Dementia risk significantly increases with combined gait speed, memory decline
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Combined declines in gait speed and memory were associated with an increased risk for dementia among older adults who had not previously showed signs of the condition, according to a study published in JAMA Network Open.
“Older adults whose walking (gait) and memory abilities decline with age have a higher risk of dementia than peers who decline in just one of these conditions,” Qu Tian, PhD, MS, a staff scientist for the National Institute on Aging, told Healio Primary Care. “Older persons with dual decline in memory and gait speed should receive further attention to address issues that may increase dementia risk, including cardiovascular and metabolic risk factors.”
Tian and colleagues conducted a multicohort meta-analysis of six prospective cohort studies performed between 1997 and 2019 in the United States and Europe. All participants were aged 60 years or older with a baseline gait speed of 0.6 m/s, which indicated that they did not have a dismobility. Those who developed dementia had multiple measures of their gait speed and memory testing completed before diagnosis.
Researchers defined declined gait speed as a loss of 0.05 m/s each year, and memory decline as being in the lowest tertile of annualized change in each study. They divided participants into four groups — those with memory decline only, gait speed decline only, dual decline and no decline.
A total of 8,699 participants were included in the analyses. Their mean gait speed ranged from 1.05 m/s to 1.26 m/s, and the incidence of dementia ranged from five to 21 per 1,000 person-years across the studies.
Compared with those without decline, Tian and colleagues found that the risk for developing dementia was 2.1 to 4.6 times greater among participants with memory decline alone (pooled HR = 3.45; 95% CI, 2.45-4.86) and 2.2 to 3.6 times greater among those with gait decline alone (pooled HR = 2.24; 95% CI, 1.62-3.09).
Participants who experienced declines in both memory and gait speed during follow-up had a 5.2 to 11.7 times greater risk for developing dementia (pooled HR = 6.28; 95% CI, 4.56-8.64) compared with patients who did not experience decline.
Tian recommended that physicians with patients who have memory decline should assess their gait speed because “the dual decline phenotype can be captured early in clinical settings by routinely administering gait speed assessment and a free recall memory test.”
Additionally, she noted that patients with dual declines “should be carefully evaluated for potentially reversible risk factors for dementia, such as cardiovascular and metabolic risk factors.”– by Erin Michael
Disclosures: Tian reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.