Dementia: Decline in two bodily functions linked to a ‘significant’ risk of disease – JAMA

Dr Hilary warns about missed dementia diagnoses in July

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A dementia diagnosis is a point of no return that entails a progressive decline in cognitive abilities. Researchers are scrambling to determine the cause in a bid to prolong the quality of life of sufferers, but this has yet to be confirmed. According to recent findings published in JAMA, a “dual” decline in gait and cognitive function could significantly increase the risk of the disease.

Gait refers to a person’s pattern of walking, based on the balance and coordination of muscles the body needs in order to move forward.

It has historically been implicated in the severity of cognitive decline that characterises dementia.

The findings underscore the importance of adding gait speed measures to dementia screening assessments.

According to recent findings published in JAMA Network Open, a decline in both gait speed and cognition could be linked to an increased risk for dementia.

READ MORE: Dementia: A sleeping aid is linked to heart disease and Alzheimer’s disease

Michele L. Callisaya, associate professor at the National Centre for Healthy Ageing, told Medscape Medical News Today: “Measuring gait speed is really simple, cheap and quick; and the test can be used in the clinic along a cognitive screen to see if someone has a risk of dementia.”

A decline in gait speed is a previously recognised premonitory sign of brain decline, but the latest study focussed on the duality of gait speed and cognition in conjunction with respect to dementia.

The study was conducted by measuring gait speed in meters per second during in-person visits at baseline and every two years until the end of the study.

Professor Callisaya pointed out that gait speed could be measured using a stopwatch only, and no “fancy equipment was needed.”

The measurements, she added, could also be undertaken in any clinic by several general practitioners, physiotherapists and other healthcare personnel.

Gait is a complex task that is inextricably linked with cognition, and changes in speed are often perceivable in the early stages of Alzheimer’s.

According to the Journal of the Alzheimer’s Association: “Gait and cognitive performance are strongly linked in neurodegenerative disease.

“High gait variability is associated with cognitive dysfunction in Alzheimer’s and Lewy body disorders.”

Simply put, dementia is characterised by the death of brain cells, which control many aspects of cognitive health; namely memory and thinking.

But as the disease tightens its grip, patients usually notice distinguished changes in the way they walk too.

In some cases, these changes may be apparent several years before a formal diagnosis is made.

Studies have generally found patients walk slower, with shorter steps that are more variable and asymmetric.

Patients also tend to spend long with both feet in the group compared to control subjects.

This is because stride to stride changes rely on higher cortical brain control.

The decrease in walking speed is supposedly provoked by a shortened stride length to increase the support phase.

Fortunately, there is evidence that even a genetic predisposition to the disease can be defied with a healthier lifestyle, so adherence to a healthy diet and regular exercise routine are widely encouraged.

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