Just like the way a person’s walk can reveal a lot about their personality, new research suggests that the variability and asymmetry in gait patterns can actually predict cognitive impairment in older adults with cerebral small vessel disease (CSVD). CSVD is a common condition among older individuals and is associated with vascular cognitive impairment and dementia. By analyzing gait parameters using advanced methods, researchers found that increased gait variability and gait asymmetry were linked to declines in cognitive performance. This study compared cognitive function and gait performance between individuals with CSVD and a control group. The results showed that patients with CSVD had poorer performance in visual learning and sustained attention tests, along with higher step time and step length variability. The findings indicate that gait assessment could serve as an early marker for cognitive decline in individuals with CSVD. Further research may reveal how these gait abnormalities relate to specific cognitive impairments and help develop targeted interventions to prevent or delay the onset of vascular cognitive impairment and dementia. To learn more about this fascinating connection between gait variability and cognitive decline, check out the full article.

IntroductionAdvanced methods of gait research, including approaches to quantify variability, and orderliness/regularity/predictability, are increasingly used to identify patients at risk for the development of cognitive impairment. Cerebral small vessel disease (CSVD) is highly prevalent in older adults and is known to contribute to the development of vascular cognitive impairment and dementia (VCID). Studies in preclinical models demonstrate that subclinical alterations precede CSVD-related cognitive impairment in gait coordination. In humans, CSVD also associates with gait abnormalities. The present study was designed to test the hypothesis that increased gait variability and gait asymmetry predict a decline in cognitive performance in older adults with CSVD.MethodsTo test this hypothesis, we compared cognitive performance and gait function in patients with CSVD (age: 69.8 ± 5.3 years; n = 11) and age- and sex-matched control participants (age: 70.7 ± 5.8 years; n = 11). Based on imaging findings, patients with CSVD were identified [presence of white matter hyperintensities plus silent brain infarcts and/or microhemorrhages on magnetic resonance imaging (MRI) assessment]. Cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Gait parameters were measured during the single and dual tasks, during which participants, in addition to the motor task, completed a series of mental arithmetic calculations. Spatial and temporal parameters of gait variability, symmetry, and permutation entropy were determined using a pressure-sensitive gait mat during single and dual cognitive task conditions.ResultsPatients with CSVD exhibited lower performance in a visual learning test (p = 0.030) and in a sustained attention test (p = 0.007). CSVD also affected step time variability (p = 0.009) and step length variability (p = 0.017). Step lengths of CSVD participants were more asymmetric (p = 0.043) than that of controls, while the two groups were statistically similar regarding step time symmetry and entropy of step time and length. Gait variability was inversely associated with sustained attention, especially among CSVD patients, and this relationship was significantly different between the two groups. The association of sustained attention with gait symmetry was also significantly different between the two groups.DiscussionOur findings provide additional evidence in support of the concept that increased gait variability and asymmetry may predict cognitive impairment in older adults with CSVD.

Read Full Article (External Site)