Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults.
BACKGROUND
Gait variability is an index of how much gait parameters, such as step length, change from one step to the next. Gait variability increases with age and in individuals affected by cortical and subcortical neurodegenerative conditions, and it is associated with falls and incident mobility disability. The brain anatomical correlates of gait variability have not been studied in high-functioning community-dwelling older adults.


METHODS
Gait variability and brain MRIs were assessed in a cohort of 331 men and women (mean age = 78.3 years) free from stroke, dementia or Parkinson's disease. Gait variability was computed for spatial parameters (step length and step width) and for temporal parameters (stance time). Subclinical brain vascular abnormalities were measured on brain MRIs as infarcts and white matter hyperintensities.


RESULTS
Greater variability of step length was associated with greater prevalence of infarcts, including infarcts in the basal ganglia, and with greater white matter hyperintensities severity, independent of age, gender, cognitive function and cardiovascular disease. Weaker associations were found between the other variability measures and the MRI measures.


CONCLUSIONS
In this group of older adults free from neurodegenerative diseases, a greater variability of step length was associated with greater burden of subclinical brain vascular abnormalities as defined by MRI.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA. rosanoc@edc.pitt.edu
Caterina
C
Rosano
Jennifer
J
Brach
Stephanie
S
Studenski
W T
WT
Longstreth
Anne B
AB
Newman
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D020144:Basal Ganglia Cerebrovascular Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D051346:Mobility Limitation; D019636:Neurodegenerative Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D009460:Neurologic Examination; D012307:Risk Factors; D014481:United States