Alzheimer’s development predicted through changes in gait
When you are stuck behind an older woman at the supermarket, do you get impatient at her slow pace? Maybe she simply has all the time in the world and no longer must rush through each day as though she needs to put out a fire. Or maybe she has arthritis or another physical illness that is slowing her down. There’s nothing wrong with being more cautious about movements and slowing a bit as we age. However, for some people, a slow gait, particularly an uneven gait, could be a sign of brain disease such as Alzheimer’s.
According to a recent article in the New York Times, researchers have found that some changes in the gait of an aging adult can signify issues other than just normal aging.
A total of five studies presented at the Alzheimer’s Association International Conference in Vancouver recently provided strong evidence that when a person’s natural walk gets slower or less controlled, his or her cognitive function is likely also suffering, unless of course there is an obvious explanation such as severe arthritis.
According to Molly Wagster, chief of the National Institute on Aging’s behavioral and systems neuroscience branch, “Changes in walking may predate actually observable cognitive changes in people who are on their way to developing dementia.”
Researchers said the studies could lead to developing a relatively simple tool that doctors could use to “forecast, if not diagnose, possible Alzheimer’s disease…People who are focused on cognition largely never watch people move…The tests are all done sitting down. But damage to the wiring is an important shared problem of difficulty with thinking and difficulty with moving.”
The researchers found that thinking skills such as memory, processing information or organizing activities nearly always decline “in parallel with the ability to walk fluidly.”
A study led by Dr. M. Arfan Ikram, a neuroepidemiologist at Erasmus MC University Medical Center in Rotterdam, tried to connect particular changes in gait with specific cognitive impairments. The researchers found that slower walking is strongly linked to declines in executive function, which is the ability to plan and organize.
Deciding whether a slow gait is the precursor to Alzheimer’s is a bit more complicated than just observing a patient walking across a room. Scientists asked the study participants to walk while counting backward from 50 by twos, or while naming different animals. The idea is that the person is required to perform dual tasks. This type of test reveals “deficits that you can’t see with the naked eye.”
Test that can predict Alzheimer’s
Recently, a test using spinal fluid to determine if indicators of future Alzheimer’s disease are present, has been in the news. This test is expensive and can be painful, though it’s thought to be accurate. Researchers have also been working on blood tests, but at this time there isn’t a simple, inexpensive blood test available that can accurately predict Alzheimer’s disease. Perfecting such a blood test is only a matter of time.
These tests will certainly have their place. However, training doctors to simply observe their aging patients walk seems practical and cheap. Watching the patient will take only moments of a doctor’s time. Then, if the physician has doubts about cognitive issues, he or she could ask the person to perform a mental task while walking. The results of this simple test could lead the doctor to recommend further testing or put a patients mind at rest for the time being. It certainly seems to me that this small test could be a part of any aging person’s annual physical without breaking any budgets. I hope to see it widely used before long.
Belluck, P. (2012, July 16) Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait. New York Times. Retrieved from http://www.nytimes.com/2012/07/17/health/research/signs-of-cognitive-decline-and-alzheimers-are-seen-in-gait.html?_r=1&utm_source=July+27%2C+2012&utm_campaign=Constant+Contact&utm_medium=email