Reduced Walking Speed in Subjective and Mild Cognitive Impairment: A Cross-Sectional Study

Knapstad, Mari Kalland; Steihaug, Ole Martin; Aaslund, Mona Kristin; Nakling, Arne; Naterstad, Ingvill Fjell; Fladby, Tormod; Aarsland, Dag; Giil, Lasse Melvær

doi:10.1519/jpt.0000000000000157

Cited by 37 publications

(47 citation statements)

References 43 publications

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“…This is one of the first studies in the literature to assess the longitudinal relationship between slow gait speed and cognitive function in those with a diagnosis of AD At baseline, the only significant predictors of slow gait speed were greater age and poorer cognition in multivariate analysis. This finding is noteworthy and is largely consistent with previous studies in the literature which have demonstrated a relationship between cognitive function and gait speed in a cross-sectional manner in those with AD [17][18][19].…”

Section: Discussionsupporting

confidence: 92%

“…Whilst the evidence for the relationship between slow gait speed and later dementia risk is mounting, the relationship between gait speed and cognitive trajectories in those with Alzheimer Disease (AD) is less clear. Whilst a handful of studies have evaluated the association between gait speed and dementia in cross-section [17][18][19], longitudinal analyses are limited. A notable study has demonstrated a decline in gait speed associated with clinical progression in those with Mild Cognitive Impairment (MCI) [20].…”

Section: Introductionmentioning

confidence: 99%

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Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

2020

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Background: Previous evidence suggests that slower gait speed is longitudinally associated with cognitive impairment, dementia and falls in older adults. Despite this, the longitudinal relationship between gait speed, cognition and falls in those with a diagnosis of dementia remains poorly explored. We sought to assess this longitudinal relationship in a cohort of older adults with mild to-moderate Alzheimer Disease (AD). Methods: Analysis of data from NILVAD, an 18-month randomised-controlled trial of Nilvadipine in mild to moderate AD. We examined: (i) the cross-sectional (baseline) association between slow gait speed and cognitive function, (ii) the relationship between baseline slow gait speed and cognitive function at 18 months (Alzheimer Disease Assessment Scale, Cognitive Subsection: ADAS-Cog), (iii) the relationship between baseline cognitive function and incident slow gait speed at 18 months and finally (iv) the relationship of baseline slow gait speed and incident falls over the study period. Results: Overall, one-tenth (10.03%, N = 37/369) of participants with mild-to-moderate AD met criteria for slow gait speed at baseline and a further 14.09% (N = 52/369) developed incident slow gait speed at 18 months. At baseline, there was a significant association between poorer cognition and slow gait speed (OR 1.05, 95% CI 1.01-1.09, p = 0.025). Whilst there was no association between baseline slow gait speed and change in ADAS-Cog score at 18 months, a greater cognitive severity at baseline predicted incident slow gait speed over 18 months (OR 1.04, 1.01-1.08, p = 0.011). Further, slow gait speed at baseline was associated with a significant risk of incident falls over the study period, which persisted after covariate adjustment (IRR 3.48, 2.05-5.92, p < 0.001). Conclusions: Poorer baseline cognition was associated with both baseline and incident slow gait speed. Slow gait speed was associated with a significantly increased risk of falls over the study period. Our study adds further evidence to the complex relationship between gait and cognition in this vulnerable group and highlights increased falls risk in older adults with AD and slow gait speed. Trial registration: Secondary analysis of the NILVAD trial (Clincaltrials.gov NCT02017340; EudraCT number 2012-002764-27). First registered: 20/12/2013.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

2020

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“…Two studies found an association between changes in gait and EF, 12,46 however, the divergent results of the present investigation may have occurred because the authors used instruments to assess EF and gait variables different from those used in this study investigation. The literature shows that in addition to the consistency in the results and quality of the studies, there seems to be variations in the results according to the instrument chosen for the evaluation, sample size, population studied, and the evolution of cognitive impairment in the volunteers.…”

Section: Discussioncontrasting

confidence: 58%

“…The literature shows that in addition to the consistency in the results and quality of the studies, there seems to be variations in the results according to the instrument chosen for the evaluation, sample size, population studied, and the evolution of cognitive impairment in the volunteers. 12,22,46,47 As MCI and dementia become more prevalent with the increase in age, early diagnosis is essential. The results of the present study seem to indicate that slowing GS is a potential early marker of cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Changes in executive function and gait in people with mild cognitive impairment and Alzheimer disease

Cezar

Ansai

Oliveira

et al. 2021

Dement. neuropsychol.

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ABSTRACT. Changes in executive function and motor aspects can compromise the prognosis of older adults with mild cognitive impairment (MCI) and favor the evolution to dementia. Objectives: The aim of this study was to investigate the changes in executive function and gait and to determine the association between changes in these variables. Methods: A 32-month longitudinal study was conducted with 40 volunteers: 19 with preserved cognition (PrC), 15 with MCI and 6 with Alzheimer disease (AD). Executive function and gait speed were assessed using the Frontal Assessment Battery, the Clock-Drawing test and the 10-meter walk test. For data analysis, the Pearson product-moment correlation, two-way repeated-measures ANOVA, and chi-square were conducted. Results: After 32 months, an improvement in the executive function was found in all groups (p=0.003). At baseline, gait speed was slower in individuals with MCI and AD compared to those with PrC (p=0.044), that was maintained after the follow-up (p=0.001). There was significant increase in number of steps in all groups (p=0.001). No significant association was found between changes in gait speed and executive function. Conclusions: It should be taken into account that gait deteriorates prior to executive function to plan interventions and health strategies for this population.

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“…Gait disturbance has also been found in neurodegenerative disease and aging, which may give insight into longer-term effects of multiple mTBIs. For example, the walking speed of patients with AD is slower than healthy older adults (Johansson et al, 2017) and walking speed differences appear already in those with mild cognitive impairment (MCI; Knapstad et al, 2019), suggesting that gait change is an early event and can be used to diagnose potential problems. It is therefore possible that long-term tracking of gait post-mTBI can reveal future risk for developing neurodegenerative conditions related to multiple mTBIs and may represent a sensitive dynamic balance measure for these cases.…”

Section: Current Assessment Tools For Mtbimentioning

confidence: 99%

Assessment of Long-Term Effects of Sports-Related Concussions: Biological Mechanisms and Exosomal Biomarkers

et al. 2020

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Reduced Walking Speed in Subjective and Mild Cognitive Impairment: A Cross-Sectional Study

Cited by 37 publications

References 43 publications

Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

Gait speed, cognition and falls in people living with mild-to-moderate Alzheimer disease: data from NILVAD

Changes in executive function and gait in people with mild cognitive impairment and Alzheimer disease

Assessment of Long-Term Effects of Sports-Related Concussions: Biological Mechanisms and Exosomal Biomarkers

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