Relationship Between Balance, Gait, and Activities of Daily Living in Older Adults With Dementia

Abstract

Introduction: Gait characteristics are closely associated with executive functions including basic and high-level cognitive processes such as attention, working memory, decision-making, and problem-solving. Impaired cognitive function resulting from dementia is associated with loss of balance and poor activities of daily living (ADLs). If associations between gait parameters, balance, and ADLs are observed, then quantitative gait analysis may be optimal for reinforcing balance and ADL assessments in people with dementia. This study aimed to determine the association between balance, gait, and ADLs in older adults with dementia. Materials and Methods: A cross-sectional study was conducted in 46 older adults who have been diagnosed with dementia. Measurements including the Mini-Mental Statement Examination-Korean version (MMSE-K), Berg Balance Scale (BBS), 10-meter walk test (10MWT), Modified Barthel index (MBI), and GAITRite were used to assess cognitive function, balance, walking speed, ADLs, and gait parameters, respectively. The Pearson product correlation coefficient ( r) was used for correlation analysis. Results and Discussion: Among the gait parameters, velocity was positively associated with the BBS, 10MWT, and MBI ( r = 0.341-0.516, P > .05). Step length ( r = 0.301-0.586, P > .05), stride length ( r = 0.329-0.580, P > .05), and walk ratio ( r = 0.324-0.556, P > .05) were positively associated with the MMSE-K, BBS, 10MWT, and MBI. A moderate positive association between single support time and MBI was observed ( r = 0.308, P = .039). Additionally, a moderate negative association between double support time and the MBI was observed ( r = −0.349, P = .019). This study presents the first empirical evidence on the association between balance, gait, and ADLs in older adults with dementia. Conclusions: This study identified important associations between balance, gait, and ADL assessments in people with dementia. Further studies involving targeted interventions addressing gait parameters and improving balance and functional performance in people with dementia are required in the future.

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors

“…Unfortunately, no correlation data are available for the remaining gait and iTUG parameters with ACE-R, but it is noteworthy that the recent study by Choi et al [33] detected significant correlations between cadence, double support phase duration and stride length with cognitive status (assessed using MoCA), which is similar to our findings. Moreover, a recent study by Lee et al [58] reported the existence of a significant moderate correlation between walk ratio and MMSE score in individuals with dementia. Such findings are in agreement with those presented here, which indicate a similar trend for correlation between walk ratio and ACE-R score.…”

“…In addition, the relationship between step length and cadence (i.e., walk ratio, [ 56 , 57 ]) was calculated. It has been reported that the walk ratio is indicative of cautious gait, poor balance and impaired central control of gait and has also been associated with falls and cognitive performance in older persons [ 57 , 58 ]. The gait parameters known to be influenced by an individual’s anthropometry (i.e., gait speed, stride length and cadence) were normalized by dividing them by each participant’s height [ 59 – 61 ].…”

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

“…Dementia is a group of different progressive diseases that currently has no cure and is arguably the most pressing public health challenge [2,6]. It is a syndrome that primarily affects older people and is characterized Open Access *Correspondence: vorapun.sen@mahidol.ac.th by a decline in cognitive performance that affects the individual's ability related to cognitive and physical functions [1,[7][8][9][10]. Dementia and falls were reported as the top five causes of disability-adjusted life-years (DALYs) in people aged 75 and older [11].…”

Single-Task or Dual-Task? Gait Assessment as a Potential Diagnostic Tool for Alzheimer’s Dementia

“…Rather, it involves continuouscontrol of the body position [ 2 ] as well as higher-mental processes such as attention, working memory, decision-making, and problem-solving [ 3 ]. In other words, successful gait performance requires appropriate integration of the sensorimotor and cognitive systems [ 4 ]. When a person fails to combine the two systems successfully, the risk of falls may be elevated.…”