Gait Speed and Grip Strength Reflect Cognitive Impairment and Are Modestly Related to Incident Cognitive Decline in Memory Clinic Patients With Subjective Cognitive Decline and Mild Cognitive Impairment: Findings From the 4C Study

Hooghiemstra, Astrid M.; Ramakers, Inez H.G.B.; Sistermans, Nicole; Pijnenburg, Yolande A.L.; Aalten, Pauline; Hamel, Renske; Melis, René J. F.; Verhey, Frans R.J.; Rikkert, Marcel G M Olde; Scheltens, Philip; Flier, Wiesje M. van der

doi:10.1093/gerona/glx003

Cited by 69 publications

(76 citation statements)

References 43 publications

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“…Our data are in line with a recent population study that concluded that a slow baseline gait speed was only modestly related to future cognitive decline, and provided no early marker of clinical progression from MCI to dementia [ 41 ]. Another recent study reported a lack of gait differences between frail and cognitively impaired old adults during single- or dual-task walking [ 42 ].…”

Section: Discussionsupporting

confidence: 90%

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

Kikkert

Vuillerme

Campen

et al. 2017

J NeuroEngineering Rehabil

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Background: A detailed gait analysis (e.g., measures related to speed, self-affinity, stability, and variability) can help to unravel the underlying causes of gait dysfunction, and identify cognitive impairment. However, because geriatric patients present with multiple conditions that also affect gait, results from healthy old adults cannot easily be extrapolated to geriatric patients. Hence, we (1) quantified gait outcomes based on dynamical systems theory, and (2) determined their discriminative power in three groups: healthy old adults, geriatric patients with-and geriatric patients without cognitive impairment. Methods: For the present cross-sectional study, 25 healthy old adults recruited from community (65 ± 5.5 years), and 70 geriatric patients with (n = 39) and without (n = 31) cognitive impairment from the geriatric dayclinic of the MC Slotervaart hospital in Amsterdam (80 ± 6.6 years) were included. Participants walked for 3 min during singleand dual-tasking at self-selected speed while 3D trunk accelerations were registered with an IPod touch G4. We quantified 23 gait outcomes that reflect multiple gait aspects. A multivariate model was built using Partial Least Square-Discriminant Analysis (PLS-DA) that best modelled participant group from gait outcomes. Results: For single-task walking, the PLS-DA model consisted of 4 Latent Variables that explained 63 and 41% of the variance in gait outcomes and group, respectively. Outcomes related to speed, regularity, predictability, and stability of trunk accelerations revealed with the highest discriminative power (VIP > 1). A high proportion of healthy old adults (96 and 93% for single-and dual-task, respectively) was correctly classified based on the gait outcomes. The discrimination of geriatric patients with and without cognitive impairment was poor, with 57% (single-task) and 64% (dual-task) of the patients misclassified. Conclusions: While geriatric patients vs. healthy old adults walked slower, and less regular, predictable, and stable, we found no differences in gait between geriatric patients with and without cognitive impairment. The effects of multiple comorbidities on geriatric patients' gait possibly causes a 'floor-effect', with no room for further deterioration when patients develop cognitive impairment. An accurate identification of cognitive status thus necessitates a multifactorial approach.

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Section: Discussionsupporting

confidence: 90%

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

Kikkert

Vuillerme

Campen

et al. 2017

J NeuroEngineering Rehabil

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“…51 Vancampfort et al recently reported that among middle-aged and older adults, weak grip strength was associated with increased odds of having mild cognitive impairment. 52 Others have shown a correlation between grip strength and the Mini-Mental State Examination scores of geriatric inpatients, 53 information processing speed and executive functioning of patients attending a memory clinic, 54 Stroop Task and 6item Cognitive Impairment Test scores of physically active adults, 55 visual memory,and reaction time of patients with schizophrenia, 56 and Animal Fluency Test and Digital Symbol Substitution Test scores of cancer survivors. 57 A link between grip strength and depression has been demonstrated among residents of 6 low and middle income countries 58 as well as Brazil 59 and Korea.…”

Section: Grip Strength As a Biomarker Of Current Statusmentioning

confidence: 99%

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

Bohannon

2019

CIA

470

344

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Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.

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“…Relevant links between cognition and gait have been established earlier. Older adults with cognitive impairment are known to have slower pace ( 26 ). Verghese and colleagues in the early 2000 implicated that presence of neurological gait in older adults could predict the risk of dementia ( 18 ).…”

Section: Mcr Syndromementioning

confidence: 99%

Motoric Cognitive Risk Syndrome: Predictor of Dementia and Age-Related Negative Outcomes

et al. 2017

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Cognitive disorders represent a leading cause of disability in the aging population, of which dementia has the highest global burden. Early signs of dementia such as slow gait and memory complaints are known to present well before the overt manifestation of the disease. Motoric cognitive risk (MCR) syndrome characterized by the simultaneous presence of gait disturbances and memory complaints in older subjects has been proposed to study the close interactions between the physical and cognitive domains as well as a possible approach to identify individuals at increased risk of dementia. In addition, studies have shown MCR as a predictor of other negative outcomes in older adults, including disability, falls and death. However, the concept of MCR is still in its early stage and approach to the syndrome is still not well established. This review aims to put together the various aspects of MCR syndrome including its pathophysiology, diagnosis, epidemiology, and relationship with other geriatric conditions.

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Gait Speed and Grip Strength Reflect Cognitive Impairment and Are Modestly Related to Incident Cognitive Decline in Memory Clinic Patients With Subjective Cognitive Decline and Mild Cognitive Impairment: Findings From the 4C Study

Abstract: Our findings suggest that markers of physical performance are related to current cognitive status and modestly related to cognitive decline but are seemingly not useful as an early marker of incident clinical progression.

Cited by 69 publications

References 43 publications

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

Motoric Cognitive Risk Syndrome: Predictor of Dementia and Age-Related Negative Outcomes

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