Dementia is a debilitating neurodegenerative disease that affects over 50 million people worldwide, with 10 million new cases every year. The number of people with dementia may reach 152 million by 2050. While big strides have been achieved in the field of neurology, dementia still stands as an incurable disease. Brain scans, blood biomarkers and testing of cognitive functions are currently the most common methods used in detection. However, these tests can be costly and invasive. Thankfully, there might be a connection between dementia and walking… and from that connection, there could be a less invasive test and earlier treatment.
People don’t pay much attention to it, but walking is a complex process. For every step a human body takes, neurons fire in a localized section of the brain. Plaque buildup, such as in the case of dementia patients, can jam the brain’s circuitry. Consequently, with delays in sending and receiving these signals, a person’s balance, speed, and gait symmetry become impaired. Additionally, patients suffering from neurodegenerative illnesses cannot respond quickly to changes in the terrain. Thus, without acuity to quickly assess the environment and adjust pace, it affects balance and speed. Indeed, the relationship between dementia and walking cannot be contradicted.
Gait Testing as a Predictor for Cognitive Decline
Gait testing as a tool for diagnosis looks at the patients’ gait cost or speed under various conditions. First, patients will walk at varying speeds (slow, normal or preferred speed, and peak speed) to establish the baseline. After completing the single task, patients will then perform the cognitive dual task and motor dual task. Ideally, a person with healthy cognitive functions can perform multiple tasks at a time. But for patients with a high risk of dementia – the ability to concentrate and focus decreases as additional tasks pile up on top of one another.
The succeeding tasks highlight the connection between dementia and walking. Cognitive dual task aims to measure the patient’s ability to think while simultaneously performing motor tasks. Examples of this test include walking while counting backwards or walking while repeating phrases.
On the other hand, dual motor tasks pertain to completing two motor tasks at the same time. A dual motor task aims to measure changes in gait speed when another task is added. Will the patient’s gait speed change if asked to carry a tray while walking? The answer to these questions will make up the patient’s personal gait pattern. By exhibiting unique impairment signatures through gait testing, the link between dementia and walking offers promise as an early indicator of cognitive decline.
Joining the Quest: Studies Looking at the Link between Dementia and Walking Difficulties
Dementia can damage the brain in various ways and this includes mobility and motor skills. For people who are at risk, the exploratory studies around gait impairment as an early indicator for dementia, hold so much promise. With experts looking at changes in walking patterns and gait impairments as an early indicator of neurodegenerative diseases, private ventures are joining the research.
- Canada-based Lawson Health Research has been granted research funding worth $1.35 million. The program dubbed as Canadian Consortium on Neurodegeneration in Aging (CCNA) is led by Dr. Manuel Montero-Odasso. The allocation of the majority of the funds will be for understanding the connection between dementia and walking. Dr. Montero-Odasso, with the Mobility, Exercise and Cognition (MEC) team will test the impact of physical exercise, cognitive training and vitamin D supplementation.
- A collaboration between Apple, Eli Lilly and Company and Evidation Health is likewise developing. The partnership was presented in the form of a feasibility study at a Data Science Conference in Anchorage, Alaska. According to this research, devices such as iPhones, watches and sleep monitors can gather data to predict cognitive impairment.
- Newcastle University will be working with pharmaceutical company Novartis in a project called MOBILISE-D. The project aims to develop wearable technology focused on the aging European population. With a €50 million funding from European Innovative Medicines Initiative 2 Joint Undertaking, the project aims to tap on technology to predict, detect and measure mobility loss.
Early detection is crucial in improving the patient’s quality of life. However, the opportunity to detect dementia in its early stages is not always possible. Why? Most of the early symptoms of dementia such as forgetfulness or losing track of time are often relegated as age-related memory changes. Moreover, such impaired cognitive functions manifest gradually. Thus, by the time of diagnosis, dementia has already progressed. At this point, the patient has become totally dependent on others for self-care. With experts looking at the link between dementia and walking, we may soon have a better way of catching this debilitating disease in its early stages.
