Differences in Walking Patterns Could Predict Type of Cognitive Decline in Older Adults

Summary: Gait variability in older adults could be a predictor of cognitive decline and Alzheimer’s disease. Researchers found higher gait variability was associated with lower cognitive performance and an accurate predictor of Alzheimer’s disease.

Source: Lawson Health Research Institute

Canadian researchers are the first to study how different patterns in the way older adults walk could more accurately diagnose different types of dementia and identify Alzheimer’s disease.

A new study by a Canadian research team, led by London researchers from Lawson Health Research Institute and Western University, evaluated the walking patterns and brain function of 500 participants currently enrolled in clinical trials. Their findings are published today in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

“We have longstanding evidence showing that cognitive problems, such as poor memory and executive dysfunction, can be predictors of dementia. Now, we’re seeing that motor performance, specifically the way you walk, can help diagnose different types of neurodegenerative conditions,” says Dr. Manuel Montero-Odasso, Scientist at Lawson and Professor at Western’s Schulich School of Medicine & Dentistry.

Dr. Montero-Odasso is world renowned for his research on the relationship between mobility and cognitive decline in aging. Leading the Mobility, Exercise and Cognition (MEC) team in London, he is pioneering novel diagnostic approaches and treatments to prevent and combat early dementia.

This study compared gait impairments across the cognitive spectrum, including people with Subjective Cognitive Impairment, Parkinson’s Disease, Mild Cognitive Impairment, Alzheimer’s disease, Lewy body dementia and Frontotemporal dementia, as well as cognitively healthy controls.

Four independent gait patterns were identified: rhythm, pace, variability and postural control. Only high gait variability was associated with lower cognitive performance and it identified Alzheimer’s disease with 70 percent accuracy. Gait variability means the stride-to-stride fluctuations in distance and timing that happen when we walk.

This shows an older man walking up some steps
Gait variability means the stride-to-stride fluctuations in distance and timing that happen when we walk. Image is in the public domain

“This is the first strong evidence showing that gait variability is an important marker for processes happening in areas of the brain that are linked to both cognitive impairment and motor control,” notes Dr. Frederico Perruccini-Faria, Research Assistant at Lawson and Postdoctoral Associate at Western’s Schulich School of Medicine & Dentistry, who is first author on the paper. “We’ve shown that high gait variability as a marker of this cognitive-cortical dysfunction can reliably identify Alzheimer’s disease compared to other neurodegenerative disorders.”

When cognitive-cortical dysfunction is happening, the person’s ability to perform multiple tasks at the same time is impacted, such as talking while walking or chopping vegetables while chatting with family.

Having gait variability as a motor marker for cognitive decline and different types of conditions could allow for gait assessment to be used as a clinical test, for example having patients use wearable technology. “We see gait variability being similar to an arrhythmia. Health care providers could measure it with patients in the clinic, similar to how we assess heart rhythm with electrocardiograms,” adds Dr. Montero-Odasso.

Funding: This study was primarily funded by the Canadian Consortium on Neurodegeneration in Aging (CCNA), a collaborative research program tackling the challenge of dementia and other neurodegenerative illnesses. The CCNA was supported by a grant from the Canadian Institutes of Health Research.

About this dementia research news

Source: Lawson Health Research Institute
Contact: Laura Goncalves – Lawson Health Research Institute
Image: The image is in the public domain

Original Research: Open access.
Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study” by Frederico Pieruccini‐Faria, Sandra E. Black, Mario Masellis, Eric E. Smith, Quincy J. Almeida, Karen Z. H. Li, Louis Bherer, Richard Camicioli, Manuel Montero‐Odasso. Alzheimer’s & Dementia


Gait variability across neurodegenerative and cognitive disorders: Results from the Canadian Consortium of Neurodegeneration in Aging (CCNA) and the Gait and Brain Study


Gait impairment is common in neurodegenerative disorders. Specifically, gait variability—the stride‐to‐stride fluctuations in distance and time—has been associated with neurodegeneration and cognitive impairment. However, quantitative comparisons of gait impairments across the cognitive spectrum of dementias have not been systematically investigated.


Older adults (N = 500) with subjective cognitive impairment, Parkinson disease (PD), mild cognitive impairment (MCI), PD‐MCI, Alzheimer’s disease (AD), PD‐dementia, Lewy body dementia, and frontotemporal dementia, as well cognitive normal controls, who were assessed for their gait and cognitive performance.


Factor analyses grouped 11 quantitative gait parameters and identified four independent gait domains: rhythm, pace, variability, and postural control, for group comparisons and classification analysis. Among these domains, only high gait variability was associated with lower cognitive performance and accurately discriminated AD from other neurodegenerative and cognitive conditions.


Our findings indicate that high gait variability is a marker of cognitive‐cortical dysfunction, which can help to identify Alzheimer’s disease dementia.

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  1. In trying to comprehend this information – I realized that I didn’t really know what “gait variabilty” is – could you define it a little more and give an example? ty

  2. As a veterinarian, I know that we have been using pressure plate analysis of gait abnormalities for decades. These analyses may not assess postural changes, but those are more easily subjectively noted. Another instance of lack of cooperation between human and veterinary medicine.

  3. Why can’t you define gait variableness. Does that mean if we vary our gait we are apt to develop dementia.

  4. What exactly do you imply?do you mean that older adults who have gait variability are more prone to get dementia?

    1. I read it as indicating high gate variability is one marker that can be used to help diagnosis process for existing cognitive disease, in particular likelihood that the decline is Altheimer’s Disease rather than other causes. Before everyone jumps on the bandwagon, this is a single 500 subject study that would need replication before it is generally accepted as accurate. But, the idea of differentiating causes of dementia with an easy to perform analysis would be great. I accurate,it leads to the ability to appropriate direct treatment to delay progression of the disease.

      (None of the conditional statements imply there are any problems with the results or analysis. I think many in the general public don’t realize the scientific path to confirm accuracy of the results and analysis from a single paper,)

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