Slowing gait and risk for cognitive impairment

Rosso, Andrea L.; Verghese, Joe; Metti, Andrea L.; Boudreau, Robert M.; Aizenstein, Howard; Kritchevsky, Stephen B.; Harris, Tamara B.; Yaffe, Kristine; Satterfield, Suzanne; Studenski, Stephanie A.; Rosano, Caterina

doi:10.1212/wnl.0000000000004153

Cited by 119 publications

(68 citation statements)

References 40 publications

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“…Participants are primarily white (93%, self-identified), matching South Island demographic characteristics. 9 Assessments were performed at birth; at ages 3,5,7,9,11,13,15,18,21,26,32, and 38 years; and, most recently (completed April 2019), at age 45 years, when 938 of the 997 participants (94.1%) still alive participated. At each assessment, each participant was brought to the research unit for interviews and examinations.…”

Section: Study Design and Populationmentioning

confidence: 99%

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

et al. 2019

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IMPORTANCE Gait speed is a well-known indicator of risk of functional decline and mortality in older adults, but little is known about the factors associated with gait speed earlier in life. OBJECTIVES To test the hypothesis that slow gait speed reflects accelerated biological aging at midlife, as well as poor neurocognitive functioning in childhood and cognitive decline from childhood to midlife. DESIGN, SETTING, AND PARTICIPANTS This cohort study uses data from the Dunedin Multidisciplinary Health and Development Study, a population-based study of a representative 1972 to 1973 birth cohort in New Zealand that observed participants to age 45 years (until April 2019). Data analysis was performed from April to June 2019. EXPOSURES Childhood neurocognitive functions and accelerated aging, brain structure, and concurrent physical and cognitive functions in adulthood. MAIN OUTCOMES AND MEASURES Gait speed at age 45 years, measured under 3 walking conditions: usual, dual task, and maximum gait speeds. RESULTS Of the 1037 original participants (91% of eligible births; 535 [51.6%] male), 997 were alive at age 45 years, of whom 904 (90.7%) had gait speed measured (455 [50.3%] male; 93% white). The mean (SD) gait speeds were 1.30 (0.17) m/s for usual gait, 1.16 (0.23) m/s for dual task gait, and 1.99 (0.29) m/s for maximum gait. Adults with more physical limitations (standardized regression

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Section: Study Design and Populationmentioning

confidence: 99%

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

et al. 2019

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“…While speed could be considered useful in clinical screening, other studies indicate that it is also important to establish how gait parameters would be involved in aging since it has been reported that they could predict the risk of falls and loss in mobility affecting the quality of life [11]. The importance of these findings lies in the recognition of predictive factors that are easily accessible to clinicians who can detect early cognitive deterioration as well as dementia, which in turn will enable the creation of better strategies for planning, prevention, and treatment options [12].…”

Section: Gait and Agingmentioning

confidence: 99%

Smart Tracking and Wearables: Techniques in Gait Analysis and Movement in Pathological Aging

Muñoz¹,

Valderrama²,

Orozco³

et al. 2020

Smart Healthcare

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In this chapter, we describe the aging process and, more specifically, the pathological aging, associated with neurodegenerative diseases and its relation with gait. Then, we explain the importance of using quantitative gait analysis techniques using wearables and other technologies to diagnose different conditions that can be complex to discriminate using only the physician naked-eye diagnosis. We analyze different approaches used for gait analysis using wearables and affordable devices like inertial units (IMU), accelerometers, and depth cameras like Microsoft Kinect or Intel's RealSense, which have been available at least in an academic context but will be available for daily use in the near future.

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“…Balance, muscle strength, gait and cognitive impairments all significantly increase the risk of falls [11][12][13]. Cognitive impairment compromises 'top down' control of gait and balance, which is required for navigating the environment [14,15]. People with dementia are eight times more likely to fall than those without dementia [16], and falls account for 26% of hospital admissions in those with dementia [17].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

Taylor

Parsons

Taylor

et al. 2020

Trials

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Background: Falls are two to four times more frequent amongst older adults living in long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesised that a progressive exercise program targeting balance and strength will reduce fall rates when compared to a seated exercise program and do so cost effectively. Methods/design: This is a single blind, parallel-group, randomised controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥ 65 years) will be recruited from LTC facilities in New Zealand. Participants (n = 528 total, with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia (intervention group), or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 h twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), fall rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline and after 6 and 12 months. Cost-effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 30 November 2018. Discussion: This study evaluates the efficacy and cost-effectiveness of a progressive strength and balance exercise program for aged care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programmes for this vulnerable population.

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Slowing gait and risk for cognitive impairment

Abstract: The association between gait slowing and cognitive impairment is supported by a shared neural substrate that includes a smaller right hippocampus. This finding underscores the value of long-term gait slowing as an early indicator of dementia risk.

Cited by 119 publications

References 40 publications

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

Smart Tracking and Wearables: Techniques in Gait Analysis and Movement in Pathological Aging

Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

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