Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling
Identifieur interne : 000614 ( Pmc/Checkpoint ); précédent : 000613; suivant : 000615Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling
Auteurs : Manuel Montero-Odasso [Canada] ; Joe Verghese [États-Unis] ; Olivier Beauchet [France] ; Jeffrey M. Hausdorff [États-Unis]Source :
- Journal of the American Geriatrics Society [ 0002-8614 ] ; 2012.
Abstract
Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia.
This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments.
Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia.
Url:
DOI: 10.1111/j.1532-5415.2012.04209.x
PubMed: 23110433
PubMed Central: 3498517
Affiliations:
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<front><div type="abstract" xml:lang="en"><p id="P1">Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia.</p>
<p id="P2">This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments.</p>
<p id="P3">Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia.</p>
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Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada</aff>
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“Gait and Brain Lab” Lawson Health Research Institute, London, ON, Canada</aff>
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Department of Neurology; Albert Einstein College of Medicine; Bronx, NY</aff>
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Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital; UPRES EA 2646, UNAM, France</aff>
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Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Department of Physical Therapy, Tel Aviv University, Israel, and the Department of Medicine, Harvard Medical School, Boston, MA</aff>
<author-notes><corresp id="FN1">Corresponding author: Manuel Montero-Odasso, MD, PhD, AGSF, Gait and Brain Lab, Parkwood Hospital, Rm. A-280, Western University and Lawson Health Research Institute, 801 Commissioners Rd East. London, Ontario. Canada N6C 5J1, Tel: 519-685-4292 ext. 42369, Fax: 519-685-4093, <email>mmontero@uwo.ca</email>
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<corresp id="FN2">Alternative corresponding author: Olivier Beauchet, MD, PhD, Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, 49933 Angers Cedex 9, France;; Phone: ++33 2 41 35 47 25; Fax: ++33 2 41 35 48 94; <email>olbeauchet@chu-angers.fr</email>
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<abstract><p id="P1">Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia.</p>
<p id="P2">This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments.</p>
<p id="P3">Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia.</p>
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