Manner of walking may be key to early dementia detection

Paul Mayne//Western News

Through examining an individual’s manner of walking, Schulich School of Medicine & Dentistry professor Dr. Manuel Montero-Odasso believes it is conceivable we will be able to diagnose Alzheimer’s disease and other dementias before people even have significant memory loss.

Something as simple as walking and talking could lead to early dementia detection and, potentially, to halting its progression, according to one Western researcher.

In a Western- and Lawson Health Research Institute-led study, researchers have shown that a person’s manner of walking – or gait­­ – when combined with a cognitively demanding task may be an effective predictor of dementia. There is currently no definitive way for health-care professionals to forecast the onset of dementia in a patient with memory complaints.

“We believe gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function,” said Geriatric Medicine professor Dr. Manuel Montero-Odasso.

Montero-Odasso and his team are assessing up to 150 seniors with mild cognitive impairment – a slight decline of memory and other mental functions – to detect an early predictor of cognitive and mobility decline.

“Finding methods to detect dementia early is vital to our ability to slow or halt the progression of the disease,” said Montero-Odasso of his study, Association of Dual-Task Gait with Incident Dementia in Mild Cognitive Impairment, recently published in the journal JAMA Neurology.

“One of the problems now with Alzheimer’s and other dementia is, we realize treatment, once it has been established, never worked. Neurons are already damaged and there is no magic treatment. A shift is now going to an earlier stage focus.”

Following the same group for six years, researchers asked participants to walk while simultaneously performing a cognitively demanding task, such as counting backwards or naming animals. Those individuals who slowed down more than 20 per cent while performing the task were at a higher risk of progressing 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,” said Montero-Odasso, whose funding was recently renewed by the Canadian Institutes of Health Research for $1 million over five years.

The ‘gait cost’ – or difference in speed at which participants completed a single task (walking) versus a dual-task – was higher in patients with mild cognitive impairments.

“Our results reveal a ‘motor signature’ of cognitive impairment that can be used to predict dementia,” Montero-Odasso said.

The next step is engaging the health-care community to potentially create guidelines for creating prediction models.

“It is conceivable we will be able to diagnose 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 mild cognitive impairment to dementia.”

Moving forward, Montero-Odasso said, unlike the early years of the study, all participants will be able to take part in blood work and imaging, creating a prediction model for everyone. This will help determine if the ‘walk/talk’ test alone is enough of a predictor or if it needs to be combined with other characteristics such as age, sex, blood pressure and other markers to further the specificity.

“The nice thing about research is the excitement of the discovery,” said Montero-Odasso, adding should the study lead to earlier detection and treatment of dementia, it could also create significant financial benefits on the health-care system. “Every day we have a new discovery. Sometimes research can change pathways.”