About 500,000 Canadians are living with Alzheimer’s disease or a related dementia. Unless the swelling tide of dementia turns, this number is expected to soar to 1.1 million within 25 years. To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints. However, with the likes of researchers like Dr. Montero-Odasso, there is a glimmer of hope. Dr. Montero-Odasso through his work in geriatric medicine at Parkwood Institute in London, Canada is committed to cutting-edge research that will predict this irreversible, progressive disease of the brain; Alzheimer’s disease.

“Gait and Brain Study” – Dr. Manuel Montero-Odasso, a geriatrician and director of the “Gait and Brain Lab” is looking at walking speed and variability as a predictor of dementia’s progression and whether it is associated with physical changes in the brain. The “Gait and Brain Study” is a longitudinal cohort study funded by the CIHR which is assessing up to 150 seniors with mild cognitive impairment (MCI) which is considered a pre-dementia syndrome, in order to detect an early predictor of cognitive and mobility decline; and progression to Dementia. While walking has long been considered an automatic motor task, emerging evidence suggests cognitive function plays a key role in the control of walking, avoidance of obstacles and maintenance of navigation.

In a recent research article published in JGMS, Dr. Montero-Odasso’s team asks people with MCI, to walk on a specially-designed mat linked to a computer. The computer records the individual’s walking gait variability and speed. This information is then compared to their walking gait while simultaneously performing a cognitive demanding task, such as counting backwards or doing calculations while walking; “walking-while-talking”. It was subsequently determined that some specific gait characteristics are associated with high variability, particularly during “walking- while- talking”. These gait abnormalities were more marked in those MCI individuals with worst episodic memory and with executive dysfunction revealing a “motor signature” of cognitive impairment. If his research is confirmed in prospective studies, ‘walking- while- talking” gait changes can be an effective predictor of cognitive decline and may eventually help with an earlier diagnoses of dementia.

“Finding early dementia detection methods is vital,” says Dr. MMO. “In the future, it is conceivable that we will be able to make the diagnosis of Alzheimer’s disease and other dementias before people even have significant memory loss. Our hope is to combine these methods with promising new medications to slow or halt the progression of MCI to dementia. We believe that gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function that researchers should take advantage of. The high variability seen in people with MCI can be seen as a “gait arrhythmia” which has been proven to predict mobility decline, and falls, and now, cognitive impairment in individuals with MCI”.

There is something about the way you walk! Gait disturbances can help to predict dementia in older adults