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Abstract
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After birth, in contrast to most other species with legs, humans need up to a year to learn to balance on both feet and walk upright. Therefore, human gait is neither a simple motor activity nor is it simply a motor activity. Gait is a complex activity that is as much a cognitive as a motor task. Complex processes in the brain enable and control walking. Disruption of these processes, as in neurodegenerative or neurovascular disease, causes not only cognitive impairment but also functional impairment, including walking difficulties. Both gait impairments and cognitive impairments are risk factors for falls [1].
However, as logical this sounds today, the conclusions above only became evident at the beginning of this century, thanks to the emergence of user-friendly technologies for objective gait analysis among older adults. Quantifying gait beyond subjective visual clinical assessments or simple walking speed measures opened up a completely new field of clinical research in Geriatrics. Gait parameters such as stride variability and stride width were shown to be valuable predictors for falls [2]. The same gait parameters measured under defined stress conditions such as motor-cognitive dual tasking proved to be an even more sensitive marker for fall risk as well as risk of cognitive decline [3,4]. Thanks to quantitative gait analysis with standardized procedures and conditions, results were easily comparable between different gait labs and research groups [5]. As an example, pooling gait data of aging cohorts from all over the world allowed the development of the motor cognitive risk syndrome (MCR), the combination of slow gait with cognitive complaints as a strong predictor for dementia over an observation time of 12 years...
Key points
- Gait and cognition are closely linked to each other; Early detection of slowing gait allows the early detection not only of fall risk but also of possible cognitive deficits.
- Measuring gait speed is simple, quick and not costly and should be a standard assessment for older patients in a GP's office.
Language: en |