Gait problems may be an early indicator of cognitive decline, dementia

Impaired quantitative gait precedes cognitive decline and may be a useful indicator for the eventual development of dementia, a recent study has found.

The study included 4,258 participants (median age, 67 years; 55 percent female) who were free of dementia at baseline. Quantitative gait was measured through the GAITRite system, while cognitive assessments were performed using the Stroop colour word test, Letter Digit Substitution Test, Word Fluency Test, 15-Word List Learning Test and Purdue Pegboard Test.

A summary of seven mutually independent gait domains was used for the analysis. Researchers found that baseline impairments in the domains of pace (β, 0.06, 95 percent CI, 0.04–0.09; p<0.001), base of support (β, 0.03, 0.01–0.05; p=0.003) and rhythm (β, 0.02. 0.00–0.04; p=0.02) were significantly correlated with a decline in global cognition.

In particular, pace was associated with a decline in all cognitive tests except for the World Learning Test recognition task. Base of support, on the other hand, was tied to Stroop interference and naming tasks, while rhythm correlated with scores in the Stroop interference task and Word Fluency Test.

Global gait scores were likewise significantly associated with a deterioration of global cognition (β, 0.06, 0.03–0.08; p<0.001).

Over a median follow-up of 4 years, 78 cases of incident dementia were recorded, most of whom (82 percent; n=64) had Alzheimer’s disease. Gait pace (hazard ratio [HR], 1.33, 1.04–1.71; p=0.02) and variability (HR, 1.25, 1.01–1.56; p=0.04) emerged as significant risk factors.

Moreover, each standard-deviation decrease in the global gait score corresponded to a 29-percent increase in the likelihood of incident dementia (HR, 1.29, 1.08–1.54; p=0.006).