Gait Kinematic and Kinetic Characteristics of Older Adults With Mild Cognitive Impairment and Subjective Cognitive Decline: A Cross-Sectional Study

Abstract

BackgroundOlder adults with mild cognitive impairment (MCI) have slower gait speed and poor gait performance under dual-task conditions. However, gait kinematic and kinetic characteristics in older adults with MCI or subjective cognitive decline (SCD) remain unknown. This study was designed to explore the difference in gait kinematics and kinetics during level walking among older people with MCI, SCD, and normal cognition (NC).MethodsThis cross-sectional study recruited 181 participants from July to December 2019; only 82 met the inclusion criteria and consented to participate and only 79 completed gait analysis. Kinematic and kinetic data were obtained using three-dimensional motion capture system during level walking, and joint movements of the lower limbs in the sagittal plane were analyzed by Visual 3D software. Differences in gait kinematics and kinetics among the groups were analyzed using multivariate analysis of covariance (MANCOVA) with Bonferroni post-hoc analysis. After adjusting for multiple comparisons, the significance level was p < 0.002 for MANCOVA and p < 0.0008 for post-hoc analysis.ResultsTwenty-two participants were MCI [mean ± standard deviation (SD) age, 71.23 ± 6.65 years], 33 were SCD (age, 72.73 ± 5.25 years), and 24 were NC (age, 71.96 ± 5.30 years). MANCOVA adjusted for age, gender, body mass index (BMI), gait speed, years of education, diabetes mellitus, and Geriatric Depression Scale (GDS) revealed a significant multivariate effect of group in knee peak extension angle (F = 8.77, p < 0.0001) and knee heel strike angle (F = 8.07, p = 0.001) on the right side. Post-hoc comparisons with Bonferroni correction showed a significant increase of 5.91° in knee peak extension angle (p < 0.0001) and a noticeable decrease of 6.21°in knee heel strike angle (p = 0.001) in MCI compared with NC on the right side. However, no significant intergroup difference was found in gait kinetics, including dorsiflexion, plantar flexion, knee flexion, knee extension, hip flexion, and hip extension(p > 0.002).ConclusionAn increase of right knee peak extension angle and a decrease of right knee heel strike angle during level walking were found among older adults with MCI compared to those with NC.

Use of electroencephalogram, gait, and their combined signals for classifying cognitive impairment and normal cognition

“…A significant increase in dorsiflexion and a decrease in plantar flexion under cognitive dual-task conditions were observed in patients with AD relative to the normal controls ( Rucco et al, 2017 ). More recently, Zhong et al (2021) found that older adults with MCI had larger knee peak extension angles and smaller knee heel strike angles than those with normal cognition. These previous studies suggest that cognitive impairment may affect gait kinematic parameters, along with spatio-temporal parameters.…”

“…Most studies have stressed the importance of spatio-temporal gait features (i.e., slow gait velocity and shorter stride length and time) that can distinguish cognitive impairment ( Toots et al, 2019 ; Xie et al, 2019 ; Sebastiani et al, 2020 ). There has been little interest in gait kinematics according to cognitive status; two recent studies have provided evidence of an association between gait kinematics and cognitive status ( Rucco et al, 2017 ; Zhong et al, 2021 ). Rucco et al (2017) examined gait patterns in patients with AD and those with behavioral variants of frontotemporal dementia.…”

Use of machine learning to identify functional connectivity changes in a clinical cohort of patients at risk for dementia

“…Participants were assigned to the MCI group if any one of the three following criteria were met ( Bondi et al, 2014 ; Zhong et al, 2021 ): (1) had an impaired score (> 1 SD below the age-corrected normative mean) on both assessments in at least one cognitive domain (memory, language, or executive function); (2) had one impaired score (> 1 SD below the age-corrected normative mean), in each of the three cognitive domains (memory, language, or executive function); or (3) Functional Assessment Questionnaire (FAD) scores ≥ 9. The standard deviation (SD)-based cut-offs utilized in our investigation were based on published studies in the Chinese population that had been adjusted for education and age ( Li et al, 2019 ).…”

Addressing Mild Cognitive Impairment and Boosting Wellness for the Elderly through Personalized Remote Monitoring

“…Over time, multiple studies have examined the influence of different types of data on MCI: hear-disease-related data [ 41 ], demographic information [ 42 ], daily activities [ 43 ], or kinetic data [ 44 ].…”