Investigation of the Relationship between Gait Disturbance and Cognitive Impairment

Background: The worldwide prevalence of dementia has become a considerable global health issue. There are a number of diseases that cause dementia, with the most common is Alzheimer’s disease (AD), which is responsible for 60 to 80 percent of all dementia. However, effective curative treatment for AD is still lacking. Despite under appropriate treatment, rapid decline of cognitive function is not uncommon. Therefore, finding potential modifiable risk factors in cognitive deterioration and then offering some intervention in addition to medication to ameliorate cognitive decline is necessary. Aim: Besides those well-known risk factors of cognitive impairment, gait impairments and falls was found to be more prevalent in individuals with dementia than in those with normal aging and are related to the severity of cognitive impairment. The main purpose of this study is to identify differences in gait and dual task performance between elderly subjects with mild cognitive impairment and dementia due to AD in Taiwan. We also want to explore discrete relationships of gait disturbance and each specific cognitive domain.Method: We will recruit elderly people with mild cognitive impairment or dementia due to Alzheimer’s disease. They will undergo interview for individual data collection, questionnaire, cognitive function assessments, gait analysis, evaluation of sarcopenia and polysomnography. We will perform univariable analyses by t test and Mann-Whitney U test for continuous variable and Chi-square test for categorical variable. Further linear or logistic regression analyses will also be done.Expected results: Independent gait characteristics would be related to discrete cognitive functions in a specifc rather than global manner and the pattern of association would be different with respect to pathology and ageing.Future work: This protocol is the beginning of a prospective cohort study. We will follow up the cognitive function tests and gait analysis every year after recruitment for at least 5 years. We want to investigate the causal inference rather than only the association between gait and cognition. Besides, based on better understanding the interactions between aging, gait alternations and cognitive impairment, we want to provide better targeted intervention including physical activity and cognitive training to combat the functional deterioration in older adults with cognitive impairments and dementia.