Gait Disturbances are Associated with Increased Cognitive Impairment and Cerebrospinal Fluid Tau Levels in a Memory Clinic Cohort

Marijn Muurling (Corresponding Author), Hanneke F.M. Rhodius-Meester, Juha Pärkkä, Mark van Gils, Kristian S. Frederiksen, Marie Bruun, Steen G. Hasselbalch, Hilkka Soininen, Sanna Kaisa Herukka, Merja Hallikainen, Charlotte E. Teunissen, Pieter Jelle Visser, Philip Scheltens, Wiesje M. van der Flier, Jussi Mattila, Jyrki Lötjönen, Casper de Boer

    Research output: Contribution to journalArticleScientificpeer-review

    15 Citations (Scopus)


    BACKGROUND: Gait analysis with accelerometers is a relatively inexpensive and easy to use method to potentially support clinical diagnoses of Alzheimer's disease and other dementias. It is not clear, however, which gait features are most informative and how these measures relate to Alzheimer's disease pathology.

    OBJECTIVE: In this study, we tested if calculated features of gait 1) differ between cognitively normal subjects (CN), mild cognitive impairment (MCI) patients, and dementia patients, 2) are correlated with cerebrospinal fluid (CSF) biomarkers related to Alzheimer's disease, and 3) predict cognitive decline.

    METHODS: Gait was measured using tri-axial accelerometers attached to the fifth lumbar vertebra (L5) in 58 CN, 58 MCI, and 26 dementia participants, while performing a walk and dual task. Ten gait features were calculated from the vertical L5 accelerations, following principal component analysis clustered in four domains, namely pace, rhythm, time variability, and length variability. Cognitive decline over time was measured using MMSE, and CSF biomarkers were available in a sub-group.

    RESULTS: Linear mixed models showed that dementia patients had lower pace scores than MCI patients and CN subjects (p < 0.05). In addition, we found associations between the rhythm domain and CSF-tau, especially in the dual task. Gait was not associated with CSF Aβ42 levels and cognitive decline over time as measured with the MMSE.

    CONCLUSION: These findings suggest that gait - particularly measures related to pace and rhythm - are altered in dementia and have a direct link with measures of neurodegeneration.

    Original languageEnglish
    Pages (from-to)1061-1070
    Number of pages10
    JournalJournal of Alzheimer's Disease
    Issue number3
    Publication statusPublished - 2020
    MoE publication typeA1 Journal article-refereed


    Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. The chair of Wiesje van der Flier is supported by the Pasman stichting. This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under Grant Agreement no. 611005 (Predict ND). The collaboration project DAILY (project no. LSHM19123-HSGF) is co-funded by the PPP Allowance made available by Health-Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships.


    • Alzheimer’s disease
    • cognitive dysfunction
    • dementia
    • gait analysis
    • tau proteins


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