Gait analysis in demented subjects: Interests and perspectives

Olivier Beauchet¹, Gilles Allali², Gilles Berrut³, Caroline Hommet⁴, Véronique Dubost⁵, Frédéric Assal²

¹Department of Geriatrics, Angers University Hospital, France; ²Department of Neurology, Geneva University Hospital, France; ³Department of Geriatrics, Nantes University Hospital, France; ⁴Department of Internal Medicine and Geriatrics, Tours University Hospital, France; ⁵Department of Geriatrics, Dijon University Hospital, France

Abstract: Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer’s disease (AD) and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia. Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects. Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage.

Keywords: gait, prediction of dementia, risk of falling, older adult