A Simple Gait Analysis May Diagnosis Dementia

A recent study published in the online issue of Neurology concluded that a simple walking test, or a person’s gait, may be able to accurately diagnose dementia.

The test involves seeing how fast a person can walk while doing something else concurrently such as carrying an object or counting backward. Researchers found that the walking test can help differentiate whether someone has idiopathic normal-pressure hydrocephalus (iNPH) of progressive supranuclear palsy (PSP).

In the cross-sectional study, where temporal and spatial gait parameters were analyzed, researchers administered the test to 38 people diagnosed with PSP, 27 people diagnosed with iNPH and 38 healthy individuals.

Participants walked on a 22-foot-long pressure-sensitive carpet in order to examine walking under 5 conditions: single task (preferred, slow and maximal speed), cognitive dual task (walking and counting backwards) and motor dual task (walking while carrying a tray).

All of the participants received a complete neurologic exam, an eye exam, an MRI scan, thinking and memory tests, and were able to walk at least 30 feet without a walker or cane.

The test, an inexpensive and effective way to improve diagnosis of dementia, was able to show which participants had which illness relatively early in the course of the disease.

“It is important that people with idiopathic normal-pressure hydrocephalus are accurately diagnosed so they can be treated, and their health can improve,” study author Charlotte Selge, MD, of the Ludwig Maximillian University of Munich in Germany, said in a statement. “A simple walking test may help determine if a person has iNPH or PSP relatively early in the course of the disease.”

Both patients with PSP and iNPH exhibited significant gait dysfunction, which appeared worse in patients with iNPH with a broad-based gait. Stride variability was increased in both patient groups but was more pronounced in PSP. Cognitive-dual task led to a greater reduction of gait velocity in PSP compared to iNPH (34% versus 17%, respectively), while motor-dual task exposed a dissociation of gait performance — those patients with PSP experienced a worsened gait state, but patients with iNPH tended to improve, which may mean the dual-task test wasn’t challenging enough for those with iNPH.

“People with PSP appear to be more sensitive to these dual-task walking tests than people with iNPH,” Selge said.

Simply by assessing walking, researchers could accurately diagnose those participants with PSP and iNPH about 82% of the time, but when adding both dual-task tests to the assessment, diagnostic accuracy increased to 97%.

“Our study found that adding another task while someone walks, and evaluating how it affects their walking ability, improves accuracy of the diagnosis,” Selge added. “Our findings suggest that adding these dual-task tests would be an inexpensive and effective way to improve diagnosis of iNPH.”

Researchers want to pursue further studies, increasing the complexity of tasks to provide greater accuracy and insight into how the diseases affect walking.

The study, “Gait analysis in PSP and NPH” was published in Neurology February 2018.

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