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Walking: What can it tell us about dementia?
Professor Lynn Rochester PhD
http://research.ncl.ac.uk/bam/@BAM_Research
• Links between gait & cognitive function
• Research illustrating the links
• Ongoing work in Newcastle
Improve existing management
Develop treatments to modify dementia/protect the brain
• Distinguish dementias • Early & predict risk• Track change
Diagnostic Markers
http://www.bsmp.co.uk/tests-and-results.aspx
http://nursingcrib.com/medical-laboratory-diagnostic-test/cerebrospinal-fluid-csf-analysis/
http://www.netdoctor.co.uk/procedures/examinations/a1161/mri-scan/
Walking speed: the 6th Vital Sign?
Fritz, et al.," J Geriatr Phys Ther, 32, 46-9, 2009
Age & speed predicts life expectancy
Studenski et al., 2011
Hickey et al., 2017
Walking in the real-world
Distracted walking
Non-motor substrates? 1,2,3
• Frontal cortex• Anterior cingulate• Hippocampus• Visual cortex• Association areas
1 Holtzer et al., 2014; 2 Annweiler et al., 2012; 3 Hamacher et al., 2015
Neural substrates
SMA/PMCDLPFC
Peripheral
Cortical
Subcortical
BrainstemSpinal Cord Bohnen NI, et al., 2011
Cognitive impairment & gait
Bahureska et al., 2017
Gait decline precedes & predicts cognitive decline, mild cognitive impairment & dementia
Cognition & gait share neurodegenerative mechanisms
• Robust relationship between gait & cognitive function
• Gait characteristics predict early changes in cognitive function in PD – marker of dementia risk?
What can gait analysis tell us about dementia & its subtypes? An integrated
study of brain & behaviour
Ríona Mc Ardle
Walking looks simple…
AsymmetryPostural Control
Rhythm VariabilityPace
Lord et al., 2013
Unique gait signatures?
The real world…
Gait assessment in the real-world
Habitual behaviours Gait analysisDel Din et al., 2015
Blondell et al., BMC Public Health, 2014 Norton et al., Lancet Neurology, 2014
• 7 modifiable risk factors for dementia (AD)
– diabetes, hypertension, obesity, inactivity, depression, smoking, low education
• Physical inactivity (increased risk of dementia)
Higher levels of PA associated with reduced risk of cog decline & dementia
Diagnostic Markers
http://www.bsmp.co.uk/tests-and-results.aspx
http://nursingcrib.com/medical-laboratory-diagnostic-test/cerebrospinal-fluid-csf-analysis/
http://www.netdoctor.co.uk/procedures/examinations/a1161/mri-scan/
http://blogs.plos.org/thestudentblog/author/rionamcardle/
http://research.ncl.ac.uk/bam/@BAM_Research
Acknowledgements
Brain & Movement Research:
Lynn Rochester
Brook Galna
Silvia Del-Din
Lisa Alcock
Annette Pantall
Carol Pringle
Sam Stuart
Rosie Morris
Riona McArdle
Heather Hunter
Philip Brown
Rodrigo Vitorio
Ellen Lirani
Michael Dunne-Willows
Sue LordAlan Godfrey