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Motor phenotype of decline in cognitive performance among community-dwellers without dementia: population-based study and meta-analysis.

Abstract

BACKGROUND

Decline in cognitive performance is associated with gait deterioration. Our objectives were: 1) to determine, from an original study in older community-dwellers without diagnosis of dementia, which gait parameters, among slower gait speed, higher stride time variability (STV) and Timed Up & Go test (TUG) delta time, were most strongly associated with lower performance in two cognitive domains (i.e., episodic memory and executive function); and 2) to quantitatively synthesize, with a systematic review and meta-analysis, the association between gait performance and cognitive decline (i.e., mild cognitive impairment (MCI) and dementia).

METHODS

Based on a cross-sectional design, 934 older community-dwellers without dementia (mean±standard deviation, 70.3±4.9years; 52.1% female) were recruited. A score at 5 on the Short Mini-Mental State Examination defined low episodic memory performance. Low executive performance was defined by clock-drawing test errors. STV and gait speed were measured using GAITRite system. TUG delta time was calculated as the difference between the times needed to perform and to imagine the TUG. Then, a systematic Medline search was conducted in November 2013 using the Medical Subject Heading terms "Delirium," "Dementia," "Amnestic," "Cognitive disorders" combined with "Gait" OR "Gait disorders, Neurologic" and "Variability."

FINDINGS

A total of 294 (31.5%) participants presented decline in cognitive performance. Higher STV, higher TUG delta time, and slower gait speed were associated with decline in episodic memory and executive performances (all P-values <0.001). The highest magnitude of association was found for higher STV (effect size  =  -0.74 [95% Confidence Interval (CI): -1.05;-0.43], among participants combining of decline in episodic memory and in executive performances). Meta-analysis underscored that higher STV represented a gait biomarker in patients with MCI (effect size  =  0.48 [95% CI: 0.30;0.65]) and dementia (effect size  = 1.06 [95% CI: 0.40;1.72]).

CONCLUSION

Higher STV appears to be a motor phenotype of cognitive decline.

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  • Authors+Show Affiliations

    ,

    Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.

    ,

    Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

    ,

    Gait and Brain Lab, Parkwood Hospital, Lawson Health Research Institute, London, Ontario, Canada.

    ,

    Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.

    ,

    Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.

    Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada.

    Source

    PloS one 9:6 2014 pg e99318

    MeSH

    Aged
    Aged, 80 and over
    Cognition Disorders
    Cognitive Dysfunction
    Cross-Sectional Studies
    Dementia
    Executive Function
    Female
    France
    Gait
    Geriatric Assessment
    Humans
    Locomotion
    Male
    Memory, Episodic
    Phenotype
    Population Surveillance
    Psychomotor Performance
    Qualitative Research
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Systematic Review

    Language

    eng

    PubMed ID

    24911155

    Citation

    Beauchet, Olivier, et al. "Motor Phenotype of Decline in Cognitive Performance Among Community-dwellers Without Dementia: Population-based Study and Meta-analysis." PloS One, vol. 9, no. 6, 2014, pp. e99318.
    Beauchet O, Allali G, Montero-Odasso M, et al. Motor phenotype of decline in cognitive performance among community-dwellers without dementia: population-based study and meta-analysis. PLoS ONE. 2014;9(6):e99318.
    Beauchet, O., Allali, G., Montero-Odasso, M., Sejdić, E., Fantino, B., & Annweiler, C. (2014). Motor phenotype of decline in cognitive performance among community-dwellers without dementia: population-based study and meta-analysis. PloS One, 9(6), pp. e99318. doi:10.1371/journal.pone.0099318.
    Beauchet O, et al. Motor Phenotype of Decline in Cognitive Performance Among Community-dwellers Without Dementia: Population-based Study and Meta-analysis. PLoS ONE. 2014;9(6):e99318. PubMed PMID: 24911155.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Motor phenotype of decline in cognitive performance among community-dwellers without dementia: population-based study and meta-analysis. AU - Beauchet,Olivier, AU - Allali,Gilles, AU - Montero-Odasso,Manuel, AU - Sejdić,Ervin, AU - Fantino,Bruno, AU - Annweiler,Cédric, Y1 - 2014/06/09/ PY - 2014/01/28/received PY - 2014/05/13/accepted PY - 2014/6/10/entrez PY - 2014/6/10/pubmed PY - 2015/10/8/medline SP - e99318 EP - e99318 JF - PloS one JO - PLoS ONE VL - 9 IS - 6 N2 - BACKGROUND: Decline in cognitive performance is associated with gait deterioration. Our objectives were: 1) to determine, from an original study in older community-dwellers without diagnosis of dementia, which gait parameters, among slower gait speed, higher stride time variability (STV) and Timed Up & Go test (TUG) delta time, were most strongly associated with lower performance in two cognitive domains (i.e., episodic memory and executive function); and 2) to quantitatively synthesize, with a systematic review and meta-analysis, the association between gait performance and cognitive decline (i.e., mild cognitive impairment (MCI) and dementia). METHODS: Based on a cross-sectional design, 934 older community-dwellers without dementia (mean±standard deviation, 70.3±4.9years; 52.1% female) were recruited. A score at 5 on the Short Mini-Mental State Examination defined low episodic memory performance. Low executive performance was defined by clock-drawing test errors. STV and gait speed were measured using GAITRite system. TUG delta time was calculated as the difference between the times needed to perform and to imagine the TUG. Then, a systematic Medline search was conducted in November 2013 using the Medical Subject Heading terms "Delirium," "Dementia," "Amnestic," "Cognitive disorders" combined with "Gait" OR "Gait disorders, Neurologic" and "Variability." FINDINGS: A total of 294 (31.5%) participants presented decline in cognitive performance. Higher STV, higher TUG delta time, and slower gait speed were associated with decline in episodic memory and executive performances (all P-values <0.001). The highest magnitude of association was found for higher STV (effect size  =  -0.74 [95% Confidence Interval (CI): -1.05;-0.43], among participants combining of decline in episodic memory and in executive performances). Meta-analysis underscored that higher STV represented a gait biomarker in patients with MCI (effect size  =  0.48 [95% CI: 0.30;0.65]) and dementia (effect size  = 1.06 [95% CI: 0.40;1.72]). CONCLUSION: Higher STV appears to be a motor phenotype of cognitive decline. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24911155/Motor_phenotype_of_decline_in_cognitive_performance_among_community_dwellers_without_dementia:_population_based_study_and_meta_analysis_ L2 - http://dx.plos.org/10.1371/journal.pone.0099318 DB - PRIME DP - Unbound Medicine ER -