Dementia predicted by slow walking speed and memory problems

Early diagnosis of dementia is critical to delaying the onset of cognitive decline. Now, a new study published in the journal Neurology suggests that a simple test of walking speed and memory could provide just that.

Approximately 5.2 million Americans are living with Alzheimer's disease - the most common form of dementia. It is estimated that this number will triple to almost 16 million by the year 2050, emphasizing the need for strategies that could slow, halt or prevent the disease.

Researchers say that a slow walking speed and memory complaints could be an early sign of dementia.

Current methods used to diagnose dementia involve a variety of assessments, including physical examinations, memory tests and brain scans.

But in this latest study, the research team - led by investigators at the Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center in New York, NY - reveals a potential new test that could diagnose pre-dementia.

Researchers at the Saul. R. Korey Department of Neurology and the Department of Medicine at the Albert Einstein College of Medicine, have examined hundreds of patients and noticed that if an older person was walking slowly, there was a good chance that his cognitive tests were also abnormal.

This gave them the idea that perhaps we could use this simple clinical sign - how fast someone walks - to predict who would develop dementia.

The research leader, Dr. Verghese says that in a 2002 study published in the New England Journal of Medicine, he and his colleagues revealed how abnormal walking gait (the pattern of walking) could accurately predict the later development of dementia.

The team built on this finding in their latest research, developing a test that uses gait speed and cognitive complaints to diagnose Motoric Cognitive Risk syndrome (MCR), which the researchers believe is an early sign of dementia.

Patients with MCR 'twice as likely to develop dementia'

The researchers estimated the prevalence of MCR by analyzing 22 studies from 17 countries involving 26,802 adults aged 60 or over who were free of dementia or disability.

Of these, 9.7% - almost 1 in 10 - met criteria for MCR. In other words, they had abnormally slow walking gait (less than 1 meter per second) and cognitive complaints.

The researchers then used four of the 22 studies - involving 4,812 individuals - to determine whether MCR can accurately predict future dementia development. Overall, participants were followed-up for an average of 12 years.

The team found that the participants who met the criteria for MCR were almost twice as likely to develop dementia during the 12-year follow-up, compared with those who did not meet MCR criteria.

Dr. Verghese explains the findings further in the video below:

Dr. Verghese notes that in many clinical and community settings, some people are unable to access the current tests used to diagnose dementia, but that these findings show the MCR test could change that:

"Our assessment method could enable many more people to learn if they're at risk for dementia, since it avoids the need for complex testing and doesn't require that the test be administered by a neurologist.

The potential payoff could be tremendous, not only for individuals and their families, but also in terms of health care savings for society. All that's needed to assess MCR is a stopwatch and a few questions, so primary care physicians could easily incorporate it into examinations of their older patients."

The researchers note that for patients who meet the criteria for MCR, the following steps will involve determining the mechanisms behind their gait and cognitive problems, which could also reveal other underlying and modifiable health issues.

Evidence increasingly suggests that brain health is closely tied to cardiovascular health, meaning that treatable conditions such as hypertension, smoking, high cholesterol, obesity and diabetes can interfere with blood flow to the brain and thereby increase a person's risk for developing Alzheimer's and other dementias.

And they point out that even if no specific cause of MCR can be identified, it is known that adopting certain lifestyle factors, such as a healthy diet and exercising, can slow the rate of cognitive decline.

In addition, the research group has shown that cognitively stimulating activities - playing board games, card games, reading, writing and also dancing - can delay dementia's onset.

"Knowing they're at high risk for dementia can also help people and their families make arrangements for the future, which is an aspect of MCR testing that the researchers have found is very important in the clinical practice."

Researchers recently reported on a study suggesting that eye and smell tests could offer early diagnosis of Alzheimer's.