What can gait tell us about dementia? Review of epidemiological and neuropsychological evidence

Valkanova, Vyara; Ebmeier, Klaus P.

doi:10.1016/j.gaitpost.2017.01.024

Cited by 74 publications

(77 citation statements)

References 131 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With regard to the mechanisms linking walking speed with future dementia, several possibilities could help explain our findings. It is thought that walking and cognition rely on similar brain regions, predominately in the prefrontal cortex . Gait is a complex process in which the locomotor systems receive input from the basal ganglia, motor cortex, and cerebellum .…”

Section: Discussionmentioning

confidence: 99%

“…It is thought that walking and cognition rely on similar brain regions, predominately in the prefrontal cortex . Gait is a complex process in which the locomotor systems receive input from the basal ganglia, motor cortex, and cerebellum . Although this process is largely automatic, walking relies on sensory feedback and high‐order cognitive control …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Walking Speed, Cognitive Function, and Dementia Risk in the English Longitudinal Study of Ageing

Hackett

Davies‐Kershaw

Cadar

et al. 2018

J American Geriatrics Society

View full text Add to dashboard Cite

Background Physical and cognitive function decline with age. Slow walking speed has been associated with negative health outcomes and dementia is often preceded by cognitive decline. This study investigated walking speed, cognitive function and the interaction between changes in these measures in relation to dementia risk. Method Walking speed and cognition were assessed in 3,932 individuals aged ≥60 years at wave 1 (2002–03) and 2 (2004–05) of the English Longitudinal Study of Ageing. New dementia cases were assessed from wave 3 (2006–07) to wave 7 (2014–15). The associations were modelled using Cox proportional hazards regression. Results Participants with faster baseline walking speeds (HR 0.36; 95% CI 0.22 – 0.60) had a decreased risk of dementia. Those who had a greater decline in walking speed (waves 1 – 2 (HR 1.23; 95% CI 1.03 – 1.47) had an increased dementia risk. Participants with greater baseline cognition (HR 0.42; 95% CI 0.34 – 0.54) had a reduced dementia risk. Those who had a greater decline in cognition (waves 1–2) had a greater risk of dementia (HR 1.78; 95% CI 1.53 – 2.06). Change in walking speed and change in cognition did not interact significantly in relation to dementia risk (HR 1.01; 95% CI 0.88 – 1.17). Conclusions In this community-dwelling sample of English adults those with slower walking speeds and a greater decline in speed over time had an increased risk of developing dementia independent of changes in cognition. Further research is required to understand the mechanisms that may drive these associations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Walking Speed, Cognitive Function, and Dementia Risk in the English Longitudinal Study of Ageing

Hackett

Davies‐Kershaw

Cadar

et al. 2018

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…Despite the relevance of such a finding, gait slowing could not be considered as a specific parameter for either disease, as it also occurs in healthy aging. From a neuropathological point of view, gait slowing may be primarily due to neuropathological mechanisms that are common to normal aging and neurodegenerative diseases, especially increased prion-inflammatory makers and vascular burden (Valkanova and Ebmeier 2017). In the next sections, we identified dual-task-related changes in other parameters than gait speed that could be specific to AD and PD at the prodromal stage.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, in a recent meta-analysis including 14 studies, Bahureksa et al (2017) found that dual-task walking highlights the sensitivity of the latter gait parameters for discriminating between MCI subtypes and healthy controls. Furthermore, it has been shown that dual-taskrelated gait changes could differentiate between nonamnestic and amnestic MCI Valkanova and Ebmeier 2017). Specifically, the pace domain (i.e., gait speed and stride length) was more affected in non-amnestic MCI, whereas the rhythm (i.e., cadence, swing time, stance time, and double support time) and variability (i.e., stride length variability and swing time variability) domains were worse in amnestic MCI (Verghese et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

Belghali¹,

Chastan²,

Cignetti³

et al. 2017

GeroScience

View full text Add to dashboard Cite

Alzheimer's and Parkinson's diseases are age-related progressive neurodegenerative diseases of increasing prevalence worldwide. In the absence of curative therapy, current research is interested in prevention, by identifying subtle signs of earlystage neurodegeneration. Today, the field of behavioral neuroscience has emerged as one of the most promising areas of research on this topic. Recently, it has been shown that the exacerbation of gait disorders under dual-task conditions (i.e., simultaneous performance of cognitive and motor tasks) could be a characteristic feature of Alzheimer's and Parkinson's diseases. The cognitive-motor dual-task paradigm during walking allows to assess whether (i) executive attention is abnormally impaired in prodromal Alzheimer's disease or (ii) compensation strategies are used in order to preserve gait function when the basal ganglia system is altered in prodromal Parkinson's disease. This review aims at (i) identifying patterns of dual-taskrelated gait changes that are specific to Alzheimer's and Parkinson's diseases, respectively, (ii) demonstrating that these changes could potentially be used as prediagnostic markers for disease onset, (iii) reviewing pros and cons of existing dual-task studies, and (iv) proposing future directions for clinical research.

show abstract

“…Recent reviews highlight the importance of measuring gait across the life course, from its development in children [47], link to fall risk [48,49] and its relationship to dementia in adults [50]. While clinically assessed gait speed has been shown to have use in assessing longevity and cognitive function in older adults [51,52], micro gait characteristics offer a more focused examination to differentiate pathology and identifying specific features of disease progression [53].…”

Section: Micro Gaitmentioning

confidence: 99%

Wearables for independent living in older adults: Gait and falls

Godfrey

2017

Maturitas

View full text Add to dashboard Cite

Solutions are needed to satisfy care demands of older adults to live independently. Wearable technology (wearables) are one approach to offer a viable means for ubiquitous, sustainable and scalable monitoring in habitual free-living environments. Gait has been presented as a relevant (bio) marker in ageing and pathological studies, with objective assessment achievable by inertial-based wearables. Commercial wearables have struggled to provide accurate analytics and have been limited by non-clinically oriented gait outcomes. Moreover, some research grade wearables also fail to provide transparent functionality due to limitations in proprietary software. Innovation within this field is often sporadic with large heterogeneity of wearable types and algorithms for gait outcomes leading to a lack of pragmatic use. This review provides a summary of recent wearable gait assessment literature, focusing on the need for an algorithm fusion approach to measurement cumulating in the ability to better detect and classify falls. A brief presentation of wearables in one pathological group is presented, identifying appropriate work for researchers in other cohorts to utilise. Opportunities for how this domain needs to progress are also summarised. Highlights• Wearables can meet older adults' needs for independent living.• Gait assessment is a (bio)marker within ageing and different pathologies.• Measuring gait with wearables has been innovative but fraught with inconsistencies.

show abstract

What can gait tell us about dementia? Review of epidemiological and neuropsychological evidence

Abstract: An integrated approach for evaluating these major geriatric syndromes, based on their close relationship, will not only increase our understanding of cognitive-motor interactions, but most importantly may be used to aid early diagnosis, prognosis and the development of new interventions.

Cited by 74 publications

References 131 publications

Walking Speed, Cognitive Function, and Dementia Risk in the English Longitudinal Study of Ageing

Walking Speed, Cognitive Function, and Dementia Risk in the English Longitudinal Study of Ageing

Loss of gait control assessed by cognitive-motor dual-tasks: pros and cons in detecting people at risk of developing Alzheimer’s and Parkinson’s diseases

Wearables for independent living in older adults: Gait and falls

Contact Info

Product

Resources

About