TY - JOUR
T1 - Prognostic relevance of gait-related cognitive functions for dementia conversion in amnestic mild cognitive impairment
AU - The Alzheimer's Disease Neuroimaging Initiative
AU - Tuena, Cosimo
AU - Maestri, Sara
AU - Serino, Silvia
AU - Pedroli, Elisa
AU - Stramba-Badiale, Marco
AU - Riva, Giuseppe
AU - Silbert, Lisa C.
AU - Lind, Betty
AU - Crissey, Rachel
AU - Kaye, Jeffrey A.
AU - Carter, Raina
AU - Dolen, Sara
AU - Quinn, Joseph
AU - Schneider, Lon S.
AU - Pawluczyk, Sonia
AU - Becerra, Mauricio
AU - Teodoro, Liberty
AU - Dagerman, Karen
AU - Spann, Bryan M.
AU - Brewer, James
AU - Fleisher, Adam
AU - Vanderswag, Helen
AU - Ziolkowski, Jaimie
AU - Heidebrink, Judith L.
AU - Zbizek-Nulph, Lisa
AU - Lord, Joanne L.
AU - Albers, Colleen S.
AU - Petersen, Ronald
AU - Mason, Sara S.
AU - Knopman, David
AU - Johnson, Kris
AU - Villanueva-Meyer, Javier
AU - Pavlik, Valory
AU - Pacini, Nathaniel
AU - Lamb, Ashley
AU - Kass, Joseph S.
AU - Doody, Rachelle S.
AU - Shibley, Victoria
AU - Chowdhury, Munir
AU - Rountree, Susan
AU - Dang, Mimi
AU - Stern, Yaakov
AU - Honig, Lawrence S.
AU - Mintz, Akiva
AU - Ances, Beau
AU - Morris, John C.
AU - Winkfield, David
AU - Albert, Marilyn
AU - Onyike, Chiadi
AU - Pearlson, Godfrey D.
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Increasing research suggests that gait abnormalities can be a risk factor for Alzheimer’s Disease (AD). Notably, there is growing evidence highlighting this risk factor in individuals with amnestic Mild Cognitive Impairment (aMCI), however further studies are needed. The aim of this study is to analyze cognitive tests results and brain-related measures over time in aMCI and examine how the presence of gait abnormalities (neurological or orthopedic) or normal gait affects these trends. Additionally, we sought to assess the significance of gait and gait-related measures as prognostic indicators for the progression from aMCI to AD dementia, comparing those who converted to AD with those who remained with a stable aMCI diagnosis during the follow-up. Methods: Four hundred two individuals with aMCI from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database were included. Robust linear mixed-effects models were used to study the impact of gait abnormalities on a comprehensive neuropsychological battery over 36 months while controlling for relevant medical variables at baseline. The impact of gait on brain measures was also investigated. Lastly, the Cox proportional-hazards model was used to explore the prognostic relevance of abnormal gait and neuropsychological associated tests. Results: While controlling for relevant covariates, we found that gait abnormalities led to a greater decline over time in attention (DSST) and global cognition (MMSE). Intriguingly, psychomotor speed (TMT-A) and divided attention (TMT-B) declined uniquely in the abnormal gait group. Conversely, specific AD global cognition tests (ADAS-13) and auditory-verbal memory (RAVLT immediate recall) declined over time independently of gait profile. All the other cognitive tests were not significantly affected by time or by gait profile. In addition, we found that ventricles size increased faster in the abnormal gait group compared to the normal gait group. In terms of prognosis, abnormal gait (HR = 1.7), MMSE (HR = 1.09), and DSST (HR = 1.03) covariates showed a higher impact on AD dementia conversion. Conclusions: The importance of the link between gait and related cognitive functions in terms of diagnosis, prognosis, and rehabilitation in aMCI is critical. We showed that in aMCI gait abnormalities lead to executive functions/attention deterioration and conversion to AD dementia.
AB - Background: Increasing research suggests that gait abnormalities can be a risk factor for Alzheimer’s Disease (AD). Notably, there is growing evidence highlighting this risk factor in individuals with amnestic Mild Cognitive Impairment (aMCI), however further studies are needed. The aim of this study is to analyze cognitive tests results and brain-related measures over time in aMCI and examine how the presence of gait abnormalities (neurological or orthopedic) or normal gait affects these trends. Additionally, we sought to assess the significance of gait and gait-related measures as prognostic indicators for the progression from aMCI to AD dementia, comparing those who converted to AD with those who remained with a stable aMCI diagnosis during the follow-up. Methods: Four hundred two individuals with aMCI from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database were included. Robust linear mixed-effects models were used to study the impact of gait abnormalities on a comprehensive neuropsychological battery over 36 months while controlling for relevant medical variables at baseline. The impact of gait on brain measures was also investigated. Lastly, the Cox proportional-hazards model was used to explore the prognostic relevance of abnormal gait and neuropsychological associated tests. Results: While controlling for relevant covariates, we found that gait abnormalities led to a greater decline over time in attention (DSST) and global cognition (MMSE). Intriguingly, psychomotor speed (TMT-A) and divided attention (TMT-B) declined uniquely in the abnormal gait group. Conversely, specific AD global cognition tests (ADAS-13) and auditory-verbal memory (RAVLT immediate recall) declined over time independently of gait profile. All the other cognitive tests were not significantly affected by time or by gait profile. In addition, we found that ventricles size increased faster in the abnormal gait group compared to the normal gait group. In terms of prognosis, abnormal gait (HR = 1.7), MMSE (HR = 1.09), and DSST (HR = 1.03) covariates showed a higher impact on AD dementia conversion. Conclusions: The importance of the link between gait and related cognitive functions in terms of diagnosis, prognosis, and rehabilitation in aMCI is critical. We showed that in aMCI gait abnormalities lead to executive functions/attention deterioration and conversion to AD dementia.
KW - Cognitive dysfunction
KW - Digit symbol substitution test
KW - Embodiment
KW - Gait abnormalities
KW - Gait assessment
KW - Trail making test
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U2 - 10.1186/s12877-023-04175-8
DO - 10.1186/s12877-023-04175-8
M3 - Article
C2 - 37525134
AN - SCOPUS:85166286562
SN - 1471-2318
VL - 23
JO - BMC geriatrics
JF - BMC geriatrics
IS - 1
M1 - 462
ER -