Abstract
BackgroundGait characteristics measured at usual pace may allow profiling in patients with cognitive problems. The influence of age, gender, leg length, modified speed or dual tasking is unclear.MethodsCross-sectional analysis was performed on a data registry containing demographic, physical and spatial-temporal gait parameters recorded in five walking conditions with a GAITRite® electronic carpet in community-dwelling older persons with memory complaints. Four cognitive stages were studied: cognitively healthy individuals, mild cognitive impaired patients, mild dementia patients and advanced dementia patients.ResultsThe association between spatial-temporal gait characteristics and cognitive stages was the most prominent: in the entire study population using gait speed, steps per meter (translation for mean step length), swing time variability, normalised gait speed (corrected for leg length) and normalised steps per meter at all five walking conditions; in the 50-to-70 years old participants applying step width at fast pace and steps per meter at usual pace; in the 70-to-80 years old persons using gait speed and normalised gait speed at usual pace, fast pace, animal walk and counting walk or steps per meter and normalised steps per meter at all five walking conditions; in over-80 years old participants using gait speed, normalised gait speed, steps per meter and normalised steps per meter at fast pace and animal dual-task walking. Multivariable logistic regression analysis adjusted for gender predicted in two compiled models the presence of dementia or cognitive impairment with acceptable accuracy in persons with memory complaints.ConclusionGait parameters in multiple walking conditions adjusted for age, gender and leg length showed a significant association with cognitive impairment. This study suggested that multifactorial gait analysis could be more informative than using gait analysis with only one test or one variable. Using this type of gait analysis in clinical practice could facilitate screening for cognitive impairment.
Highlights
Gait is a complex action composed of a cyclic movement, changing support and balance from one foot to the other
Multivariable logistic regression analysis adjusted for gender predicted in two compiled models the presence of dementia or cognitive impairment with acceptable accuracy in persons with memory complaints
We explored if the use of different walking conditions had additional value in screening and predicting the presence of cognitive impairment
Summary
Gait is a complex action composed of a cyclic movement, changing support and balance from one foot to the other. It is influenced by muscular strength and performance, peripheral neuronal activation and control, and by central neural commanding control [1,2]. Gait speed is proposed as a screening criterion for cognitive decline in Motor Cognitive Risk (MCR) Syndrome and mild cognitive impairment (MCI) [6]. The MCR subjects were detectible due to their lower gait speed at usual pace. Using gait characteristics that are related to specific neurologic regions in the brain affected by dementia may result in higher sensitivity and/or specificity to detect the cognitive declining subjects. The influence of age, gender, leg length, modified speed or dual tasking is unclear.
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