The Association Between Gait Speed and Cognitive Status in Community-Dwelling Older People: A Systematic Review and Meta-analysis

Peel, Nancye M.; Alapatt, Linson John; Jones, Lee; Hubbard, Ruth E.

doi:10.1093/gerona/gly140

Cited by 122 publications

(113 citation statements)

References 28 publications

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“…These findings survived correction for multiple testing applied within the brain structure domain, but if correction multiple testing had been applied across all study measures simultaneously, only total brain volume would have remained associated with gait speed, suggesting that findings for cortical thickness, surface area, and white matter hyperintensities, although consistent with the literature, should be treated with caution.Third, slow gait at midlife was associated with poorer neurocognitive functioning across multiple cognitive domains; there was a mean difference of 16 IQ points (>1 SD) between the slowest and fastest walkers (ie, bottom vs top quintile). These findings align with those of several studies4 of older adults showing associations of slow gait with cognitive impairment and risk of dementia.Remarkably, in our study, gait speed was associated not only with concurrent neurocognitive functioning in adulthood but also with neurocognitive functioning in early childhood. The effect sizes between participants in the slowest and fastest gait speed quintiles were far from trivial: at age 3 years, the difference in brain health was 0.62 SD Research is needed to unpack the association between childhood neurocognitive functioning and midlife gait speed.…”

supporting

confidence: 92%

“…1,2 Reduced gait speed is a sign of advancing age 3 ; it is associated with poorer response to rehabilitation, age-related diseases, including cardiovascular disease and dementia, and early mortality. [4][5][6] Gait speed is frequently used in geriatric settings as a quick, simple, and reliable way of estimating older patients' functional capacity. It is increasingly recognized that gait is associated with not only musculoskeletal mechanisms but also with the central nervous system (CNS).…”

Section: Introductionmentioning

confidence: 99%

“…It is increasingly recognized that gait is associated with not only musculoskeletal mechanisms but also with the central nervous system (CNS). 4,7 To date, longitudinal research on gait and cognitive functioning has primarily focused on older adults, many with neurological diseases. 8 Few studies have integrated cognitive and structural measures of the CNS with gait in healthy midlife adults, and, to our knowledge, none has examined the childhood CNS origins of gait.…”

Section: Introductionmentioning

confidence: 99%

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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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confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Neurocognitive and Physical Function With Gait Speed in Midlife

et al. 2019

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“…However, an intricate interaction between motor function and cognition is now recognized. Slow gait speed is predictive of multiple adverse outcomes [1] and, although it is also impacted by conditions such as sarcopenia and physical frailty [2], it is strongly associated with prevalent and incident cognitive impairment [3]. Structural and functional brain imaging studies have shown that cognition and motor control share common brain pathways, particularly in the prefrontal and temporal areas [4].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Age on Gait Speed When Texting

Alapatt

Peel

Reid

et al. 2020

IJERPH

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Texting while walking exerts a high cognitive load, and may be a sensitive test of the integrity of the cognitive–motor interface. We aimed to investigate the association between chronological age and gait speed while texting. A convenience sample of 308 community-dwellers was recruited: n ≥ 50 in each age group (20–29, 30–39, 40–49, 50–59) and n = 100 aged ≥60 years. Gait speed was measured over 10 metres under two experimental conditions: 1) walking at usual pace; 2) walking at usual pace while texting the message “Good morning Harry” on their smartphone. Both median gait speed with and without texting decreased with increasing age (p < 0.001). The differences between single- and dual-task gait speed were substantial for each age group and increased after the age of 50 years (p < 0.001). Median gait speeds while texting in people aged 50–59 (1.07 m/s) and ≥60 years (1.00 m/s) were below the recommended minimum for safely crossing roads (1.20 m/s). Texting while walking currently exposes people aged 50 and over to considerable environmental hazards. The significant slowing of gait speed while texting from middle age may be a marker of neurodegeneration, a cohort effect, or an appropriate compensatory response to reduce the risk of injury.

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“…For instance, in a recently published study from the English Longitudinal Study of Aging, both baseline gait speed and change in gait speed was associated with dementia risk over a follow up of > 10 years [10]. This follows a large body of evidence indicating the strong relationship between slow gait speed and later cognitive decline [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 95%

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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The Association Between Gait Speed and Cognitive Status in Community-Dwelling Older People: A Systematic Review and Meta-analysis

Cited by 122 publications

References 28 publications

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

Association of Neurocognitive and Physical Function With Gait Speed in Midlife

The Effect of Age on Gait Speed When Texting

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

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