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Could the Way You Walk Increase the Risk of Alzheimer's Disease?

There is overwhelming evidence pointing to the connection between a slow gait and Alzheimer’s disease (AD), according to a recent New York Times article.  In fact, 5 different studies were presented at the AD Association International Conference in Vancouver, pointing to the evidence that as a person’s gait changes with age, so too does his/her cognitive functioning level.   

These studies discovered evidence that cognitive thinking skills (such as memory) were closely associated with a person’s ability to walk “fluidly” says the New York Times article.

“Changes in walking may predate actually observable cognitive changes in people who are on their way to developing dementia,” said Molly Wagster, chief of the National Institute on Aging’s behavioral and neuroscience department. Experts are hoping that these studies could result in the development of a simple tool that doctors could use to help diagnose possible AD.

“You can probably just watch them walk down the hall in your office and look for people who are starting to show deterioration in their gait and have no other explanation for it,” said William Thies, Alzheimer’s Association’s chief medical and scientific officer. “If the gait begins to deteriorate, we begin to have a conversation about how is your memory,” Thies commented.

In the past, scientific research has shown the association between gait changes and heart disease, Parkinson’s, heart attack and stroke.  But research studies are just beginning to associate slow gait with AD as well.

Dr. Studenski, a gerontologist and expert on walking reported, “It’s like driving a car, you need an engine, a chassis and steering.” Studenski, an expert on walking, was not involved in the dementia studies, but provided input on the physiology of the brain and walking. “The engine of walking is the heart, lungs and blood” she said. “The chassis is the muscles, joints and bones, the steering and the wiring is the nervous system,” said Dr. Studenski.  Studenski went on to explain that most cognitive functioning tests that screen for early AD are done with the patient sitting down.  “But damage to the wiring is an important shared problem of difficulty with thinking and difficulty with moving,” said Studenski.

Study on Gait and Alzheimer’s Disease

One study, at Basel Mobility Center in Switzerland, followed 1,153 elderly participants, including patients at the center being treated for memory problems.  The study initially eliminated participants with arthritis and ruled out other physical issues that would adversely affect one’s gait.  Twenty five percent of the participants had no cognitive impairment, other group participants had MCI or were in early or later stages of AD.

Study participants walked on the electronic walkway. Their gait was observed while completing a cognitive task (such as counting backwards by 2’s). Sensors in the walkway notated variations in the person’s speed, number of steps per minute, and the width of the walking stride.

Lead study author Dr. Stephanie Bridenbaugh noted that an elderly participant may walk normally at first, then when asked to count backward while walking, the gait would noticeably worsen. One 72 year old woman in the study “wobbled and teetered” when counting backwards while ambulating on the walkway.  The woman was referred to the memory clinic, where she was already deemed to be afflicted with MCI. 

Overall, those in the study who walked with a slower or more inconsistent gait performed worse on cognitive tests.  The worst walkers were those with the most severe AD.

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