Quantitative gait analysis in mild cognitive impairment, dementia, and cognitively intact individuals: a cross-sectional case–control study

Abstract

Background Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate between the three cognitive status groups. Methods Ninety-three older adults were screened and classified into three groups; mild cognitive impairment (MCI) (n = 32), dementia (n = 31), and a cognitively intact (n = 30). Spatiotemporal gait variables were assessed under single- and dual-tasks using an objective platform system. Effects of cognitive status and walking task were analyzed using a two-way ANCOVA. Sub-comparisons for between- and within-group were performed by one-way ANCOVA and Paired t-tests. Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was used to discriminate between three groups on gait variables. Results There were significant effects (P < 0.05) of cognitive status during both single and dual-task walking in several variables between the MCI and dementia and between dementia and cognitively intact groups, while no difference was seen between the MCI and cognitively intact groups. A large differentiation effect between the groups was found for step length, stride length, and gait speed during both conditions of walking. Conclusions Spatiotemporal gait variables showed discriminative ability between dementia and cognitively intact groups in both single and dual-tasks. This suggests that gait could potentially be used as a clinical differentiation marker for individuals with cognitive problems.

Extracted step parameters during the Timed Up and Go test discriminate between groups with different levels of cognitive ability - A cross-sectional study.

“…With some variation, there was an overall trend that groups with more severe cognitive impairment walked with shorter steps both during the TUG condition and the two TUGdt conditions. These results are in accordance with previous studies where shorter stride/step length has been found to occur in groups with dementia compared to MCI and/or controls [10,38] as well as between people with MCI and controls [39]. However, those studies were conducted while participants performed straight, overground walking, primarily in movement laboratory settings.…”

“…In addition, assessments have generally been conducted in motion laboratory settings (i.e. advanced equipment) [10,12,15] or have been conducted in clinical settings requiring spacious environments [13], which may not be available in most clinical facilities and therefore hampers potential for implementation. Also, few studies have been able to discriminate between different groups with less severe impairment (i.e.…”

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

“…This study underscores the potential of curved path walking as a valuable tool for early MCI detection, a crucial step in enhancing patient care and intervention strategies. Despite previous research highlighting dual-task walking’s importance in dementia [ 49, 50 ], some studies found no significant difference in MCI detection using dual-task straight walking [ 51, 52 ]. Our findings suggest curved path walking may be more sensitive for MCI detection, indicating that integrating cognitive tasks with curved walking could improve diagnostic accuracy.…”

A novel dual-task paradigm with story recall shows significant differences in the gait kinematics in older adults with cognitive impairment: A cross-sectional study

“… Ghoraani et al (2021) , Montero-Odasso et al (2020) , and Ramírez and Gutiérrez (2021) have all shown that slowed gait speed while dual-tasking can not only differentiate MCI from NC individuals, but can also predict its progression to dementia. A recent study showed that most of the spatiotemporal gait variables could discriminate between dementia and cognitively intact individuals under single and dual tasks ( Bovonsunthonchai et al, 2022 ). The DT in this study is counting backward which is similar to the DT calculation in our study.…”