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Dementia Risk Screening Should Include Dual Gait Speed Alongside Memory Assessment
Clinicians should include gait speed in dementia risk screening assessments, according to a cohort study published in JAMA Network Open.
“These results highlight the importance of gait in dementia risk assessment and suggest that dual decline in gait speed and a memory measure may be the best combination associated with accurate assessment of future dementia risk,” said Taya A. Collyer, PhD, and co-authors in the study.
Participants comprised 16,855 “relatively healthy” people over 65 years old in Australia and the United States who also participated in a randomized clinical trial testing low-dose aspirin between 2010 and 2017.
Gait speed was measured at 0, 2, 4, and 6 years, and at the trial close-out visit in 2017, where participants completed 2 walks of 3 meters. The mean average of 2 walks measured in meters per second (m/s) was used in the analysis. Cognitive measures assessed at years 0, 1, 3, 5, and 2017 close-out consisted of global cognition (Modified Mini-Mental State examination [3MS]), delayed free recall (Hopkins Verbal Learning Test-Revised [HVLT-R-delay]), processing speed (Symbol Digit Modalities [SDMT]), and verbal fluency (Controlled Oral Word Association Test–single-letter version [COWAT-F]).
A decline in gate speed of 0.05 m/s or greater per year was defined as “gate decline.” Researchers classified participants into the following 4 groups: dual decline in gait and cognition, gait decline only, cognitive decline only, and nondecliners.
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Of participants included in the study compared with nondecliners, risk of dementia was highest in the gait plus HVLT-R decliners (hazard ratio [HR], 24.7; 95% CI, 16.3-37.3), followed by the gait plus 3MS (HR, 22.2; 95% CI, 15.0-32.9), gait plus COWAT-F (HR, 4.7; 95% CI, 3.5-6.3), and gait plus SDMT (HR, 4.3; 95% CI, 3.2-5.8) groups. “Dual decliners had a higher risk of dementia than those with either gait or cognitive decline alone for 3MS and HVLT-R,” researchers found in their analysis.
“Measurement of gait speed has long been recommended in clinical practice as a marker of overall health and adverse outcomes such as falls, disability, hospitalization, and mortality. Our findings suggest that serial measurement of gait along with a simple test of memory would be more sensitive to future dementia risk than either measure alone,” researchers concluded.
