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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2017 | Research

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

Authors: Lisette H. J. Kikkert, Nicolas Vuillerme, Jos P. van Campen, Bregje A. Appels, Tibor Hortobágyi, Claudine J. C. Lamoth

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2017

Abstract

Background

A detailed gait analysis (e.g., measures related to speed, self-affinity, stability, and variability) can help to unravel the underlying causes of gait dysfunction, and identify cognitive impairment. However, because geriatric patients present with multiple conditions that also affect gait, results from healthy old adults cannot easily be extrapolated to geriatric patients. Hence, we (1) quantified gait outcomes based on dynamical systems theory, and (2) determined their discriminative power in three groups: healthy old adults, geriatric patients with- and geriatric patients without cognitive impairment.

Methods

For the present cross-sectional study, 25 healthy old adults recruited from community (65 ± 5.5 years), and 70 geriatric patients with (n = 39) and without (n = 31) cognitive impairment from the geriatric dayclinic of the MC Slotervaart hospital in Amsterdam (80 ± 6.6 years) were included. Participants walked for 3 min during single- and dual-tasking at self-selected speed while 3D trunk accelerations were registered with an IPod touch G4. We quantified 23 gait outcomes that reflect multiple gait aspects. A multivariate model was built using Partial Least Square- Discriminant Analysis (PLS-DA) that best modelled participant group from gait outcomes.

Results

For single-task walking, the PLS-DA model consisted of 4 Latent Variables that explained 63 and 41% of the variance in gait outcomes and group, respectively. Outcomes related to speed, regularity, predictability, and stability of trunk accelerations revealed with the highest discriminative power (VIP > 1). A high proportion of healthy old adults (96 and 93% for single- and dual-task, respectively) was correctly classified based on the gait outcomes. The discrimination of geriatric patients with and without cognitive impairment was poor, with 57% (single-task) and 64% (dual-task) of the patients misclassified.

Conclusions

While geriatric patients vs. healthy old adults walked slower, and less regular, predictable, and stable, we found no differences in gait between geriatric patients with and without cognitive impairment. The effects of multiple comorbidities on geriatric patients’ gait possibly causes a ‘floor-effect’, with no room for further deterioration when patients develop cognitive impairment. An accurate identification of cognitive status thus necessitates a multifactorial approach.

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Title: Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment
Authors: Lisette H. J. Kikkert
Nicolas Vuillerme
Jos P. van Campen
Bregje A. Appels
Tibor Hortobágyi
Claudine J. C. Lamoth
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2017
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-017-0297-z

At a glance: The STEP trials

Springer Medicine

Gait characteristics and their discriminative power in geriatric patients with and without cognitive impairment

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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