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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Source: http://www.usatoday.com/news/health/story/2012-07-15/walking-change-can-indicate-alzheimers/56223518/1
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I had read about this somewhere, and wondered if working on speeding up your pace, as in working on a treadmill, might help correct or ameliorate the problem. Any research or speculation?
What about other causes of gait change? My gait and stride, as well as balance, have decreased significantly because of severe peripheral neuropathy that developed during chemotherapy several years ago. Do these conditions predict Alzheimer’s?
I have see those age also are becoming -what is called yin deficient in Chinese Medicine. We all basically dry up as we age unless we are nourishing as we age with oils like walnut, avocado,olives etc…. Most elderly stop eating nutritious foods and that leads to lack of nutritious foods to feed the body. Many have bad dentures or no teeth and eating is a problem.
I see the tendons dry up and become so tight that yes the range of motion to stretch the legs and feet have become shorter from the tendon tightening up.
Just adding another observation.
Leslie Gray L.Ac
I have noticed changes in walking. Where can I get an accurate test? Having asked that, I did notice a change for the better since getting treated for brain issues. Still, I fear cognitive decline more than anything else and am tired of living in fear. I am now in Oregon, but am moving to Washington state very soon.
I have a very short stride much like taking ‘geisha’ steps. I can’t remember if I’ve been like this all my life. I am 57 y/o and already paranoid about losing my faculties, this little article just scared me to death! Should I visit a Neurologist or just ask my family practice physician if there’s anything I should be worried about?
My walk has changed, and I have been aware of this. Also, several other situations have engaged my mind. This Feb. I had the good fourtune to live 84 years. Like every one as old or older, I worry about alzheimers .
Dr. Amen (or Danny to me) —I have noticed me slowing down. WHen I walk faster my lower back about kills me. I have had my back checked and I do have some problems there.
What if you always had a shorter stride? As a young person I moved pretty quickly but always in shorter strides. Now with my short legs and a bad knee, I find longer strides are more difficult as my knee hurts.
What about older people having foot problems and nursing one foot or the other and pausing to ease the pain? The length and quickness of stride could certainly be influenced by certain parts of the feet or other body aches. How was this issue ruled out?
Nicola – The word “could” should not be overlooked.
Marilyn – These are research scientists, so yes, other factors would have been considered.
It is important to note that the study says, that walking, physical coordination are impacted as are cognitive factors. People are more likely to compensate for cognitive factors early on in the disease; whereas, *subtle* changes in gait are less troubling to them.
Nicola – If you have the income, considering getting brain imagin work done. The Amen Clinics has a facility in WA state. I had an excellent experience with their cinic in Newport Beach when I lived in So Cal. After 4 years under their care I was rescanned and could see that I went from what looked like a bad brain to a great brain. Not cheap but the best investment I ever made.
Nancy
Is there any similar work being done with Parkinson’s?
Interesting… I have noticed for a couple of years now that I am unable to keep up with my friends and family while walking/hiking. I am healthy and physically fit, so I find this odd. I was always a fast walker, you know the person you would ask “where’s the fire?”. I am not slow and do not feel like I am walking slower, but my peers certainly are out pacing me. I also have 5 close relatives that died from Alzheimer’s.
thank you Nancy for the reassurance. I guess I got nervous because I did get a SPECT scan that said that the parietal area of the brain was not functioning at optimal levels. the evaluation on that area had a black diamond with a question mark in the middle with Alzheimer’s listed. It was very, very far from conclusive, but it scared me. It didn’t help that I was having noticeable cognitive problems then. Now I am much better and can think much more clearly now that I’m on multi-vitamins and an anti-seizure medicine. But I still get fretful about the issue of Alzheimer’s. While the vitamins did help, I went to a naturopathic psychiatrist because I had other symptoms –my left arm was painfully numb. I was taking too much Vitamin B6. When I cut that down, the symptom went away. I really like the Amen method, but it is hard to do a consultation –hence the visit to another naturopathic psychiatrist. That was very recent and my gait is better! Unfortunately, Dr. Caroline Smythe, MD ( and she utilizes naturopathy) moved away from my area. I am moving myself and am making an all call out there to ask if anyone knows a psychiatrist that is familiar and supportive of the Amen Clinic methods In Bellingham, WA. I am moving up there August 15. I tried to find out on the website, but couldn’t get anywhere. Guess I should give them a call on the phone, but I thought I’d ask the patients out there too. I better stop typing –I’m enjoying the new-found ability to type faster than I have ever dine before and I’m having a hard time stopping (lol)!
Where wouldI get a referral for brain imagery and about what would be the cost? Does insurance help defray the cost?
hank you, Judy Starr
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