fuentes-Abolafio,Brendon Stubbs,Luis Miguel Pérez-Belmonte,María Rosa Bernal-López,Antonio Cuesta-Vargas,Ricardo Gómez-Huelgas

doi:10.1186/s12877-020-01678-6

Abstract

BackgroundPatients with mild cognitive impairment (MCI) experience alterations of functional parameters, such as an impaired balance or gait. The current systematic review set out to investigate whether functional objective performance may predict a future risk of MCI; to compare functional objective parameters in patients with MCI and a control group; and to assess changes in these parameters after different physical activity interventions.MethodsElectronic databases, including PubMed, AMED, CINAHL, EMBASE, PEDro and Web of Science as well as grey literature databases, were searched from inception to February 2020. Cohort studies and Randomized Controlled Trials (RCTs) were included. The risk of bias of the included studies was assessed independently by reviewers using quality assessment checklists. The level of evidence per outcome was assessed using the GRADE criteria.ResultsSeventeen studies met inclusion criteria including patients with MCI. Results from RCTs suggested that gait speed, gait variability and balance may be improved by different physical activity interventions. Cohort studies showed that slower gait speed, above all, under Dual Task (DT) conditions, was the main impaired parameter in patients with MCI in comparison with a Control Gorup. Furthermore, cohort studies suggested that gait variability could predict an incident MCI. Although most of included cohort studies reported low risk of bias, RCTs showed an unclear risk of bias.ConclusionsStudies suggest that gait variability may predict an incident MCI. Moreover, different gait parameters, above all under DT conditions, could be impaired in patients with MCI. These parameters could be improved by some physical activity interventions. Although cohort studies reported low risk of bias, RCTs showed an unclear risk of bias and GRADE criteria showed a low level of evidence per outcome, so further studies are required to refute our findings.ProsperoCRD42019119180.

Highlights

Patients with mild cognitive impairment (MCI) experience alterations of functional parameters, such as an impaired balance or gait
Accepted diagnosis criteria of MCI reported that patients with MCI were characterized by an objective impairment of cognition that is often not severe enough to interfere with activities of daily living (ADL), instrumental activities of daily living (IADL) or in social or occupational functioning [5, 8, 10,11,12,13,14, 17,18,19,20,21]
Functional kinematic parameters were obtained by wearable sensors, tri-axial accelerometers, digital balance platform, motion and contact sensors, cameras and electronic walkways such as the GAIT Rite

Summary

Introduction

Patients with mild cognitive impairment (MCI) experience alterations of functional parameters, such as an impaired balance or gait. Patients with MCI may have problems in functional tasks [5] and it has been reported that these patients present the alteration of functional parameters, such as mobility, muscle strength, balance, gait dysfunction, or increased risk of falls [8, 22,23,24,25,26]. Veronese et al [30] showed an association between decreased gait speed and low performance in the Short Physical Performance Battery (SPPB) and cognitive decline Other functional tests, such as Timed Up Go (TUG), Hand Grip Strength Test (HGST), Sit to Stand Test (STS), or Walking Speed Test (WST), have been used to demonstrate the association between the performance on functional tests and MCI [22, 30, 37, 38]

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