Last Updated: 2008-08-26 12:18:44 -0400 (Reuters Health)
NEW YORK (Reuters Health) – Older patients with amnestic or non-amnestic subtypes of mild cognitive impairment often exhibit gait dysfunction, according to findings published in the July issue of the Journal of the American Geriatrics Society.
"Mild cognitive impairment (MCI) syndrome is conceptualized as a transition state between cognitive normalcy and dementia in older adults," Dr. Joe Verghese and colleagues from Yeshiva University, Bronx, New York, write. "Although neuropsychological characteristics of the MCI syndromes are well known, other behavioral markers are not well established."
Some recent studies have suggested that gait disturbances occur in the earliest stages of dementia, including MCI, the researchers note, and to investigate further they studied 54 subjects with amnestic MCI, 62 with non-amnestic MCI, and 295 cognitively normal control subjects in the Einstein Aging Study.
Gaits were assessed for neurological impairment by a neurologist, and for quantitative parameters such as velocity, cadence and stride length variability using a computerized walkway with embedded sensors.
Neurologically impaired gaits were significantly more common in subjects with amnestic MCI (31.5%), but not in those with non-amnestic MCI (19.4%) than in control subjects (16.3%).
Compared to control subjects, both MCI subtypes had worse quantitative gait on most parameters.
The investigators note that disability scores among individuals with MCI were worse for those with any gait abnormalities than without gait abnormalities (p < 0.001).
"The findings of the current study that link motoric and cognitive impairment in MCI raise the possibility of shared pathogeneses, including Alzheimer’s pathology, Lewy body pathology, and vascular disease," Dr. Verghese and colleagues suggest.
"Assessment of gait in older adults may provide a window on brain function that complements current definitions of MCI and usefully predicts dementia and other outcomes of interest," they propose.
J Am Geriatr Soc 2008;56:1244-1251.
Copyright Reuters 2008.