Gait Variability and Fall Risk in Older Adults: The Role of Cognitive Function

Pieruccini‐Faria, Frederico; Montero‐Odasso, Manuel; Hausdorff, Jeffrey M.

doi:10.1007/978-3-030-24233-6_7

Cited by 24 publications

(17 citation statements)

References 204 publications

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“…Abnormal gait is prevalent in established dementia, 1 and can also predict progression from normal cognition, cognitive complaints, and mild cognitive impairment (MCI) to dementia syndromes. 2 , 3 , 4 , 5 , 6 , 7 Quantitative gait parameters, particularly the variability in the stride‐to‐stride fluctuations, have been shown to be a sensitive marker of neurological dysfunction 8 , 9 , 10 , 11 , 12 and associated with future mobility disability 13 and incident dementia. 14 , 15 Increased gait variability has been seen especially in neurodegenerative diseases that affect cognition, whereas not in those without cognitive involvement, suggesting that the cortical networks involved in gait control are shared with cognitive processes.…”

Section: Introductionmentioning

confidence: 99%

Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study

Pieruccini‐Faria

Black

Masellis

et al. 2021

Alzheimer's & Dementia

105

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Introduction Gait impairment is common in neurodegenerative disorders. Specifically, gait variability—the stride‐to‐stride fluctuations in distance and time—has been associated with neurodegeneration and cognitive impairment. However, quantitative comparisons of gait impairments across the cognitive spectrum of dementias have not been systematically investigated. Methods Older adults (N = 500) with subjective cognitive impairment, Parkinson disease (PD), mild cognitive impairment (MCI), PD‐MCI, Alzheimer's disease (AD), PD‐dementia, Lewy body dementia, and frontotemporal dementia, as well cognitive normal controls, who were assessed for their gait and cognitive performance. Results Factor analyses grouped 11 quantitative gait parameters and identified four independent gait domains: rhythm, pace, variability, and postural control, for group comparisons and classification analysis. Among these domains, only high gait variability was associated with lower cognitive performance and accurately discriminated AD from other neurodegenerative and cognitive conditions. Discussion Our findings indicate that high gait variability is a marker of cognitive‐cortical dysfunction, which can help to identify Alzheimer's disease dementia.

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Section: Introductionmentioning

confidence: 99%

Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study

Pieruccini‐Faria

Black

Masellis

et al. 2021

Alzheimer's & Dementia

105

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“…Despite the scarcity of research regarding gait assessment in FTD ( 213 ), it has shown to be critical when differentiating between neurodegenerative diseases. For instance, the study developed by Allali et al ( 214 ) found that patients with bvFTD showed an increase in stride time coefficient variation during a single (walking) and dual tasks (walking and counting backward by one) in comparison to the AD group.…”

Section: Resultsmentioning

confidence: 99%

Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges

et al. 2022

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Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.

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“…However, there are significant differences in the age of the elderly with different risks of falling. It demonstrates the view that gait variability will increases with age, leading to a higher risk of falling [37]. The statistical analysis results of the remaining various gait characteristics and terrain tests are described as follows.…”

Section: Resultsmentioning

confidence: 99%

A Novel Environment-Adaptive Timed Up and Go Test System for Fall Risk Assessment With Wearable Inertial Sensors

et al. 2021

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Falls are often accompanied by huge social costs, and fall risk assessment is essential to protect the elderly from serious injuries and reduce financial burdens. The standard timed up and go (TUG) balance assessment test focuses on the total walking time and scenarios without environmental changes, which is flawed in providing rich information related to falls and evaluating the gait adaptability in response to environmental changes. Therefore, a fall risk assessment system that relies on a variable environment is actually needed. Methods: We have constructed an environment-adaptive TUG (EATUG) test system with three terrain surfaces (levels/obstacles/stairs). One hundred and three elderly from Shenzhen Luohu Hospital is recruited to participate in the experiment. The wearable inertial sensors attached to the two shanks are used to acquire data, and the gait parameters that may be related to falls are extracted and quantified. Results: Most of the parameters have significant differences between the high-risk group and the low-risk group (e.g., peak power, maximum radius, double support, etc., p<0.001). In addition, the average sensitivity and specificity of fall risk prediction are 85.7% and 92.9%, while the average accuracy is 9.52% higher than the standard TUG test. Conclusion: The EATUG test system can provide richer gait characteristics and fall-related information, which is a good improvement on the drawbacks of the standard TUG test. Significance: The proposed test system is expected to replace the standard TUG test and be used for fall screening of high-risk elderly in the community to reduce the occurrence of falls. Index Terms-Falls risk assessment; timed up and go (TUG) test; the elderly; wearable inertial sensors; environment-adaptive TUG (EATUG) test.

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Gait Variability and Fall Risk in Older Adults: The Role of Cognitive Function

Cited by 24 publications

References 204 publications

Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study

Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study

Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges

A Novel Environment-Adaptive Timed Up and Go Test System for Fall Risk Assessment With Wearable Inertial Sensors

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