Quantitative gait dysfunction and risk of cognitive decline and dementia

Abstract

Background: Identifying quantitative gait markers of preclinical dementia may lead to new insights into early disease stages, improve diagnostic assessments, and identify new preventive strategies.

Objective: To examine relationship of quantitative gait parameters with decline on specific cognitive domains as well as risk of developing dementia in older adults.

Methods: We conducted a prospective cohort study nested within a community based aging study. Of the 427 subjects aged 70 and older with quantitative gait assessments, 399 were dementia-free at baseline.

Results: Over 5 years follow-up (median 2 years), 33 subjects developed dementia. Factor analysis was used to reduce eight baseline quantitative gait parameters to three independent factors representing pace, rhythm, and variability. In linear models, a one-point increase on the rhythm factor was associated with further memory decline (by 107%), whereas the pace factor was associated with decline on executive function measured by the digit symbol substitution (by 29%) and letter fluency tests (by 92%). In Cox models adjusted for age, sex, and education, a one-point increase on baseline rhythm (hazard ratio [HR] 1.48; 95% CI 1.03-2.14) and variability factor scores (HR 1.37; 95% CI 1.05-1.78) were associated with increased risk of dementia. The pace factor predicted risk of developing vascular dementia (HR 1.60; 95% CI 1.06-2.41).

Conclusion: Our findings indicate that quantitative gait measures predict future risk of cognitive decline and dementia in initially nondemented older adults.