Researchers at the Alzheimer’s Association recently reported that subtle changes in the way a person walks can be an early indication of cognitive decline and a signal for further testing. These findings are the first to link a physical symptom to the disease, which up until now required doctors to begin a diagnosis through lengthy neurological exams that tested cognition.
The evidence which was compiled from five separate studies is “robust,” experts say. They note walking changes can occur even before cognitive decline surfaces.
“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,” says Bill Thies, chief medical and scientific officer for the Alzheimer’s Association.
The disease afflicts 5.4 million in the USA, and the number is forecast to spike to 16 million in 2050 as Baby Boomers age. In hopes of avoiding such a spike, the U.S. government announced a plan back in May to help train doctors in earlier detection and to find a cure for Alzheimer’s by 2025.
“Walking and movements require a perfect and simultaneous integration of multiple areas of the brain,” says Rodolfo Savica, author of a study at the Mayo Clinic in Rochester, Minn.
Walking changes occur because the disease interferes with the circuitry between areas of brain. Savica ruled out other diseases, such as Parkinson’s and arthritis, as possible causes.
In the Mayo Clinic study, researchers measured the stride length, cadence and velocity of more than 1,341 participants through a computerized gait instrument at two or more visits roughly 15 months apart. Those with lower cadence, velocity and length of stride experienced significantly larger declines in global cognition, memory and executive function.
“These changes support a possible role of gait changes as an early predictor of cognitive impairment,” Savica says.
Another large study of 1,153 adults with a mean age of 78, by researchers at the Basel Mobility Center in Basel, Switzerland, found that gait became “slower and more variable as cognition decline progressed.”
Participants were divided into groups based on cognitive diagnoses: cognitively healthy, mild cognitive impairment (MCI) or Alzheimer’s dementia. Gait was measured using a walkway with 30,000 integrated sensors. Those with Alzheimer’s walked slower than those with MCI, who walked slower than those who were cognitively healthy.
One annual test might not work with everyone, as many witness their spouse or loved one walking much better during the gait test than they typically do at home. In fact research was conducted on 19 dementia-free volunteers at Oregon Health and Science University in Portland. They measured gait speed during MRIs and gait speeds at home. The results showed that participants walked faster in the lab than at home. Slower in-home walking speed was associated with smaller total brain size and dementias cause brain shrinkage.
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