Six-month change in gait speed to discriminate between those with and without falls history in older people with Mild Cognitive Impairment and mild Alzheimer disease

Older people with Mild Cognitive Impairment (MCI) have higher rates of falls and more severe consequences when falling, compared to older people with Preserved Cognition (PrC).1,2 Recent studies indicate that older people with MCI and Alzheimer`s disease (AD) in the mild stage present alterations in physical mobility, expressed in gait deficit and balance, factors closely linked to the risk of falls.3,4

Within gait parameters, gait speed is a reliable, sensitive and specific measurement5 that plays an important role in the prediction of falls.6 In older people with preserved cognition, gait speed reduction is a useful variable for predicting falls.6,7 However, in older people with MCI3 and AD in the mild stage,8 this relationship needs to be better studied.

Most of the studies found on gait speed and prediction of falls in older people with MCI and AD, are restricted to a transversal analysis of gait speed as a predictor of falls.6,9,10 Follow-up longitudinal studies may provide more information on variations in gait speed over time and allow the establishment of relationships between the level of cognitive impairment and the prediction of falls. It is known that older people with dementia fall more often than older people with PrC,11 and also the fact that the outcomes of falls in these older people tend to be worse as it is five times more likely that fallers with cognitive impairment will be institutionalized than older people who do not fall with cognitive impairment.2 As fall-related injuries are ubiquitous, preventing them in individuals aged 60 and over is essential. To the best of our knowledge, there are few studies on this topic in older people. This information can bring new foundations that support possible interventions to geriatric nursing.

Thus, the objectives of this study were: To identify if there are differences in the gait speed of older people with Preserved Cognition (PrC), Mild Cognitive Impairment (MCI) and with Alzheimer`s disease (AD) in a mild stage over a 6-month period. To verify if the change in the gait speed (ΔGS= Final gait speed – Initial gait speed) discriminated fallers in older people with MCI and AD in a mild stage. It was hypothesized that those with AD versus MCI or PrC would be more likely to have a decline in gait speed and that there would be associations between change in gait speed and falls in older people with cognitive impairment.

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