Breaking Down the Risk of Dementia in OAs With Memory, Gait Decline

^{By Julie Gould} 

For older adults without dementia who are experiencing declines in both memory and gait, researchers found this patient population is at a higher risk of developing dementia and “may be a group to target for prevention.” The findings of this study were published online in JAMA Network Open.   

In order to understand the risk of dementia in older adults who were experiencing declines in memory and gait speed, Qu Tian, PhD, MS, National Institute on Aging, and colleagues conducted a multicohort meta-analysis of various prospective cohort studies. The studies analyzed were conducted between 1997 and 2018 in the United States and Europe. 

According to the study findings, study participants with memory decline only had a 2.2 to 4.6 times higher risk for developing dementia compared with usual aging adults. Further, participants experiencing decline in gait only had 2.1 to 3.6 times higher risk. Of important note, participants experiencing decline in both memory and gait had 5.2 to 11.7 times the risk.

We spoke with Dr Tian to better understand the study and its findings, as well as future research that will be conducted.

What existing data led you and your co-investigators to conduct this research?

We analyzed 6 aging cohorts from 4 countries across the US and Europe. 

Please briefly describe your study and its findings. Were any of the outcomes particularly surprising?

This global study of 8,699 participants across the US and Europe examined parallel declines in walking and memory abilities in relation to subsequent dementia risk. Older adults whose walking (gait) and memory abilities decline with age have a higher risk of dementia than peers who decline in only one of these conditions.

What are the possible real-world applications of these findings in clinical practice?

Among older adults living in the community in the absence of cognitive impairment and slow gait (less than or equal to 0.60 m/sec), the dual decline phenotype can be captured early in clinical settings by routinely administering gait speed assessment and a free recall memory test. Individuals who experience parallel declines in walking and memory abilities should receive further attention to address issues that may increase dementia risk, such as cardiovascular and metabolic risk factors. 

Do you and your co-investigators intend to expand upon this research?

Yes. We would like to research whether older individuals who experience parallel declines progress to dementia through specific mechanisms should be further investigated.

Reference:

Tian Q, Resnick SM, Mielke MM, et al. Association of dual decline in memory and gait speed with risk for dementia among adults older than 60 years: a multicohort individual-level meta-analysis [published online February 21, 2020]. JAMA Netw Open. 2020;3(2):e1921636. doi:10.1001/jamanetworkopen.2019.21636