Jeffrey M Hausdorff1,2,3,4, Inbar Hillel1, Shiran Shustak1, Silvia Del Din5, Esther M J Bekkers6,7, Elisa Pelosin8,9, Freek Nieuwhof10, Lynn Rochester5,11, Anat Mirelman1,3,12. 1. Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel. 2. Department of Physical Therapy, Sackler Faculty of Medicine, Israel. 3. Sagol School of Neuroscience, Tel Aviv University, Israel. 4. Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago. 5. Institute of Neuroscience, Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. 6. KU Leuven, Department of Rehabilitation Sciences, Neuromotor Rehabilitation Research Group, Belgium. 7. Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Parkinson Centre Nijmegen (ParC), The Netherlands. 8. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Italy. 9. IRCCS San Martino Teaching Hospital, Genoa, Italy. 10. Radboud University Medical Center, Departments of Neurology, Geriatric medicine, and Radboud Alzheimer Center, Nijmegen, The Netherlands. 11. The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK. 12. Department of Neurology and Neurosurgery, Sackler School of Medicine, Tel Aviv University, Israel.
Abstract
Background: Recent work demonstrated that the gait of people with mild cognitive impairment (MCI) differs from that of age-matched controls and, in general, that walking ability, as measured in the clinic, does not necessarily reflect actual, daily performance. We evaluated if the quantity and quality of everyday walking (ie, community ambulation) differs in older adults with MCI, compared to age-matched controls. Methods: Inclusion criteria included: age 65-90 years, able to walk at least 5 minutes unassisted, and ≥2 falls in the past 6 months. Subjects with MCI were included if they scored 0.5 on the Clinical Dementia Rating Scale. To assess stepping quantity and quality, subjects wore a tri-axial accelerometer on the lower-back for 7 days. Results: Age and gender were similar (p > .10) in MCI (n = 36, 77.8 ± 6.4 years; 27.8% men) and controls (n = 100, 76.0 ± 6.2 years; 22.0% men). As expected, Montreal Cognitive Assessment scores were lower (p < .001) in MCI (21.31 ± 4.05), compared to controls (25.81 ± 2.64). Walking time was lower (p = .016) in MCI (0.74 ± 0.48 hours/d), compared to controls (1.05 ± 0.66 hours/d). Within-bout walking (eg, stride regularity) was less consistent (p = .024) in MCI (0.51 ± 0.14), compared to controls (0.58 ± 0.14). Changes in stride regularity across bouts were lower (p < .001) in MCI (0.13 ± 0.04), compared to controls (0.17 ± 0.01). Conclusions: Older adults with MCI walk less and with a more variable within-bout and less variable across-bout walking pattern, as compared to cognitively-intact subjects matched with respect to age and gender. These findings extend previous clinical work and suggest that MCI affects both the quantity and quality of community ambulation.
Background: Recent work demonstrated that the gait of people with mild cognitive impairment (MCI) differs from that of age-matched controls and, in general, that walking ability, as measured in the clinic, does not necessarily reflect actual, daily performance. We evaluated if the quantity and quality of everyday walking (ie, community ambulation) differs in older adults with MCI, compared to age-matched controls. Methods: Inclusion criteria included: age 65-90 years, able to walk at least 5 minutes unassisted, and ≥2 falls in the past 6 months. Subjects with MCI were included if they scored 0.5 on the Clinical Dementia Rating Scale. To assess stepping quantity and quality, subjects wore a tri-axial accelerometer on the lower-back for 7 days. Results: Age and gender were similar (p > .10) in MCI (n = 36, 77.8 ± 6.4 years; 27.8% men) and controls (n = 100, 76.0 ± 6.2 years; 22.0% men). As expected, Montreal Cognitive Assessment scores were lower (p < .001) in MCI (21.31 ± 4.05), compared to controls (25.81 ± 2.64). Walking time was lower (p = .016) in MCI (0.74 ± 0.48 hours/d), compared to controls (1.05 ± 0.66 hours/d). Within-bout walking (eg, stride regularity) was less consistent (p = .024) in MCI (0.51 ± 0.14), compared to controls (0.58 ± 0.14). Changes in stride regularity across bouts were lower (p < .001) in MCI (0.13 ± 0.04), compared to controls (0.17 ± 0.01). Conclusions: Older adults with MCI walk less and with a more variable within-bout and less variable across-bout walking pattern, as compared to cognitively-intact subjects matched with respect to age and gender. These findings extend previous clinical work and suggest that MCI affects both the quantity and quality of community ambulation.
Authors: Vicki L Gray; Andrew P Goldberg; Mark W Rogers; Laila Anthony; Michael L Terrin; Jack M Guralnik; William C Blackwelder; Diana F H Lam; Siddhartha Sikdar; Brajesh K Lal Journal: J Vasc Surg Date: 2019-11-04 Impact factor: 4.268
Authors: Eran Gazit; Aron S Buchman; Robert Dawe; Thomas A Curran; Anat Mirelman; Nir Giladi; Jeffrey M Hausdorff Journal: Gait Posture Date: 2019-11-09 Impact factor: 2.840
Authors: Silvia Del Din; Brook Galna; Sue Lord; Alice Nieuwboer; Esther M J Bekkers; Elisa Pelosin; Laura Avanzino; Bastiaan R Bloem; Marcel G M Olde Rikkert; Freek Nieuwhof; Andrea Cereatti; Ugo Della Croce; Anat Mirelman; Jeffrey M Hausdorff; Lynn Rochester Journal: J Gerontol A Biol Sci Med Sci Date: 2020-05-22 Impact factor: 6.053