Trouble walking is associated with cognitive difficulties.

Walking can be experienced as something we do automatically without having to think. But being able to walk is more complicated than that.

Gait can also be linked to cognitive ability* which can be impaired in neurodegenerative diseases, such as Parkinson’s disease. This is what new research from Lund University shows.

The ability to walk can be considered an essential function to be able to engage in meaningful activities in daily life. When I meet patients with different neurodegenerative diseases, I realize how important different aspects of walking difficulties are for a person to maintain their opportunities for various activities, says researcher and physiotherapist Magnus Lindh-Rengifo at Lund University.

* Perception relates to the brain’s ability to receive, remember and process information. Cognitive ability is affected, among other things, in neurodegenerative diseases where neurons disintegrate.

The computerized treadmill provided answers

To assess gait, researchers can focus on objective measurements, for example walking speed, stride length or gait variance, but also on subjective estimates such as how the patient perceives their ability to walk or fear of falling.

In one thesis, Magnus Lindh-Rengifo used a computerized treadmill to study how patients walked in different situations, for example during a relaxed walk or if another task was being performed at the same time. Brisk walking speed was also examined.

In comfortable walking, four components of gait have been identified in subjects with or without mild cognitive impairment: variability, rate/stability, cadence, and asymmetry.

Connection with cognition is enhanced

Patients with mild cognitive impairment had in many ways a similar relationship between different gait measures, but they walked worse than subjects without impairment. According to the study, this reinforces the view that cognitive ability is an important component associated with the ability to walk.

Walking was previously seen as a semi-automated, repetitive task. However, it does require a lot of cognitive engagement—especially when the walk is combined with doing something else at the same time, like holding a glass of water.

Risk of falling injuries

Fear of falling can also cause patients to avoid certain activities.

– In the long term, avoidance behavior can lead to an impaired ability to walk, which in turn increases the risk of falling. If we can support these groups of patients in their daily activities, the hope is that they can maintain capacity and quality of life for a longer period. Since we also found that the fear of falling increases over time, it is also important to continuously assess both these difficulties and perceived walking difficulties in, for example, people with Parkinson’s disease.

Magnus Lindh-Rengifo hopes the results will benefit patients in the short and long term.

There is benefit in clarifying the objective and subjective aspects of gait in people with neurodegenerative conditions, he says.

thesis:

Objective and subjective aspects of gait in people with neurodegenerative disordersLunds University.