Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment.
Lisette H J Kikkert, Nicolas Vuillerme, Jos P van Campen and 3 others
PMID 28810928WHAT IT FOUND
Gait measures separated geriatric patients from healthy older adults, but did not reliably tell cognitively impaired and cognitively intact geriatric patients apart, even during a thinking task.
Do not use walking alone to identify cognitive impairment in geriatric patients.
Key findings
01Geriatric patients walked slower than healthy old adults and had less regular, less predictable, and less stable gait dynamics.
02The models classified 96% of healthy old adults during single-task walking, but 57% and 64% of geriatric patients were misclassified during single- and dual-task walking, respectively.
03Adding the phonetic word-generation walking task did not improve discrimination between cognitively impaired and cognitively intact geriatric patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included a relatively low sample size, so it describes group differences rather than showing that gait changes cause or predict outcomes. Healthy old adults were younger (65 years on average) than geriatric patients (79 to 82 years), so gait differences may reflect age, frailty, or clinic status rather than cognitive impairment. Geriatric patients had multiple comorbidities and polypharmacy, which can affect gait and may mask additional effects of cognitive impairment. When patients did not walk for three minutes, only the longest continuous part was analysed. The analysis used only trunk acceleration outcomes, not foot-step detection or gait kinetics, so it may miss other walking features.
The easy way to misread this
Do not read the high accuracy for healthy old adults as evidence that gait can identify cognitive impairment. In geriatric patients, the models misclassified 57% and 64% during single- and dual-task walking, and the word task did not improve discrimination.