MCR is common in older adults, and is a strong and early risk factor for cognitive decline. This clinical approach can be easily applied to identify high-risk seniors in a wide variety of settings.

there is an increased risk of multiple falls, but not single falls, in older people with poorer gait. Specific measures of gait and gait variability seem to confer this risk and may be amenable to interventions designed to reduce the risk of multiple falls in older people.

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Background Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. Methods An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms “Gait” OR “Gait Disorders, Neurologic” OR “Gait Apraxia” OR “Gait Ataxia” AND “Dementia” OR “Frontotemporal Dementia” OR “Dementia, Multi-Infarct” OR “Dementia, Vascular” OR “Alzheimer Disease” OR “Lewy Body Disease” OR “Frontotemporal Dementia With Motor Neuron Disease” (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values. Results Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P < .001 for any dementia, pooled HR = 1.79 with P < .001 for VaD, HR = 1.89 with P value < .001 for non-AD]. Findings were weaker for predicting AD (HR = 1.03 with P value = .004). Conclusions This meta-analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD.

In community-dwelling older people, executive function/attention and processing speed were associated with many aspects of gait, whereas visuospatial ability may only play a role in double support phase variability.

T2DM may promote neurodegeneration independent of AD dementia diagnosis, and its effect may be driven by tau phosphorylation. The mechanisms through which T2DM may promote tau phosphorylation deserve further study.

Background and Purpose-The association between cerebral white matter lesions (WMLs) and the risk of falls in older people is uncertain, with no supporting prospective evidence. We aimed to determine the risk of incident falls associated with WML volume, and the interactions between WML volume, gait, and other sensorimotor factors leading to falls. Methods-We conducted a prospective, population-based study (nϭ294, mean age 72.3 years, independently mobile).Volumetric MRI, computerized gait measures, and sensorimotor measures of falls risk were obtained at baseline. Incident falls were recorded prospectively over a 12-month period. Using regression modeling, we estimated the risk of incident falls associated with baseline WML volume. Results-Increasing baseline WML volume was independently associated with any incident fall (Pϭ0.01) and multiple incident falls (Pϭ0.02). The risk of incident falls was doubled in people with lesion volumes in the highest quintile of its distribution compared with the lowest (adjusted relative risk, 2.32; 95% CI, 1.28 -4.14).Greater lesion volume was also associated with poorer gait and greater gait variability (both PϽ0.001).

These are the first longitudinal data demonstrating the relative contributions of brain atrophy and WML progression to gait decline in older people. Effect modification according to age and infarcts suggests a contribution of reduced physiological and brain reserve. Interventions targeting brain health may be important in preventing mobility decline in older people.