Introduction: Cross-sectional studies have shown associations between impaired gait and balance and poorer cognitive function, particularly executive function. Gait speed is a good predictor of cognitive decline in later life. Impaired gait, balance and cognitive function have been associated with brain atrophy and white matter hyper-intensities. In this study, we examine whether performance-orientated assessments of gait and balance predicts future cognitive function and decline.
Methods: In 2002, 99 people [(median age 70 years (IQ range: 67–74)] underwent cognitive assessment using the CAMCOG and assessment of gait and balance using the Tinetti POAM scale. Repeat cognitive assessment was performed in 2012.
Results: Median total CAMCOG score fell from 98 to 94 (P < 0.007) over 10 years. The median memory score fell from 24 to 23 (P < 0.001) and the executive subscore from 22 to 20 (P < 0.001). Poorer balance scores were associated with the lower total CAMCOG score (r = 0.24, P < 0.05) and the CAMCOG memory subscore (r = 0.23 P < 0.05) at follow-up and with a greater decline in the total CAMCOG score (r= −0.28, P < 0.01) and the CAMCOG memory subscore (r = −0.38, P < 0.001). Similarly, poorer gait scores were associated with the lower total CAMCOG score (r = 0.20, P < 0.05) and the CAMCOG memory subscore (r = 0.25; P < 0.05) at follow-up and with a greater decline in the total CAMCOG total score (r = −0.25, P < 0.05) and the CAMCOG memory subscore (r = −0.24, P < 0.05). These associations remained significant after adjusting for; age, sex, baseline cognitive function, history of cardiovascular disease, cerebrovascular disease, diabetes, depression, smoking status, alcohol consumption, BMI and psychoactive medication.
Conclusion: Poor gait and balance are associated with poorer cognitive function 10 years later and greater cognitive decline. In contrast to other reports, our study showed an association with memory but not executive function. Impaired gait and balance may be an early marker of ‘brain ageing’. Cognitive assessment should form part of the evaluation of patients presenting with gait and balance problems.