Gait & posture · 2025
Gait characteristics in older adults with higher-level gait disorders during normal, dual-task, and destabilising walking conditions at home and their association with cognitive impairment.
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Zhang Weihong, Paul Serene S, Gwynn Josephine Diana, Clemson Lindy, Low Lee-Fay
Аннотация
BACKGROUND: Gait disorders are common among older adults and contribute to falls and immobility. This study aimed to explore gait characteristics in older adults with higher-level gait disorders during normal, dual-task, and destabilising walking conditions at home, and their association with cognitive impairment.
METHODS: A cross-sectional study was conducted in the community with two groups (n = 60): older adults with higher-level gait disorders and an age- and gender-matched non-gait disorder (control) group. Both groups underwent cognitive assessments and gait assessments using inertial measurement units (IMUs).
RESULTS: Compared to controls, those with gait disorders exhibited worse cognitive and gait performance. Measures of gait speed, stride length, stride length variability, and double support time reflected higher-level gait disorders. Small associations were found between gait speed and stride length with attention and processing speed (Stroop, SDMT), and between double support with motor planning and processing speed (LEMOCOT, SDMT). Larger decrements (between-group effect size) in gait performance compared to controls during dual-task and destabilising walking conditions.
CONCLUSION: Instrumented gait assessment and cognitive assessment can be conducted at home in older adults with higher-level gait disorders. Their gait characteristics include reduced gait speed, increased double support and gait variability. Certain cognitive domains such as attention, processing speed, and motor planning are associated with gait control. Monitoring subtle changes in key gait parameters may provide opportunities for early intervention to address gait deficits and reveal cognitive changes requiring further investigation to formulate effective management plans.
METHODS: A cross-sectional study was conducted in the community with two groups (n = 60): older adults with higher-level gait disorders and an age- and gender-matched non-gait disorder (control) group. Both groups underwent cognitive assessments and gait assessments using inertial measurement units (IMUs).
RESULTS: Compared to controls, those with gait disorders exhibited worse cognitive and gait performance. Measures of gait speed, stride length, stride length variability, and double support time reflected higher-level gait disorders. Small associations were found between gait speed and stride length with attention and processing speed (Stroop, SDMT), and between double support with motor planning and processing speed (LEMOCOT, SDMT). Larger decrements (between-group effect size) in gait performance compared to controls during dual-task and destabilising walking conditions.
CONCLUSION: Instrumented gait assessment and cognitive assessment can be conducted at home in older adults with higher-level gait disorders. Their gait characteristics include reduced gait speed, increased double support and gait variability. Certain cognitive domains such as attention, processing speed, and motor planning are associated with gait control. Monitoring subtle changes in key gait parameters may provide opportunities for early intervention to address gait deficits and reveal cognitive changes requiring further investigation to formulate effective management plans.