My gait is still impaired 16 years post stroke and will stay that way until I die. I have zero cognitive impairment.
Gait in Cerebral Small Vessel Disease, Pre-Dementia and Dementia: A Systematic Review
Abstract
Background:
The interrelationships between gait, cerebral small vessel disease (CSVD), and cognitive impairments in aging are not well-understood – despite their common co-occurrence.
Objective:
To systematically review studies of gait impairment in CSVD, pre-dementia, and dementia and to identify key gaps for future research and novel pathways toward intervention.
Methods:
A PRISMA-guided search strategy was implemented in PubMed to identify relevant studies. Potential articles (n=263) published prior to December 1st, 2021 were screened by two reviewers. Studies with sample sizes >20 and including some adult over >65 years (n=202) were included.
Results:
The key findings were that 1) adverse gait and cognitive outcomes were associated with several (rather than select) CSVD pathologies distributed across the brain, and 2) poor gait and CSVD pathologies were more strongly associated with dementia with a vascular, rather than an Alzheimer’s disease-related, cause.
Discussion:
A better understanding of the interrelationships between gait performance in CSVD, pre-dementia and dementia requires studies examining a) comprehensive patterns in the clinical manifestations of CSVD, b) racially/ethnically diverse samples, c) samples followed for extended periods of time or across the adult lifespan, d) non-traditional CSVD neuroimaging markers (e.g., resting-state fMRI), and e) continuous (e.g., wearable sensors) and complex (e.g., dual-task) walking performance.
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