Naming animals during gait test effectively distinguishes cognitive decline
Having patients walk while naming animals was the most effective of three gait tests for differentiating those with mild cognitive impairment from those with dementia or no cognitive impairment, a trial found.
A gait test that includes naming animals can be used to accurately screen for cognitive impairment in older adults regardless of their cognitive abilities, a cross-sectional study found.
A total of 711 participants (mean age, 72 years; 43% women) underwent three different types of gait assessments: walking on an electronic walkway, walking on the walkway while counting backwards from 50 to 0, or walking on the walkway while naming animals. Of the included participants, 332 were cognitively healthy, 264 had mild cognitive impairment (MCI), and 115 had dementia. All individuals had a Mini-Mental State Examination score greater than 10, visual acuity of 2/10 or higher, no severe depression symptoms, and no acute medical illnesses in the past month. Findings were published by the Journal of the American Geriatrics Society on Aug. 29.
Gait performance deteriorated as cognitive impairment progressed, with people with dementia having slower gait speed and higher variability coefficients than the other two groups. When patients were asked to name animals, their gait speed was more accurate in discriminating unimpaired controls from those with cognitive impairment (areas under the curve [AUC], 76.9% for MCI and 99.7% for people with dementia vs. controls) than in the other types of tests. When participants with MCI and dementia were grouped together, the AUC was 84.6%, specificity was 79.7%, sensitivity was 72.8%, and the optimal cutoff score was a mean gait speed of 88cm/s while naming animals. In addition, the coefficient of stride length variability while naming animals was the most effective factor to distinguish between individuals with MCI and those with dementia (AUC, 96.7%).
One limitation to the study is that participants were recruited from a memory clinic and findings may therefore not be generalizable.
“Not all the gait assessments are equally effective in identifying cognitive decline and dementia,” the authors concluded. The naming animal gait test “could easily be incorporated into the standard battery assessment for cognitive decline and dementia in older adults.”