title: Gait phenotype from mild cognitive impairment to moderate dementia: results from the GOOD initiative.
abstract: OBJECTIVE
  The differences in gait abnormalities from the earliest to the later stages of dementia and in the different subtypes of dementia have not been fully examined. This study aims to compare spatiotemporal gait parameters in cognitively healthy individuals, patients with amnestic mild cognitive impairment (MCI) and non-amnestic MCI, and patients with mild and moderate stages of Alzheimer's disease (AD) and non-Alzheimer's disease (non-AD).
  
  
  METHODS
  Based on a cross-sectional design, 1719 participants (77.4 ± 7.3 years, 53.9% female) were recruited from cohorts from seven countries participating in the Gait, Cognition and Decline (GOOD) initiative. Mean values and coefficients of variation of spatiotemporal gait parameters were measured during normal pace walking with the GAITRite system at all sites.
  
  
  RESULTS
  Performance of spatiotemporal gait parameters declined in parallel with the stage of cognitive decline from MCI status to moderate dementia. Gait parameters of patients with non-amnestic MCI were more disturbed compared to patients with amnestic MCI, and MCI subgroups performed better than demented patients. Patients with non-AD dementia had worse gait performance than those with AD dementia. This degradation of gait parameters was similar between mean values and coefficients of variation of spatiotemporal gait parameters in the earliest stages of cognitive decline, but different in the most advanced stages, especially in the non-AD subtypes.
  
  
  CONCLUSIONS
  Spatiotemporal gait parameters were more disturbed in the advanced stages of dementia, and more affected in the non-AD dementias than in AD. These findings suggest that quantitative gait parameters could be used as a surrogate marker for improving the diagnosis of dementia.
authors.affiliation: Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.|Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Allali
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France.|Center for Functional and Metabolic Mapping, Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Annweiler
authors.affiliation: Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Blumen
authors.affiliation: Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia.|Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.
authors.forename: M L
authors.initials: ML
authors.lastname: Callisaya
authors.affiliation: Department of Geriatric Medicine, AZ ST Maarten Mechelen, Mechelen, Belgium.|Department of Geriatrics, University of Antwerp, Antwerp, Belgium.|Department of Primary an Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium.
authors.forename: A-M
authors.initials: AM
authors.lastname: De Cock
authors.affiliation: University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel, Switzerland.
authors.forename: R W
authors.initials: RW
authors.lastname: Kressig
authors.affiliation: Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia.|Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Srikanth
authors.affiliation: Centre for Memory and Mobility (CeM²), Luxembourg City, Luxembourg.
authors.forename: J-P
authors.initials: JP
authors.lastname: Steinmetz
authors.affiliation: Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Verghese
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France.|Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montréal, QC, Canada.|Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada, n: Centre of Excellence on Aging and Chronic Diseases of McGill integrated University Health Network, Quebec, Canada.|Biomathics, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Beauchet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000503:physiopathology*; D000647:Amnesia / Q000150:complications / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000503:physiopathology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010641:Phenotype
keywords: Alzheimer's disease; aging; cohort studies; dementia; gait disorders; mild cognitive impairment; motor control; quantitative gait parameters