Gait phenotype from mild cognitive impairment to moderate dementia: results from the GOOD initiative

Abstract

Background The differences in gait abnormalities from the earliest to the latter stages of dementia and in the different subtypes of dementia have not been fully examined. This study aims to compare spatio-temporal gait parameters in cognitively healthy individuals, patients with amnestic (aMCI) and non-amnestic (naMCI) MCI, and patients with mild and moderate stages of Alzheimer’s disease (AD) and non-Alzheimer’s disease (non-AD). Methods Based on a cross-sectional design, 1719 participants (77.4±7.3 years, 53.9% female) were recruited from cohorts from seven countries participating in the “Gait, cOgnitiOn & Decline” initiative. Mean values and coefficients of variation of spatio-temporal gait parameters were measured during normal pace walking with the GAITRite system at all sites. Results Performance of spatio-temporal gait parameters declined in parallel to the stage of cognitive decline from MCI status to moderate dementia. Gait parameters of patients with naMCI were more disturbed compared to patients with aMCI, and MCI subgroups performed better than demented patients. Patients with non-AD dementia had worse gait performance than those with AD dementia. This degradation of the gait parameters was similar between mean values and coefficients of variation of spatio-temporal gait parameters in the earliest stages of cognitive decline, but different in the most advanced stages, especially in the non-AD subtypes. Conclusions Spatio-temporal gait parameters were more disturbed in the advanced stages of dementia, and more affected in the non-AD dementias than in AD. These findings suggest that quantitative gait parameters could be used as a surrogate marker for improving the diagnosis of dementia.

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis

“…5–7 Recently, it has been reported, in a sample of 1719 participants (77.4 ± 7.3 years, 53.9% female) separated into cognitively healthy individuals, patients with amnestic and nonamnestic MCI, and patients with mild and moderate stages of AD and non-AD, that performance of spatiotemporal gait parameters declined in parallel to the stage of cognition, from MCI to moderate dementia. 38 Gait parameters of patients with nonamnestic MCI were more disturbed compared with patients with amnestic MCI; MCI subgroups performed better than demented patients. 38 …”

“…38 Gait parameters of patients with nonamnestic MCI were more disturbed compared with patients with amnestic MCI; MCI subgroups performed better than demented patients. 38 …”

Association of increased gait variability while dual tasking and cognitive decline: results from a prospective longitudinal cohort pilot study

“…To the best of our knowledge, this study is the first to report that dual task-related increase in stride time mean value and variability predicts cognitive decline. Cognition and locomotion are two human abilities controlled by the brain Allali et al 2016;Seidler et al 2010;Zijlstra et al 2008). Their decline is highly prevalent with physiological and pathological aging, and is greater than the simple sum of their respective prevalence, suggesting a complex age-related interplay between cognition and locomotion Allali et al 2016;Seidler et al 2010).…”

“…Cognition and locomotion are two human abilities controlled by the brain Allali et al 2016;Seidler et al 2010;Zijlstra et al 2008). Their decline is highly prevalent with physiological and pathological aging, and is greater than the simple sum of their respective prevalence, suggesting a complex age-related interplay between cognition and locomotion Allali et al 2016;Seidler et al 2010). Both declines in cognition and locomotion are associated and the temporal nature of their association has been unclear for a long time Seidler et al 2010).…”

“…Over the past 10 years, an accumulation of data highlights the evidence that a strong relationship exists between gait and cognition in two specific ways Allali et al 2016;Seidler et al 2010). First, an association has been identified with the changes in gait performance while dual tasking (Zijlstra et al 2008;Chu et al 2013;Montero-Odasso et al 2012).…”