Weaker Braking Force, A New Marker of Worse Gait Stability in Alzheimer Disease

Abstract

Background: Braking force is a gait marker associated with gait stability. This study aimed to determine the alteration of braking force and its correlation with gait stability in Alzheimer disease (AD). Methods: A total of 32 AD patients and 32 healthy controls (HCs) were enrolled in this study. Gait parameters (braking force, gait variability, and fall risk) in the walking tests of Free walk, Barrier, and Count backward were measured by JiBuEn gait analysis system. Gait variability was calculated by the coefficient of variation (COV) of stride time, stance time, and swing time. Results: The braking force of AD was significantly weaker than HCs in three walking tests (P < 0.001, P < 0.001, P = 0.007). Gait variability of AD showed significant elevation than HCs in the walking of Count backward (COV stride : P = 0.013; COV swing : P = 0.006). Fall risk of AD was significantly higher than HCs in three walking tests (P = 0.001, P = 0.001, P = 0.001). Braking force was negatively associated with fall risks in three walking tests (P < 0.001, P < 0.001, P < 0.001). There were significant negative correlations between braking force and gait variability in the walking of Free walk (COV stride : P = 0.018; COV swing : P = 0.013) and Barrier (COV stride : P = 0.002; COV swing : P = 0.001), but not Count backward (COV stride : P = 0.888; COV swing : P = 0.555). Conclusion: Braking force was weaker in AD compared to HCs, reflecting the worse gait stability of AD. Our study suggests that weakening of braking force may be a new gait marker to indicate cognitive and motor impairment and predict fall risk in AD.

Diagnostic accuracy of multi-component spatial-temporal gait parameters in older adults with amnestic mild cognitive impairment

“…Braking force was a gait marker associated with gait stability. It was weaker in patients with AD when compared to healthy elderly ( Cheng et al, 2020 ). OLS test is one of the balance tests ( Michikawa et al, 2009 ).…”

Kinematics or Kinetics: Optimum Measurement of the Vertical Variations of the Center of Mass during Gait Initiation

“…The reasons and implications of this high intra-individual variability should be further studied in order to provide a better understanding of postural control. Of interest, the BI has recently been shown to be affected by cognitive decline and could become a cognitive-related gait marker to estimate fall risk without the addition of cognitive tasks [ 29 ]. BI has also been shown to be related to chronic ankle instability [ 30 ].…”

Do the dual-task “8-foot up and go” tests provide additional predictive value for early detection of cognitive decline in community-dwelling older women?

“…Mobility is found to be interrelated with cognitive function [ 5 ]. On the one hand, cognition plays an important role in normal walking [ 6 ] and physical mobility [ 7 ]. Impaired cognitive function may lead to an increased falls risk [ 8 , 9 ].…”

“…The mechanism underlying their associations has not yet been completely explained. Even so, the deficit of cognitive function in attention, executive function, and working memory loss have been demonstrated to contribute to poor performance in postural control, mobility and gait [ 6 , 12 , 13 ].…”