Alzheimer’s Spotted with Abnormalities in Gait

A study presented at the Alzheimer's Association International Conference, Canada, claims that the way you walk could be a good hint in determining whether or not you would be a victim of dementia or Alzheimer's disease.

Gait disturbances such as slowing of walking pace or a more variable stride are the first signs of cognitive impairment, even before such impairments have been spotted by neuropsychological tests.

"With an aging baby boomer generation advancing into greater risk for Alzheimer's and dementia, it is important for physicians to be aware of the associations between gait and mental function. These studies suggest that observing and measuring gait changes could be a valuable tool for signaling the need for further cognitive evaluation," said William Thies, PhD, Alzheimer's Association® Chief Medical and Scientific Officer. "For busy doctors who have limited time with their patients, monitoring deterioration and other changes in a person's gait is ideal because it doesn't require any expensive technology or take a lot of time to assess. It is relatively simple and straightforward."

The study was led by Stephanie A. Bridenbaugh, MD, of the Basel Mobility Center in Basel, Switzerland and some other colleagues. They did a quantitative gait analysis in order to explore the issue. The study was conducted on 1,153 participants including outpatients from the Basel Memory Clinic and Basel Mobility Centre, including the cognitively healthy participants in a Basel cohort study from 2007 to 2011.

In order to proceed with the findings, the participants were divided into groups based on their cognitive diagnoses like cognitively healthy, mild cognitive impairment (MCI) or Alzheimer's dementia.  The participants who suffered with Alzheimer's dementia were subdivided into three categories; namely, mild, moderate or severe. Gait was measured using a 10-meter long electronic walkway with almost 30,000 integrated pressure sensors.

The participants performed one normal walk and two different dual tasks, normal walking while simultaneously counting backwards out loud or while simultaneously naming animals. The dual task helped the doctors find out which adults were walking more slowly because of pain, rather than brain changes.

Another research was done by Mohammad Ikram, MD, PhD, and his colleagues at Erasmus MC, Rotterdam, the Netherlands. They investigated the relationship between cognition and gait in community-dwelling elderly.  In this, they studied 232 individuals age 49 and above from The Rotterdam Study. In this study, standardized neuropsychological tests were used to measure information processing speed, memory, fine motor speed and executive function. Gait was assessed using an electronic walkway. Each participant performed a normal walk, a tandem walk and a turn. Gait variables were grouped into seven independent factors namely, Rhythm, Pace, Phases, Variability, Base of Support, Tandem, and Turn.

"Future studies should explore the link between gait and dementia," Ikram said. "Can we use gait to predict dementia? If so, how long before cognitive symptoms?"

A third study evaluated patients over multiple visits. It was found that those who had slower steps and smaller pace, had excessive decline in thinking, memory and executive processing, according to the study led by Rodolfo Savica from the Mayo Clinic in Rochester, Minnesota.

"Motor and cognitive function may be part of the same spectrum of the disease," Savica said. "These motor changes happen before the memory changes."

Heather Snyder, senior associate director of the Alzheimer's Association, reports that these studies "continue to build the evidence that there is a connection between gait and cognition."

Currently in the United States, Alzheimer's disease is the most common form of dementia, affecting more than 5 million people, according to the Centers for Disease Control and Prevention. The number of people who suffer from the disease is expected to double every 20 years as population increases and people live longer.

The studies, though, have revealed a link between walking ability and dementia; it could not prove a cause-and-effect connection. Research presented at medical meetings is typically considered preliminary until published in a peer-reviewed journal.