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Slow gait in MCI is associated with ventricular enlargement: results from the Gait and Brain Study

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Slow gait is ubiquitous among older adults and predicts cognitive decline and progression to dementia. Age-related structural brain changes could be responsible for abnormal gait. The purpose of this study was to determine whether brain lateral ventricle volume, a measure of brain atrophy, was associated with gait velocity among older adults with mild cognitive impairment (MCI), while considering the effects of age and brain vascular burden. Twenty community-dwellers with MCI, free of hydrocephalus, aged 76 years (69/80) [median (25th/75th percentile)] (35 % female) from the ‘Gait and Brain Study’ were included in this analysis. Quantitative gait performance was measured while steady-state walking at self-selected pace with a 6-m electronic portable walkway (GAITRite). Brain ventricle volume was quantified using semi-automated software from three-dimensional T1-weighted magnetic resonance imaging. Age, white matter hyperintensity burden and Mini-Mental State Examination score were used as potential confounders. Median gait velocity was 118.7 cm/s (104.4/131.3). Median brain ventricle volume was 39.9 mL (30.0/46.6) with the left ventricle being slightly larger than the right (P = 0.052). Brain ventricle volume was inversely associated with gait velocity (adjusted β = −0.63, P = 0.046). Volume of both the ventricular main bodies and the temporal horns correlated inversely with gait velocity (respectively, P = 0.009, P = 0.008). Left ventricle volume correlated with decreased gait velocity (P = 0.002) while right ventricle did not (P = 0.068). Slower gait velocity was associated with larger brain ventricle volume in our sample of people with MCI independent of age, cerebrovascular burden and cognitive worsening. This result may help elucidate the trajectories of cognitive and gait declines in people with MCI.

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Acknowledgments

The authors have mentioned everyone who contributed significantly to the work in the Acknowledgments section. Permission has been obtained from all persons named in the Acknowledgments section. Susan W. Muir, PhD, and Karen Gopaul, MSc, from the ‘Gait and Brain Lab’, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada for their help in the participants’ assessment and data gathering. There was no compensation for this contribution. Irene B. Gulka, MD, from the Department of Radiology, London Health Sciences Centre, London, Ontario, Canada, for her kind advice. There was no compensation for this contribution. Amanda F. Kahn, MSc, from the Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada, for her kind advice. There was no compensation for this contribution.

Sponsor’s role: The Gait and Brain Study is funded by the Canadian Institutes for Health and Research (CIHR): (Principal investigator: Dr. Montero-Odasso; operating grant number 211220). Software for quantification of brain ventricle volumes was provided my Merge Healthcare (Mississauga, Canada). Dr. Annweiler is supported by a grant from the Canadian Institutes for Health and Research—Institute of Aging (CIHR-IA), and holds a research grant from Servier Institute in France. Dr. Montero-Odasso’s program in “Gait and Brain” function is supported, in part, by grants from the CIHR-IA, the Drummond Foundation, the Physician Services Incorporated Foundation of Canada (PSI), the Ontario Ministry of Research and Innovation, and by University of Western Ontario Department of Medicine Program of Experimental Medicine (POEM) Research Award. He is the first recipient of the Schulich Clinician-Scientist Award and recipient of the CIHR New Investigator Award. The sponsors had no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

Conflict of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Division of Geriatric Medicine, Department of Medicine, Parkwood Hospital, St. Joseph’s Health Care London, London, ON, Canada

    C. Annweiler & M. Montero-Odasso

  2. Gait and Brain Lab, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada

    C. Annweiler & M. Montero-Odasso

  3. Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France

    C. Annweiler & O. Beauchet

  4. University Memory Clinic of Angers; UPRES EA 4638, University of Angers, UNAM, Angers, France

    C. Annweiler & O. Beauchet

  5. Department of Medical Biophysics, Center for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada

    C. Annweiler & R. Bartha

  6. Division of Geriatric Medicine, Gait and Brain Lab, Parkwood Hospital, Room A-280, 801 Commissioners Rd E, London, ON, N6A 5A5, Canada

    C. Annweiler & M. Montero-Odasso

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  1. C. Annweiler
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  2. O. Beauchet
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Correspondence to C. Annweiler or M. Montero-Odasso.

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On behalf of the WALK Team (Working group Angers-London for Knowledge).

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Annweiler, C., Beauchet, O., Bartha, R. et al. Slow gait in MCI is associated with ventricular enlargement: results from the Gait and Brain Study. J Neural Transm 120, 1083–1092 (2013). https://doi.org/10.1007/s00702-012-0926-4

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