Senior man walking by the riverside to symbolize gait changes seen in people with mild cognitive impairment
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Research at the Florida Atlantic University shows that mild cognitive impairment, which can progress to conditions like Alzheimer’s disease, can be detected through gait analysis.

The study, published in the Journal of Alzheimer’s Disease Reports, used a non-invasive, low cost “depth” camera to track small changes in gait that could be linked to cognition.

The study found when the study participants walked on a curved as opposed to a straight line that 31 out of 50 gait markers were different in people with mild cognitive impairment (MCI) compared with healthy adults of a similar age.

Gait has previously been shown to change in Alzheimer’s disease patients, particularly when walking is not in a straight line, but less is known about how this change in movement manifests in the early stages of neurodegenerative decline.

The current study used a Kinect depth sensing camera, originally developed for the gaming industry but now used more for academic purposes, to track the movements of 25 joints in the body and use the information to measure 50 gait markers in individuals with MCI and healthy controls.

Of the 50 gait markers, 31 showed differences, 13 of which were significant, between people with and without cognitive decline when they walked on a curved as opposed to a straight line. The markers included “macro” markers such as average walk speed and number of steps per minute (cadence) and less obvious “micro” markers such as how long a person’s feet remain in certain sub-sections of walking such as swinging the foot from one stride to another.

“Intriguingly, curved walking illuminated notable disparities between our study groups, even for… macro gait markers. The MCI group exhibited a markedly lower average step length and speed during curve walking, coupled with higher variability across most micro-gait markers,” said lead author Behnaz Ghoraani, an associate professor at the FAU Institute for Sensing and Embedded Network Systems Engineering (I-SENSE), in a press statement.

“The MCI group showed diminished symmetry and regularity in both step and stride lengths for curved walking. They also required extended double support time in various areas, especially while changing directions, which resulted in reduced step speed.”

The early stages of cognitive decline can be hard to detect and diagnose of diseases like Alzheimer’s which are often delayed. Most available treatments work better at an early stage so the earlier a patient can be diagnosed the better. Typical diagnostic methods tend to involve brain imaging, blood testing and neurological and physical examination, but this can be time consuming, expensive and require specialist knowledge.

Having a validated, straightforward indicator that further investigation may be needed, like problems with gait, would be very useful for physicians, particularly in the primary care setting.

“Mild cognitive impairment can be an early sign of Alzheimer’s disease and other types of dementia,” said Ghoraani. “Our comprehensive approach enhances the understanding of gait characteristics and suggests curved path walking may be more sensitive to detect mild cognitive dementia, which can complement cognitive assessments and aid in early diagnosis and management.”

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