Walking is an important part of human development. Everyone, from their first steps to their last, develops their own special stride. For instance, my friends and family say they can point me out from blocks away based on my goofy saunter alone. Walking is so important to humans that the first steps a child takes are celebrated as one of the monumental moments in early childhood development. If a person’s early steps are so crucial to development, it is not surprising that the later, stumbling steps of an older person are also significant.
A recent New York Times article by Pam Belluck, “Footprints to Cognitive Decline and Alzheimer’s Are Seen in Gait,” discusses how changes in an elderly person’s walk can be significant, not only for measuring physical ailments, but also for measuring and testing cognitive impairment. In fact, according to the article, five studies presented at this year’s Alzheimer’s Association International Conference in Vancouver provided evidence that changes to an individual’s gait, such as slower and more varied step, can be evidence that his or her cognitive function is also suffering.
The studies, which all screened for arthritis and other physical problems, tested the subjects’ ability to walk normally, walk backwards, and walk while dual tasking. The studies also tested each subject’s cognitive function by examining their fine motor skills, thinking speed, and executive function. The results clearly portrayed a correlation between lower cognitive function (including the presence of dementia and Alzheimer’s disease) and slower or more unpredictable walking. One could argue that slower and more unpredictable walking should be expected in old age due to physical decline. However, these studies all adjusted for variables like height, age, weight, and sex.
One geriatrician, Dr. Stephanie Studenski, from the University of Pittsburgh, offered a great analogy in the Times article. She compared walking to driving a car. To drive a car you need all the parts—the engine, the chassis, and the steering—to work properly. Similarly, she stated that in order for a person to walk they need their vascular and respiratory systems (the engine), their muscles, joints, and bones (the chassis), and their nervous system (the steering), all to work properly. Thus, if a doctor or physical therapist observes abnormal walking patterns with the absence of any issues to the “engine” or “chassis,” then the issue is likely in the “steering” or nervous system.
If these studies are correct they could have a substantial impact on testing for dementia and Alzheimer’s. Whether these studies will help contribute to the prevention or deceleration of dementia and Alzheimer’s, possibly through physical exercise, is uncertain. However, they do help us to better identify and understand how these conditions can affect us.