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Relative Trajectories of Gait and Cognitive Decline in Aging. The journals of gerontology. Series A, Biological sciences and medical sciences BACKGROUND:Gait and cognition decline with advancing age, and presage the onset of dementia. Yet, the relative trajectories of gait and cognitive decline in aging are poorly understood-particularly among those with the motoric cognitive risk (MCR) syndrome. This study compared changes in simple and complex gait performance and cognition, as a function of age and MCR. METHODS:We examined gait and cognitive functions of 1 095 LonGenity study participants (mean age = 75.4 ± 6.7 years) with up to 12 years of annual follow-up. Participants were of Ashkenazi Jewish descent, free of dementia, ambulatory, and had a 12.2% MCR prevalence at baseline. Gait speed was measured at usual pace walking (single-task walking, STW-speed) and walking while talking (WWT-speed). Eleven neuropsychological test scores were examined separately, and as a global cognition composite. Linear mixed-effects models adjusted for baseline sex, education, parental longevity, cognitive impairment, and global health were used to estimate changes in gait and cognition, as a function of age and MCR. RESULTS:STW-speed, WWT-speed, and cognitive tests performance declined in a nonlinear (accelerating) fashion with age. STW-speed declined faster than WWT-speed and cognitive test scores. People with MCR showed faster rates of decline on figure copy and phonemic fluency. CONCLUSIONS:Gait declines at a faster rate than cognition in aging. People with MCR are susceptible to faster decline in visuospatial, executive, and language functions. This study adds important knowledge of trajectories of gait and cognitive decline in aging, and identifies MCR as a risk factor for accelerated cognitive decline. 10.1093/gerona/glab346
Association Between the Loss of Gait Harmony and Cognitive Impairment: Cross-Sectional Study. JMIR public health and surveillance BACKGROUND:Functional limitations and disabilities have been associated with a decrease in cognitive function due to increasing age. Gait performance and cognitive function have been associated with gait variability in executive function, the phase domain in memory, and gait abnormalities in cognitive decline. OBJECTIVE:Our study aimed to investigate whether gait harmony was associated with cognitive function in the older adult population. Moreover, we aimed to investigate whether gait harmony was associated with cognitive function and explore each cognitive function in a specific harmonic state. METHODS:The study population included 510 adults aged ≥60 years who visited the Department of Neurology at the Veterans Health Service Medical Center, Seoul, South Korea. Gait data were collected using a 3D motion capture device with a wireless inertial measurement unit system. For cognitive function assessments, we used the Seoul Neuropsychological Screening Battery-Core test, which evaluates the level of cognitive function or impairment in 5 cognitive domains. RESULTS:In general, the association between the Seoul Neuropsychological Screening Battery-Core tests and the stance-to-swing ratio in the >1.63 ratio group yielded lower β coefficients than those in the 1.50-1.63 ratio group. After adjustment for confounders, the odds ratio (OR) for the Digit Symbol Coding test (adjusted OR 0.42, 95% CI 0.20-0.88) and the Korean version of the Color Word Stroop Test: 60 seconds (adjusted OR 0.51, 95% CI 0.29-0.89) for frontal and executive function were significantly lower for the >1.63 ratio group than the reference group. CONCLUSIONS:Our findings suggest that the gait phase ratio is a valuable indicator of walking deficits and may also be associated with cognitive impairment in older adults. 10.2196/46264
Components of gait in people with and without mild cognitive impairment. Gait & posture BACKGROUND:Several objective gait parameters are associated with cognitive impairment, but there is limited knowledge of gait models in people with mild cognitive impairment (MCI). RESEARCH QUESTION:How can 18 objective gait characteristics be used to define different components of gait in people with MCI (with suspected incipient neurocognitive disorder) and cognitively unimpaired people (CU), respectively? METHODS:Spatiotemporal gait data were collected by using an electronic walkway (GAITRite®), i.e. assessments in comfortable gait speed. Using cross-sectional gait data, two principal component analyses (PCA) were performed (varimax rotation) to define different components of gait in people with MCI (n = 114) and CU (n = 219), respectively, from the BioFINDER-2 study. RESULTS:Both PCAs produced four components, here called Variability, Pace/Stability, Rhythm and Asymmetry. Total variance explained was 81.0% (MCI) versus 80.3% (CU). The Variability component explained the largest amount of variance (about 25%) in both groups. The highest loading gait parameter was the same for both groups in three out of four components, i.e. step velocity variability (Variability), mean step length (Pace/Stability) and mean step time (Rhythm). In the asymmetry component, stance time asymmetry (MCI) and swing time asymmetry (CU) loaded the highest. SIGNIFICANCE:The gait components seem similar in people with and without MCI, although there were some differences. This study may aid the identification of gait variables that represent different components of gait. Gait parameters such as step velocity variability, mean step length, mean step time as well as swing and stance time asymmetry could serve as interesting core variables of different gait components in future research in people with MCI (with suspected incipient neurocognitive disorder) and CU. However, the selection of gait variables depends on the purpose. It needs to be noted that assessment of variability measures requires more advanced technology than is usually used in the clinic. 10.1016/j.gaitpost.2022.01.012