Alzheimer's & Mental Health News for Senior Citizens
Alzheimer's & Mental Health News
How slow senior citizens walk increasingly found to predict Alzheimer’s, death
Latest study finds walking speed in elderly may predict Alzheimer's
By Tucker Sutherland, editor, SeniorJournal.com
Dec. 09, 2015 – There is yet another study that declares that we may as well refer to a senior citizen that walks slowly as a “dead man walking,” the term describing a prisoner walking to his execution. This study says elderly who walk slowly are heading toward Alzheimer’s disease, as a study last year did. Another study last year says slow walking seniors are less happy and have shorter longevity. Research in 2011 found walking gait especially accurate for predicting how long an old person will live.
So at least four recent research projects have concluded that senior citizen who walk slowly should not be making long-range plans.
The newest study finds the speed at which elderly people walk appears to be related to the amount of amyloid plaque they have built up in their brains, even if they don't yet have symptoms of Alzheimer's disease.
The study involved 128 people with an average age of 76 who did not have dementia but were considered at high risk for developing it, because they had some concerns about their memory. The participants had positron emission tomography (PET) scans of their brains to measure amyloid plaques in the brain.
These plaques consist of dense deposits of a protein called beta amyloid, and their progressive buildup in the brain has been associated with the development of Alzheimer's disease. Of the participants, 48 percent had a level of amyloid often associated with dementia.
Participants were also tested on thinking and memory skills and how well they could complete everyday activities. A total of 46 percent of the participants had mild cognitive impairment, which can be a precursor to the dementia that occurs in Alzheimer's disease.
Walking speed was measured with a standard test that times people on how fast they can walk about 13 feet at their usual pace. The average walking speed was 3.48 feet per second. All but two of the participants tested in the normal range of walking speed.
The researchers found an association between slow walking speed and amyloid in several areas of the brain, including the putamen, a key region involved in motor function.
The researchers compared how fast people walked both with and without taking into account the amount of amyloid and found that the amyloid level accounted for up to 9 percent of the difference in walking speed.
The relationship between amyloid levels and walking speed did not change when researchers took into account age, education level, or amount of memory problems.
"It's possible that having subtle walking disturbances in addition to memory concerns may signal Alzheimer's disease, even before people show any clinical symptoms," said study author Natalia del Campo, PhD, of the Gerontopole and the Centre of Excellence in Neurodegeneration of Toulouse (University Hospital Toulouse) in France.
The study looked only at a snapshot in time and does not prove that amyloid plaques cause the slowdown in walking speed, it shows the association, noted Del Campo. She did note there are many other causes of slow walking in older adults.
The study was published in the December 2, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology.
It was based on a larger trial called the Multidomain Alzheimer Preventive Trial, which was supported by the French Ministry of Health and Pierre Fabre Research Institute.
The study last year that tied slow walking with Alzheimer's included 27,000 seniors age 60 or older. The researchers were testing for motoric cognitive risk syndrome (MCR), a newly developed diagnosis that incorporates cognitive symptoms and slow gait in patients without dementia or mobility-related disability. is common in older adults and is an early risk factor for cognitive decline, the new study found.
This study involving older adults on five continents found that nearly 1 in 10 met criteria for pre-dementia based on a simple test that measures how fast people walk and whether they have cognitive complaints.
The researchers declared it can predict dementia in the future of those who walk slowly and have cognitive complaints. What set this study apart is the addition of the participants having "cognitive complaints" and they walked slowly.
"As a young researcher, I examined hundreds of patients and noticed that if an older person was walking slowly, there was a good chance that his cognitive tests were also abnormal," said Joe Verghese, M.B.B.S., professor in the Saul R. Korey Department of Neurology and of medicine at Einstein, chief of geriatrics at Einstein and Montefiore, and senior author.
"This gave me the idea that perhaps we could use this simple clinical sign—how fast someone walks—to predict who would develop dementia.
"In a 2002 New England Journal of Medicine study, we reported that abnormal gait patterns accurately predict whether people will go on to develop dementia. MCR improves on the slow gait concept by evaluating not only patients' gait speed but also whether they have cognitive complaints."
The test is not reliant on the latest medical technology and can be done in a clinical setting, diagnosing people in the early stages of the dementia process. Early diagnosis is critical because it allows time to identify and possibly treat the underlying causes of the disease, which may delay or even prevent the onset of dementia in some cases.
All that's needed to assess MCR is a stopwatch and a few questions, so primary care physicians could easily incorporate it into examinations of their older patients."
While the syndrome was equally common in men and women, highly educated people were less likely to test positive for MCR compared with less-educated individuals. A slow gait, said Dr. Verghese, is a walking speed slower than about one meter per second, which is about 2.2 miles per hour (m.p.h.). Less than 0.6 meters per second (or 1.3 m.p.h.) is "clearly abnormal."
Jan. 5, 2011 – How fast senior citizens walk appears to be a better gage of how long they will live than trying to do a more complicated analysis using age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalization.
This study of senior citizens found walking gait is especially accurate for predicting remaining life for those age 75 and older. The study was reported in the January 5 issue of the Journal of the American Medical Association (JAMA).
Stephanie Studenski, M.D., M.P.H., of the University of Pittsburgh, and colleagues conducted a study to assess the association of gait speed with survival in older adults and to determine the degree to which gait speed explains variability in survival after accounting for age and sex.
The study included a pooled analysis of 9 participating studies (collected between 1986 and 2000), using individual data from 34,485 community-dwelling adults age 65 years or older with walking speed data available at the beginning of the study, followed up for 6 to 21 years.
Participants had an average age of 73.5 years; 59.6 percent were women; and 79.8 percent were white.
Gait speed was calculated for each participant using distance in meters and time in seconds. All studies used instructions to walk at usual pace and from a standing start. The walk distance varied from 8 feet to 6 meters.
The average gait speed of the participants was 0.92 meters (3 feet) per second.
The researchers found that gait speed was associated with differences in the probability of survival at all ages in both sexes, but was especially informative after age 75 years. At this age, predicted 10-year survival across the range of gait speeds ranged from 19 percent to 87 percent in men and from 35 percent to 91 percent in women.
Predicted years of remaining life for each sex and age increased as gait speed increased, with a gait speed of about 2.6 feet (0.8 meters)/second at the median (midpoint) life expectancy at most ages for both sexes.
“Gait speeds of 1.0 meter (3.3 feet)/second or higher consistently demonstrated survival that was longer than expected by age and sex alone. In this older adult population the relationship of gait speed with remaining years of life was consistent across age groups, but the absolute number of expected remaining years of life was larger at younger ages," the authors write.
Gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 meter (2 feet)/second.