Seonjeong Byun1,2, Ji Won Han1, Tae Hui Kim3, Kayoung Kim4, Tae Hyun Kim1, Jae Young Park1, Seung Wan Suh1, Ji Young Seo5, Yoonseop So1, Kyoung Hwan Lee6, Ju Ri Lee1, Hyeon Jeong1, Hyun-Ghang Jeong7, Kyuhee Han1, Jong Woo Hong1, Ki Woong Kim1,2,8. 1. Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Department of Psychiatry, School of Medicine, Seoul National University, Seoul, Republic of Korea. 3. Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea. 4. Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea. 5. Department of Neuropsychiatry, Changwon Gyeongsang National University Hospital, Jinju, Republic of Korea. 6. Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea. 7. Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 8. Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
Abstract
BACKGROUND: The aim of this study was to investigate the association of gait speed and gait variability, an index of how much gait parameters, such as step time, fluctuate step-to-step, with risk of cognitive decline in cognitively normal elderly individuals. While high gait variability is emerging as an early indicator of dementing illnesses, there is little research on whether high gait variability predicts cognitive decline in cognitively normal elderly who have no evidence of cognitive impairment. METHODS: In this 4-year prospective cohort study on 91 community-dwelling cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism, we evaluated gait speed and step time variability using a tri-axial accelerometer placed on the center of body mass, and diagnosed mild cognitive impairment (MCI) according to the International Working Group on MCI. We performed Kaplan-Meier analysis with consecutive log-rank testing for MCI-free survival by cohort-specific tertiles of gait speed; hazard ratios (HR) of incident MCI were estimated using Cox proportional hazards regression analysis adjusted for age, sex, education level, Cumulative Illness Rating Scale score, GDS score, and presence of the apolipoprotein E ε4 allele. RESULTS: Out of the 91 participants in the baseline assessment, 87 completed one or more 2-year follow-up assessments, and the median duration of follow-up was 47.1 months. Kaplan-Meier curves of incident MCI show evident differences in risk by gait variability group (χ2 = 9.64, p = 0.002, log-rank test). Mean MCI-free survival in the high variability group was 12% shorter than in the mid-to-low tertile group (47.4 ± 1.74 [SD] vs. 54.04 ± 0.52 months), while it was comparable between gait speed groups (51.59 ± 0.70 vs. 50.64 ± 1.77 months; χ2 = 1.16, p = 0.281). In multivariate analysis, subjects with high gait variability showed about 12-fold higher risk of MCI (HR = 11.97, 95% CI = 1.29-111.37) than those with mid-to-low variability. However, those with slow gait speed showed comparable MCI risk to those with mid-to-high speed (HR = 5.04, 95% CI = 0.53-48.18). CONCLUSIONS: Gait variability may be a better predictor of cognitive decline than gait speed in cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism.
BACKGROUND: The aim of this study was to investigate the association of gait speed and gait variability, an index of how much gait parameters, such as step time, fluctuate step-to-step, with risk of cognitive decline in cognitively normal elderly individuals. While high gait variability is emerging as an early indicator of dementing illnesses, there is little research on whether high gait variability predicts cognitive decline in cognitively normal elderly who have no evidence of cognitive impairment. METHODS: In this 4-year prospective cohort study on 91 community-dwelling cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism, we evaluated gait speed and step time variability using a tri-axial accelerometer placed on the center of body mass, and diagnosed mild cognitive impairment (MCI) according to the International Working Group on MCI. We performed Kaplan-Meier analysis with consecutive log-rank testing for MCI-free survival by cohort-specific tertiles of gait speed; hazard ratios (HR) of incident MCI were estimated using Cox proportional hazards regression analysis adjusted for age, sex, education level, Cumulative Illness Rating Scale score, GDS score, and presence of the apolipoprotein E ε4 allele. RESULTS: Out of the 91 participants in the baseline assessment, 87 completed one or more 2-year follow-up assessments, and the median duration of follow-up was 47.1 months. Kaplan-Meier curves of incident MCI show evident differences in risk by gait variability group (χ2 = 9.64, p = 0.002, log-rank test). Mean MCI-free survival in the high variability group was 12% shorter than in the mid-to-low tertile group (47.4 ± 1.74 [SD] vs. 54.04 ± 0.52 months), while it was comparable between gait speed groups (51.59 ± 0.70 vs. 50.64 ± 1.77 months; χ2 = 1.16, p = 0.281). In multivariate analysis, subjects with high gait variability showed about 12-fold higher risk of MCI (HR = 11.97, 95% CI = 1.29-111.37) than those with mid-to-low variability. However, those with slow gait speed showed comparable MCI risk to those with mid-to-high speed (HR = 5.04, 95% CI = 0.53-48.18). CONCLUSIONS: Gait variability may be a better predictor of cognitive decline than gait speed in cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism.
Authors: On-Yee Lo; Mark A Halko; Kathryn J Devaney; Peter M Wayne; Lewis A Lipsitz; Brad Manor Journal: J Gerontol A Biol Sci Med Sci Date: 2021-09-13 Impact factor: 6.591
Authors: Iván José Fuentes-Abolafio; Brendon Stubbs; Luis Miguel Pérez-Belmonte; María Rosa Bernal-López; Ricardo Gómez-Huelgas; Antonio Cuesta-Vargas Journal: BMC Geriatr Date: 2020-08-10 Impact factor: 3.921
Authors: Juan Antonio Párraga-Montilla; Diana Patricia Pozuelo-Carrascosa; Juan Manuel Carmona-Torres; José Alberto Laredo-Aguilera; Ana Isabel Cobo-Cuenca; Pedro Ángel Latorre-Román Journal: Int J Environ Res Public Health Date: 2021-03-25 Impact factor: 3.390