Cognitive associations with comprehensive gait and static balance measures in Parkinson's disease

Rosie Morris, Douglas N. Martini, Katrijn Smulders, Valerie E. Kelly, Cyrus P. Zabetian, Kathleen Poston, Amie Hiller, Kathryn A. Chung, Laurice Yang, Shu Ching Hu, Karen L. Edwards, Brenna Cholerton, Thomas J. Grabowski, Thomas J. Montine, Joseph F. Quinn, Fay Horak

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Gait and balance impairments are cardinal features of Parkinson's disease (PD) that require cognitive input. However, the extent to which specific gait and balance characteristics relate to cognition in PD is unclear. In addition, independent models of gait and balance have not been developed from the same cohort. We aimed to i) develop models of gait and balance in a large PD cohort and ii) determine which gait and balance characteristics best related to cognition. Methods: One hundred and ninety-eight people with PD were recruited to the Pacific Udall Center. Using six inertial sensors (APDM, Inc.), comprehensive gait measurements were collected over a 2-min continuous walk and comprehensive static balance measures were collected during a 60-second standing task. Six domains of cognition were assessed: global cognition, attention, executive function, language, memory, and visuospatial function. Correlations and hierarchical linear regression determined independent associations. Results: Principal components analysis identified a gait model containing four domains accounting for 80.1% of total variance: pace/turning, rhythm, variability, and trunk. The balance model contained four independent domains accounting for 84.5% of total variance: sway area/jerkiness, sway velocity, sway frequency anteroposterior, and sway frequency mediolateral. Gait domains of pace/turning and variability were strongly associated with attention and executive function. Sway area and jerkiness of balance associated with attention and visuospatial function. Conclusions: Gait and balance characteristics were associated with specific types of cognition. The specific relationships between gait or balance with cognitive functions suggests shared cerebral cortical circuitry for mobility and cognitive functions.

Original languageEnglish (US)
Pages (from-to)104-110
Number of pages7
JournalParkinsonism and Related Disorders
Volume69
DOIs
StatePublished - Dec 2019

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Gait
Parkinson Disease
Cognition
Executive Function
Principal Component Analysis
Linear Models
Language

Keywords

  • Balance
  • Gait
  • Neurological disease

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Cognitive associations with comprehensive gait and static balance measures in Parkinson's disease. / Morris, Rosie; Martini, Douglas N.; Smulders, Katrijn; Kelly, Valerie E.; Zabetian, Cyrus P.; Poston, Kathleen; Hiller, Amie; Chung, Kathryn A.; Yang, Laurice; Hu, Shu Ching; Edwards, Karen L.; Cholerton, Brenna; Grabowski, Thomas J.; Montine, Thomas J.; Quinn, Joseph F.; Horak, Fay.

In: Parkinsonism and Related Disorders, Vol. 69, 12.2019, p. 104-110.

Research output: Contribution to journalArticle

Morris, R, Martini, DN, Smulders, K, Kelly, VE, Zabetian, CP, Poston, K, Hiller, A, Chung, KA, Yang, L, Hu, SC, Edwards, KL, Cholerton, B, Grabowski, TJ, Montine, TJ, Quinn, JF & Horak, F 2019, 'Cognitive associations with comprehensive gait and static balance measures in Parkinson's disease', Parkinsonism and Related Disorders, vol. 69, pp. 104-110. https://doi.org/10.1016/j.parkreldis.2019.06.014
Morris, Rosie ; Martini, Douglas N. ; Smulders, Katrijn ; Kelly, Valerie E. ; Zabetian, Cyrus P. ; Poston, Kathleen ; Hiller, Amie ; Chung, Kathryn A. ; Yang, Laurice ; Hu, Shu Ching ; Edwards, Karen L. ; Cholerton, Brenna ; Grabowski, Thomas J. ; Montine, Thomas J. ; Quinn, Joseph F. ; Horak, Fay. / Cognitive associations with comprehensive gait and static balance measures in Parkinson's disease. In: Parkinsonism and Related Disorders. 2019 ; Vol. 69. pp. 104-110.
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AU - Morris, Rosie

AU - Martini, Douglas N.

AU - Smulders, Katrijn

AU - Kelly, Valerie E.

AU - Zabetian, Cyrus P.

AU - Poston, Kathleen

AU - Hiller, Amie

AU - Chung, Kathryn A.

AU - Yang, Laurice

AU - Hu, Shu Ching

AU - Edwards, Karen L.

AU - Cholerton, Brenna

AU - Grabowski, Thomas J.

AU - Montine, Thomas J.

AU - Quinn, Joseph F.

AU - Horak, Fay

PY - 2019/12

Y1 - 2019/12

N2 - Introduction: Gait and balance impairments are cardinal features of Parkinson's disease (PD) that require cognitive input. However, the extent to which specific gait and balance characteristics relate to cognition in PD is unclear. In addition, independent models of gait and balance have not been developed from the same cohort. We aimed to i) develop models of gait and balance in a large PD cohort and ii) determine which gait and balance characteristics best related to cognition. Methods: One hundred and ninety-eight people with PD were recruited to the Pacific Udall Center. Using six inertial sensors (APDM, Inc.), comprehensive gait measurements were collected over a 2-min continuous walk and comprehensive static balance measures were collected during a 60-second standing task. Six domains of cognition were assessed: global cognition, attention, executive function, language, memory, and visuospatial function. Correlations and hierarchical linear regression determined independent associations. Results: Principal components analysis identified a gait model containing four domains accounting for 80.1% of total variance: pace/turning, rhythm, variability, and trunk. The balance model contained four independent domains accounting for 84.5% of total variance: sway area/jerkiness, sway velocity, sway frequency anteroposterior, and sway frequency mediolateral. Gait domains of pace/turning and variability were strongly associated with attention and executive function. Sway area and jerkiness of balance associated with attention and visuospatial function. Conclusions: Gait and balance characteristics were associated with specific types of cognition. The specific relationships between gait or balance with cognitive functions suggests shared cerebral cortical circuitry for mobility and cognitive functions.

AB - Introduction: Gait and balance impairments are cardinal features of Parkinson's disease (PD) that require cognitive input. However, the extent to which specific gait and balance characteristics relate to cognition in PD is unclear. In addition, independent models of gait and balance have not been developed from the same cohort. We aimed to i) develop models of gait and balance in a large PD cohort and ii) determine which gait and balance characteristics best related to cognition. Methods: One hundred and ninety-eight people with PD were recruited to the Pacific Udall Center. Using six inertial sensors (APDM, Inc.), comprehensive gait measurements were collected over a 2-min continuous walk and comprehensive static balance measures were collected during a 60-second standing task. Six domains of cognition were assessed: global cognition, attention, executive function, language, memory, and visuospatial function. Correlations and hierarchical linear regression determined independent associations. Results: Principal components analysis identified a gait model containing four domains accounting for 80.1% of total variance: pace/turning, rhythm, variability, and trunk. The balance model contained four independent domains accounting for 84.5% of total variance: sway area/jerkiness, sway velocity, sway frequency anteroposterior, and sway frequency mediolateral. Gait domains of pace/turning and variability were strongly associated with attention and executive function. Sway area and jerkiness of balance associated with attention and visuospatial function. Conclusions: Gait and balance characteristics were associated with specific types of cognition. The specific relationships between gait or balance with cognitive functions suggests shared cerebral cortical circuitry for mobility and cognitive functions.

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KW - Gait

KW - Neurological disease

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