April 2018 CME Article No. 4: Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition

Additional Information

Objective:
This study aimed to examine differences in spatiotemporal gait parameters between older adults with amnestic mild cognitive impairment (aMCI) and normal cognition (NC), and to examine limbic and basal ganglia neural correlates of gait and executive function in older adults without dementia.

Design:
This was a cross sectional study of 46 community dwelling older adults, ages 70-95 with aMCI (n=23) and NC (n=23). Structural magnetic resonance imaging (MRI) was used to attain volumetric measures of limbic and basal ganglia structures. Quantitative motion analysis was used to measure spatiotemporal parameters of gait. The Trail Making Test was used to assess executive function.

Results:
During fast paced walking, older adults with aMCI demonstrated significantly slower gait speed and shorter stride length compare to older adults with NC. Stride length was positively correlated with hippocampal, anterior cingulate, and nucleus accumbens volumes (P < 0.05). Executive function was positively correlated with hippocampal, anterior cingulate, and posterior cingulate volumes (P < 0.05).

Conclusions:
Compared to older adults with NC, those with aMCI demonstrated slower gait speed and shorter stride length, during fast-pace walking, and lower executive function. Hippocampal and anterior cingulate volumes demonstrated moderate positive correlation with both gait and executive function, after adjusting for age.

Learning Objectives:

Discuss gait performance and cognitive function in older adults with aMCI (amnestic mild cognitive impairment)versus normal cognition
Discuss neurocorrelates of gait and executive function in older adults without dementia
Recognize the importance of assessing gait speed and cognitive function in the clinical management of older adults at risk for dementia

Summary