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Gait analysis could be used to predict cognitive decline

Global- or domain-specific decline in cognition was associated with and can be predicted by spatial, temporal and spatiotemporal elements of gait, according to study results published in Journal of Alzheimer’s Disease.

“Previous studies reported that slower gait speed might predict cognitive impairment and dementing illnesses, supporting the role of gait speed as a possible subclinical marker of cognitive impairment,” Rodolfo Savica, MD, PhD, of the Department of Health Sciences Research at the Mayo Clinic, and colleagues wrote. “However, the predictive value of other gait parameters for cognitive decline is unclear.”

Savica and colleagues conducted an analysis of a population-based sample to assess whether specific gait parameters were associated with and/or were predictive of cognitive function. In their analysis, researchers studied 3,426 cognitively normal patients aged 70 years to 89 years from the Mayo Clinic Study of Aging. A study coordinator evaluation, neurological examination and a neuropsychological assessment that measured four cognitive domains were performed for each participant at baseline and every 15 months. The mean follow-up duration was 1.93 years.

Researchers used the GAITRite instrument to analyze temporal, spatial and spatiotemporal gait parameters. In addition, they developed general, linear mixed-effects models to calculate the annualized rate of change in cognitive domain z-scores. These models controlled for age, sex, education, depression, comorbidities, BMI, APOE 4 allele and number of visits. Patients with a history of stroke, alcoholism, Parkinson’s disease, subdural hematoma or normal pressure hydrocephalus were excluded.

“We studied gait through time in a group of healthy individuals, and we saw that small changes that are not detectable with the clinician’s eye are associated with a decline in a number of cognitive domains: memory. language, executive function and visuospatial problems,” Savica told Healio Internal Medicine.

Specifically, gait parameters that attributed to the significant reduction in global and specific cognitive domains included ambulatory time, gait speed, step count, cadence, double support time and cadence, as well as higher intra-individual variability in stride length and swing and stance time.

“Gait is a crucial part of our life that requires a perfect integration of many areas of the brain. Thus, it is not surprising that in presence of cognitive decline there also will be the presence of gait abnormalities as result of the ongoing degenerative prices,” Savica told Healio Internal Medicine. “In the future, we would continue to study gait as a possible early and cheap biomarker of cognitive decline.”

“Computerized gait analysis is a simple, noninvasive test that potentially could be used to identify patients at high risk for cognitive decline and to target appropriate therapies,” he concluded. – by Alaina Tedesco

Disclosure: The researchers report receiving support from the National Institutes of Health, the Robert H. and Clarice Smith and Abigail van Buren Alzheimer’s Disease Research Program, as well as the Rochester Epidemiology Project.