Gait dysfunction common in cognitive impairment

NEW YORK (Reuters Health) - Older patients with mild cognitive impairment often exhibit gait dysfunction, or difficulty walking, according to findings published in the Journal of the American Geriatrics Society.

Mild cognitive impairment syndrome is viewed as transition state between normal cognitive function and dementia in older people, Dr. Joe Verghese and colleagues from Yeshiva University, Bronx, New York, point out. "Although neuropsychological characteristics of the mild cognitive impairment syndromes are well known, other behavioral markers are not well established."

Some recent studies have suggested that gait disturbances occur in the earliest stages of dementia, including mild cognitive impairment , the researchers note. To investigate, they studied 54 subjects with amnestic mild cognitive impairment, 62 with non-amnestic mild cognitive impairment and 295 cognitively normal control subjects in the Einstein Aging Study.

Gaits were assessed for neurological impairment by a neurologist, and for measurable factors such as velocity, cadence and stride length variability, using a computerized walkway with embedded sensors.

Neurologically impaired gaits were significantly more common in subjects with amnestic mild cognitive impairment (31.5 percent), but not in those with non-amnestic mild cognitive impairment (19.4 percent) when compared with the control subjects (16.3 percent).

Compared with control subjects, patients with either mild cognitive impairment subtypes had the worse quantitative gait on most parameters.

The investigators note that disability scores among individuals with mild cognitive impairment were worse for those with any gait abnormalities than without gait abnormalities.

Verghese's group proposes that "assessment of gait in older adults may provide a window on brain function that complements current definitions of mild cognitive impairment and usefully predicts dementia."