A geriatrician has found that a senior's gait may be a sign of what's to come. Dr. Manuel Montero-Odasso can predict future mobility problems just by measuring how fast an elderly person walks, says a May 13, 2008 news release, "Geriatrician finds senior's gait a sign of what's to come. It’s a simple test that can reveal the future risk for falls, fractures, and balance issues, even in seemingly healthy seniors. Now as the first recipient of the Schulich School of Medicine & Dentistry’s Clinician-Scientist Award at The University of Western Ontario, Montero-Odasso received up to $200,000 a year for three years to allow him to devote more time to this important research.
Knowing how debilitating falls and fractures can be, Montero-Odasso measured the gait velocity of more than a hundred high-functioning people over the age of 75. Two years later he did a follow-up and found those with a slow gait had higher incidents of hospitalization, required a caregiver or nursing home, and had more falls, fractures and death. He hopes this research will help physicians detect and prevent mobility problems in their older patients.
Montero-Odasso also studied people with mild cognitive impairment to see whether subtle changes in the way they walk is linked to any decline to dementia. Montero-Odasso also has been awarded a $70,000 grant for a pilot project to study the effect of vitamin D on muscle and mobility in frail older persons.
“The goal of our Clinician-Scientist Award program is to recruit clinical faculty members with high potential for research leadership, and to provide mentoring to make sure they reach their potential,” says Dr. Carol Herbert, Dean of the Schulich School of Medicine & Dentistry. “The School congratulates Manuel on being selected for this highly competitive award.”
Montero-Odasso is a professor in the Department of Medicine at The University of Western Ontario, working in the Division of Geriatric Medicine at Victoria Hospital, London Health Sciences Center and Parkwood Hospital, St Joseph’s Health Care, London. He’s also an associate scientist with the Lawson Health Research Institute, according to the news release which was dated May 13, 2008.
Older people with stronger cognitive skills walk at a safer pace
Psychologists wanting to help old people safely cross the street and otherwise ambulate around this busy world have found that from age 70 and up, safe walking may require solid "executive control" (which includes attention) and memory skills, according to a March 26, 2006 news release, "Older people with stronger cognitive skills walk at a safer pace." You can check out the original paper, "Cognitive Processes Related to Gait Velocity: Results From the Einstein Aging Study (PDF)." Authors are Roee Holtzer, PhD, Joe Verghese, MD, Xiaonan Xue, PhD, and Richard B. Lipton, MD, Albert Einstein College of Medicine, Yeshiva University. The findings are in the March 2006 issue of the journal Neuropsychology, Vol. 20, No. 2, which is published by the American Psychological Association (APA).
For the old, slow gait is a significant risk factor for falls, many of which result in disabling fractures, loss of independence or even death. The finding may help explain why cognitive problems in old age, including dementia, are associated with falls. Cognitive tests could help doctors assess risk for falls; conversely, slow gait could alert them to check for cognitive impairment.
Roee Holtzer, PhD, and his colleagues conducted a cross-sectional study of 186 cognitively normal, community-dwelling adults aged 70 and older at New York City's Albert Einstein College of Medicine. Gait speed was tested with and without interference. In the interference conditions, participants had to walk while reciting alternate letters of the alphabet.
Gait velocity is walking speed
Performance on cognitive tests of executive control and memory, and to a lesser extent of verbal ability, predicted "gait velocity" (walking speed) tested without interference. For gait velocity tested with interference, only executive control and memory were predictive. Adding interference to the tests of gait allowed the researchers to better simulate the real world, in which walkers continually deal with distractions. The authors conclude that executive control and memory function are important when the individual has to walk in a busy environment.
Falls are a serious public-health issue for an aging population. Many older people are aging in the suburbs, where traffic conditions are often not designed for pedestrians of any age. And in cities, traffic lights at busy intersections are not usually timed to give people with slower perceptions and reflexes more time to safely cross the street.
The findings suggest that in old age, walking involves higher-order executive-control processes
That is, the intersecting cognitive and motor processes involved in walking may both rely on a common brain substrate, or set of structures. As a result, changes in that substrate would affect both cognition and gait. Holtzer says that risk assessment and prevention programs for falls, which have typically focused on balance, strength and gait but not cognitive function, have had limited success.
Given the new research, he posits that cognitive and neuropsychological performance, plus gait, could both factor into risk assessment and intervention design. What's more, cognitive rehabilitation and/or medication targeting cognitive functions such as executive control and memory might, among other benefits, reduce the risk of falling in people at risk.
Future study is needed to follow people through the life span to see how age affects the relationship between cognitive functions and gait. Holtzer cites evidence that gait is more automatic and less effortful in young than old people and points out that even within the narrow age range of his study's participant sample, each additional year tightened the relationship between cognitive function and gait velocity.
Do walkers ever wonder whether what they have just ate has anything to do with how fast they are able to walk after a meal or even hours later?
For example, when you're having a blood sugar spike and the insulin starts pouring out of your pancreas into your bloodstream, are you walking more slowly due to the shakes and fast heart beat from a possible situation where you have very low blood sugar from too much insulin, perhaps a few minutes after a meal that doesn't have enough protein? Could it be insulin resistance?
Or could it be hypertension that slows down your walking speed? A new study looked at the link between the drop in walking speed of a person and high blood pressure. But before you start measuring your speed of stride, more research really has to be done to find out why people suddenly start walking slower, perhaps at a given age. Is it hypertension? Or is it what you just ate?
What a slow gait when walking might signal for senior health
Older adults who don't drive either because they never learned, perhaps because they gave up their license or just by choice, usually walk for exercise or to get from their homes to the local stores a few blocks away. Do they walk slow, fast, or simply leisurely and relaxed. And is it safe to walk at noon from one's house to the supermarket or bus stop two blocks away without being assaulted or annoyed by panhandlers, emotionally disturbed people yelling at them, or muggers? According to a March 16, 2011 Health Day news release, "High blood pressure linked to drop in walking speed, study finds," if your walking speed suddenly slows down, it may signal not only high blood pressure but may possibly predict who will develop dementia and other disabilities, according to the researchers in this study.
Major declines may affect a seniors citizen's ability to remain independent, researchers say, according to that Health Day news article about the study. High blood pressure is associated with a steeper drop in the average walking speeds of seniors, a new study finds. Major decreases in walking speed can affect a senior's ability to remain independent and indicate possible health problems.
Can a sudden decrease in walking that doesn't change when you eat smaller portions or less food also predict who will develop dementia or disabilities? Interestingly, the decline in walking speed in the latest study occurred even among people who had their blood pressure under control with medications, according to the study done at the University of Pittsburgh, researchers, and their colleagues.
The study didn't look at what the people ate, only their slowing walking speed. And you have to ask yourself why did the participant's walking speed slow down even when their hypertension was lowered by blood pressure medications, according to the new study? Before you buy a device to measure how brisk you are walking, further research is needed to learn more about the link between high blood pressure and the sharp drop in walking speeds.
The study, published in the March 2011 issue of the Journal of the American Geriatric Society, received funding from the U.S. National Heart, Lung, and Blood Institute, part of the National Institutes of Health. You can read the abstract of the study: High Blood Pressure Accelerates Gait Slowing in Well-Functioning Older Adults over 18-Years of Follow-Up (pages 390–397).
The conclusion of that study noted, "High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted."
Also you may want to check out the AGS Foundation for Health in Aging for more information about walking problems. Also see the abstract of another study, Lack of Effect of Tai Chi Chuan in Preventing Falls in Elderly People Living at Home: A Randomized Clinical Trial.