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Gait tests suitable for early diagnosis of dementia?
In the case of dementia diseases, the earliest possible diagnosis is the most important factor for the achievable treatment success. The gait can provide important clues to cognitive decline, which is considered an early sign of dementia. "Gait disorders, especially slow walking, should be seen as an indicator of future cognitive decline," reports the "Journal of Alzheimer's Disease" (JAD).
In a special edition, the JAD is dedicated to the connections between gait disorders and cognitive impairments. "The way people walk is an indicator of how much their brains and their bodies are aging," reports the specialist magazine. Using special motor tests, the risk of cognitive decline and impending dementia can be estimated much better in the future.
10 million new cases every year
Cognitive impairments and dementia are serious health problems and according to the specialist magazine around fifty million people worldwide suffer from dementia. There are almost ten million new cases every year, with Alzheimer's being the most common form of dementia and accounting for around 60 to 70 percent of cases. Progressive memory loss and impaired orientation, understanding, calculations, learning ability, language and judgment are known as typical symptoms of dementia. However, impaired walking is also an essential symptom of dementia.
Studies assess the relationships
In the current edition of the JAD, a whole series of studies is presented that illustrate the connection between gait disorders and the risk of dementia. These deal with:
- the epidemiology of gait disorders and cognitive impairments,
- the relationship between gait speed and cognitive decline,
- the relationship between cerebral amyloid beta deposits and impaired gait speed,
- the so-called dual-task-gait paradigm when walking and a cognitively demanding task at the same time,
- Feasibility of gait measurement in an outpatient environment.
Indicator of future cognitive impairments
"There is a new focus on assessing motor performance to predict loss of cognitive functions," said guest editor Dr. Manuel Montero-Odasso of the University of Western Ontario in a JAD statement. Overall, gait disorders (especially slow walking) should be assessed as an indicator of future cognitive impairments. They occur in the early stages of dementia and could even predict who is at risk of developing dementia, the expert reports.
Gait tests as a routine clinical examination?
"Subtle walking impairments are more common in older adults with cognitive decline and dementia and are also associated with an increased risk of falling," explains Dr. Montero-Odasso continues. Gait tests should be "part of the routine clinical examination for older adults with cognitive impairments"; adds Professor George Perry of the University of Texas at San Antonio, also a guest author in the special edition.
Diagnosis before the onset of memory loss?
"It is conceivable that in the future we can diagnose dementia before people have a significant memory loss," emphasizes Dr. Montero-Odasso. For example, in older adults with moderate cognitive impairment, a slowdown in normal gait speed can be observed by more than 20 percent if they are given a cognitive task while walking. This is also an indication of a seven-fold increased risk of developing Alzheimer's in a period of five years. Just an example of how helpful such risk assessment tests could be. Overall, there is a lot to be said for implementing gait tests as an essential pillar in routine examinations.
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Journal of Alzheimer's Disease (JAD): Looking at the Way We Walk Can Help Predict Cognitive Decline (published October 28, 2019), j-alz.com