Walk the talk

Walking and talking can be an early predictor of dementia

Roy Bratty, 82, and his wife AnnabelMcMillan, made a family decision to participate in research when they recognized that Roy was beginning to show signs of memory issues. “When we met with our doctor, a few different research projects were suggested to us,” recalls Annabel.

They decided Roy would participate in the “Gait and Brain Study” led by Dr. Manuel Montero- Odasso, a Lawson scientist and geriatrician at St. Joseph’s Health Care London (St. Joseph’s). With his team, Dr. Montero-Odasso is currently assessing 150 seniors with mild cognitive impairment (MCI), a slight decline of memory and other mental functions which is considered a pre-dementia syndrome, in order to detect an early predictor of cognitive and mobility decline and progression to dementia.

Annabel and Roy chose to participate in the study because it is non-invasive and only requires bi-annual visits to St. Joseph’s Parkwood Institute over a six year period. “My hope is that participating in the project can help me monitor my memory loss, but also that through my participation and the information I provide, others will benefit too,” says Roy.

To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints. “Finding methods to detect dementia early is vital to our ability to slow or halt the progression of the disease,” says Dr. Montero-Odasso.

For the study, researchers ask participants to walk while simultaneously performing a cognitively demanding task (dual-tasking), such as counting backwards or naming animals. “While walking has long been considered an automatic motor task, emerging evidence suggests cognitive function plays a key role in the control of walking, avoidance of obstacles and maintenance of navigation,” adds Dr. Montero-Odasso. “We believe that gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function.”

Roy Bratty decided to participate in the “Gait and Brain Study” after he began to show signs of memory issues.

The “gait cost,” or speed at which participants completed a single task (walking) versus a dual-task, was higher in those MCI individuals with worse episodic memory and who struggle with executive functions such as attention keeping and time management. Moreover, those individuals with MCI that slow down more than 20 per cent while performing the dual-task are at a higher risk of progressing to dementia. The results demonstrate that gait, or motion testing, while simultaneously performing a cognitively demanding task can be an effective predictor of progression to dementia and eventually help with earlier diagnosis.

“Our results reveal a ‘motor signature’ of cognitive impairment that can be used to predict dementia,” elaborates Dr. Montero-Odasso. “It is conceivable that we will be able to diagnose Alzheimer’s disease and other dementias before people have significant memory loss. Our hope is to combine these methods with promising new medications to slow or halt the progression of MCI to dementia.” The study was made possible through community support, which helped to purchase key equipment and enhance research space – enabling the work of Dr. Montero-Odasso and his team.

Roy says the experience has made him more aware about the importance of taking care of himself and he regularly challenges his mind and memory by solving Sudoku puzzles. His goal to help others by participating in research may someday be realized should the research project translate into a simple test clinicians can utilize in any care environment.

Dr. Manuel Montero-Odasso is the director of the Gait and Brain Lab, which is part of Parkwood Institute Research, a program of Lawson. He is also a professor in the Department of Medicine, Schulich School of Medicine & Dentistry at Western University.