Endurance and gait speed relationships with mild cognitive impairment and dementia

Windham, B. Gwen; Parker, Sara B.; Zhu, Xiaoqian; Gabriel, Kelley Pettee; Palta, Priya; Sullivan, Kevin; Parker, Kirby G.; Knopman, David S.; Gottesman, Rebecca F.; Griswold, Michael; Mosley, Thomas H.

doi:10.1002/dad2.12281

Cited by 9 publications

(6 citation statements)

References 54 publications

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“…Firstly, the receiver operating characteristic (ROC) curve was constructed and the areas under the curves (AUCs) were compared amongst different models. Secondly, using > 5% as the threshold for the group at high risk to develop dementia in 10 years [ 29 ], categorical net reclassification improvement (NRI) was estimated for the added value of selected metabolomic biomarkers for risk stratification over conventional risk factors.…”

Section: Methodsmentioning

confidence: 99%

Plasma metabolomic profiles of dementia: a prospective study of 110,655 participants in the UK Biobank

Zhang

Wang

et al. 2022

BMC Med

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Background Plasma metabolomic profile is disturbed in dementia patients, but previous studies have discordant conclusions. Methods Circulating metabolomic data of 110,655 people in the UK Biobank study were measured with nuclear magnetic resonance technique, and incident dementia records were obtained from national health registers. The associations between plasma metabolites and dementia were estimated using Cox proportional hazard models. The 10-fold cross-validation elastic net regression models selected metabolites that predicted incident dementia, and a 10-year prediction model for dementia was constructed by multivariable logistic regression. The predictive values of the conventional risk model, the metabolites model, and the combined model were discriminated by comparison of area under the receiver operating characteristic curves (AUCs). Net reclassification improvement (NRI) was used to estimate the change of reclassification ability when adding metabolites into the conventional prediction model. Results Amongst 110,655 participants, the mean (standard deviation) age was 56.5 (8.1) years, and 51 186 (46.3%) were male. A total of 1439 (13.0%) developed dementia during a median follow-up of 12.2 years (interquartile range: 11.5–12.9 years). A total of 38 metabolites, including lipids and lipoproteins, ketone bodies, glycolysis-related metabolites, and amino acids, were found to be significantly associated with incident dementia. Adding selected metabolites (n=24) to the conventional dementia risk prediction model significantly improved the prediction for incident dementia (AUC: 0.824 versus 0.817, p =0.042) and reclassification ability (NRI = 4.97%, P = 0.009) for identifying high risk groups. Conclusions Our analysis identified various metabolomic biomarkers which were significantly associated with incident dementia. Metabolomic profiles also provided opportunities for dementia risk reclassification. These findings may help explain the biological mechanisms underlying dementia and improve dementia prediction.

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Section: Methodsmentioning

confidence: 99%

Plasma metabolomic profiles of dementia: a prospective study of 110,655 participants in the UK Biobank

Zhang

Wang

et al. 2022

BMC Med

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“…Impairments in multiple cognitive domains in older adults due to various underlying pathologies (ranging from the effects of aging per se to Alzheimer's disease) were shown to strongly associate with complex alterations in gait (Goldberger et al, 2002;Owings and Grabiner, 2004;Hausdorff, 2005;Hollman et al, 2007;Brach et al, 2008Brach et al, , 2010Montero-Odasso et al, 2014;Rosso et al, 2015;Sorond et al, 2015;Cohen et al, 2016;Moon et al, 2016;Hackett et al, 2018;Öhlin et al, 2020) shown to associate with multifaceted gait abnormalities, including slower speed and balance function (Bäzner et al, 2000;Baezner et al, 2008;de Laat et al, 2010;Choi et al, 2012;Smith et al, 2015;Kim et al, 2016;Pinter et al, 2017a,b;Su et al, 2022). In the past decade, advanced methods of gait research, including approaches to quantify variability and regularity/predictability/probability have been introduced to identify patients at risk for the development of cognitive impairment (Savica et al, 2017;Windham et al, 2022). Studies in preclinical models confirm that CSVD-related cognitive impairment is preceded by subclinical alterations in gait coordination, including increased gait variability, decreased symmetry and decreased orderliness and regularity (Toth et al, 2015;Tarantini et al, 2017;Nyul-Toth et al, 2020.…”

Section: Introductionmentioning

confidence: 99%

Gait variability predicts cognitive impairment in older adults with subclinical cerebral small vessel disease

Mukli

Detwiler

Owens

et al. 2022

Front. Aging Neurosci.

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IntroductionAdvanced methods of gait research, including approaches to quantify variability, and orderliness/regularity/predictability, are increasingly used to identify patients at risk for the development of cognitive impairment. Cerebral small vessel disease (CSVD) is highly prevalent in older adults and is known to contribute to the development of vascular cognitive impairment and dementia (VCID). Studies in preclinical models demonstrate that subclinical alterations precede CSVD-related cognitive impairment in gait coordination. In humans, CSVD also associates with gait abnormalities. The present study was designed to test the hypothesis that increased gait variability and gait asymmetry predict a decline in cognitive performance in older adults with CSVD.MethodsTo test this hypothesis, we compared cognitive performance and gait function in patients with CSVD (age: 69.8 ± 5.3 years; n = 11) and age- and sex-matched control participants (age: 70.7 ± 5.8 years; n = 11). Based on imaging findings, patients with CSVD were identified [presence of white matter hyperintensities plus silent brain infarcts and/or microhemorrhages on magnetic resonance imaging (MRI) assessment]. Cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Gait parameters were measured during the single and dual tasks, during which participants, in addition to the motor task, completed a series of mental arithmetic calculations. Spatial and temporal parameters of gait variability, symmetry, and permutation entropy were determined using a pressure-sensitive gait mat during single and dual cognitive task conditions.ResultsPatients with CSVD exhibited lower performance in a visual learning test (p = 0.030) and in a sustained attention test (p = 0.007). CSVD also affected step time variability (p = 0.009) and step length variability (p = 0.017). Step lengths of CSVD participants were more asymmetric (p = 0.043) than that of controls, while the two groups were statistically similar regarding step time symmetry and entropy of step time and length. Gait variability was inversely associated with sustained attention, especially among CSVD patients, and this relationship was significantly different between the two groups. The association of sustained attention with gait symmetry was also significantly different between the two groups.DiscussionOur findings provide additional evidence in support of the concept that increased gait variability and asymmetry may predict cognitive impairment in older adults with CSVD.

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“…A Kinect v.2 camera (a depth camera from Microsoft corporation) was used to record the participants' gait while performing two different walking tests: a straight and a curved walking test. Each test covered a distance of 10 meters, a recognized standard for reliable gait assessment across populations, including MCI subjects [16][17][18]. For each participant, three trials were conducted on both straight and curved paths, with the mean of these trials calculated to ensure robust gait analysis.…”

Section: Gait Measurementmentioning

confidence: 99%

Curve Walking Reveals More Gait Impairments in Older Adults with Mild Cognitive Impairment than Straight Walking: A Kinect Camera-Based Study

Seifallahi,

Galvin,

Ghoraani

2024

Journal of Alzheimer's Disease Reports

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Background: Mild cognitive impairment (MCI) can be an early sign of Alzheimer’s disease and other types of dementia detectable through gait analysis. Curve walking, which demands greater cognitive and motor skills, may be more sensitive in MCI detection than straight walking. However, few studies have compared gait performance in older adults with and without MCI in these conditions. Objective: To compare the capability of curve and straight walking tests for the detection of MCI among older adults. Methods: We employed a Kinect v.2 camera to record the gait of 55 older adults (30 healthy controls, 25 with MCI) during single-task straight and curve walking tests. We examined 50 gait markers and conducted statistical analyses to compare groups and conditions. The trail was approved with protocol No. IR.SEMUMS.REC.1398.237 by the ethics committee of Semnan University of Medical Sciences in Iran. Results: Older adults with MCI exhibited more compromised gait performance, particularly during curve walking. Curve walking outperformed straight walking in MCI detection, with several gait markers showing significant differences between healthy controls and MCI patients. These markers encompass average velocity, cadence, temporal markers (e.g., gait cycle subphase durations), spatial markers (e.g., foot position changes during gait subphases), and spatiotemporal markers (e.g., step and stride velocities). Conclusions: Our study suggests curve walking as a more informative and challenging test for MCI detection among older adults, facilitating early diagnosis using non-invasive, cost-effective tools like the Kinect v.2 camera, complementing cognitive assessments in early diagnosis, and tracking MCI progression to dementia.

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Endurance and gait speed relationships with mild cognitive impairment and dementia

Cited by 9 publications

References 54 publications

Plasma metabolomic profiles of dementia: a prospective study of 110,655 participants in the UK Biobank

Plasma metabolomic profiles of dementia: a prospective study of 110,655 participants in the UK Biobank

Gait variability predicts cognitive impairment in older adults with subclinical cerebral small vessel disease

Curve Walking Reveals More Gait Impairments in Older Adults with Mild Cognitive Impairment than Straight Walking: A Kinect Camera-Based Study

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