The association between cognitive impairment, gait speed, and Walk ratio

Published on May 18, 2023

Imagine you’re trying to predict the winner of a race, but you have two contenders with different strengths. One contender is gait speed, representing how fast they can run, while the other is the Walk ratio, measuring their step length divided by step frequency. Now, you want to know which contender is more closely related to their overall performance, or in this case, cognitive function. Well, a group of scientists conducted a study to find out just that! They reviewed 24 studies involving patients with cognitive impairment and healthy controls. The results showed that both the Walk ratio and gait speed were significantly associated with cognitive function. However, when they considered other factors like age, it turned out that gait speed was a stronger predictor than the Walk ratio. So, if we think of cognitive function as the finishing line, gait speed seems to be ahead of the competition! Want to dive deeper into the research? Check out the full article!

BackgroundGait speed has been found to be associated with cognitive function. However, gait speed is an unspecific measure that may not be informative about gait patterns. The Walk ratio (step length divided by step frequency) can be measured without specialized equipment, and has been suggested as an indicator of central gait control. However, the association with cognitive function is unknown.Research questionIs there a relationship between Walk ratio and cognitive function, and gait speed and cognitive function?MethodsThis was a systematic literature review of studies where spatiotemporal gait parameters was reported in populations with cognitive impairment. The search was performed through PubMed, PEDro, AMED, Cochrane, Embase, MEDLINE, and PsycINFO. The studies had to contain either the Walk ratio, or report average step length and average step frequency. In the latter case, the average step length was divided by the average step frequency. The studies also had to report gait speed and the minimal mental state examination (MMSE). Studies testing patients on treadmills or that did not state the exclusion of patients with neurologic or orthopedic diseases, possible affecting gait ability, were excluded.ResultsA total of 24 studies were included, consisting of 909 patients with cognitive impairment and 4,108 healthy controls. The patient group had a lower Walk ratio (mean difference 0.07, p ≤ 0.001) and gait speed (mean difference 0.26, p ≤ 0.001) than the healthy controls. Using linear regression models, we found an association between the MMSE and the Walk ratio (R2 = 0.29, p < 0.001) and gait speed (R2 = 0.41, p < 0.001) in separate, unadjusted models. In a final model with Walk ratio, gait speed and age, Walk ratio was not significantly associated with MMSE, while gait speed was.SignificanceOur results suggest that preferred gait speed may be preferable to the Walk ratio when assessing older adults with cognitive impairment.

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