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. 2021 Aug 3:13:664558.
doi: 10.3389/fnagi.2021.664558. eCollection 2021.

Gait Kinematic and Kinetic Characteristics of Older Adults With Mild Cognitive Impairment and Subjective Cognitive Decline: A Cross-Sectional Study

Qian Zhong  1   2 , Nawab Ali  1   3 , Yaxin Gao  1   4 , Han Wu  2 , Xixi Wu  5 , Cuiyun Sun  2 , Jinhui Ma  6 , Lehana Thabane  6   7 , Ming Xiao  8   9 , Qiumin Zhou  4 , Ying Shen  4 , Tong Wang  1 , Yi Zhu  1
Affiliations

Gait Kinematic and Kinetic Characteristics of Older Adults With Mild Cognitive Impairment and Subjective Cognitive Decline: A Cross-Sectional Study

Qian Zhong et al. Front Aging Neurosci. .

Abstract

Background: Older adults with mild cognitive impairment (MCI) have slower gait speed and poor gait performance under dual-task conditions. However, gait kinematic and kinetic characteristics in older adults with MCI or subjective cognitive decline (SCD) remain unknown. This study was designed to explore the difference in gait kinematics and kinetics during level walking among older people with MCI, SCD, and normal cognition (NC).

Methods: This cross-sectional study recruited 181 participants from July to December 2019; only 82 met the inclusion criteria and consented to participate and only 79 completed gait analysis. Kinematic and kinetic data were obtained using three-dimensional motion capture system during level walking, and joint movements of the lower limbs in the sagittal plane were analyzed by Visual 3D software. Differences in gait kinematics and kinetics among the groups were analyzed using multivariate analysis of covariance (MANCOVA) with Bonferroni post-hoc analysis. After adjusting for multiple comparisons, the significance level was p < 0.002 for MANCOVA and p < 0.0008 for post-hoc analysis.

Results: Twenty-two participants were MCI [mean ± standard deviation (SD) age, 71.23 ± 6.65 years], 33 were SCD (age, 72.73 ± 5.25 years), and 24 were NC (age, 71.96 ± 5.30 years). MANCOVA adjusted for age, gender, body mass index (BMI), gait speed, years of education, diabetes mellitus, and Geriatric Depression Scale (GDS) revealed a significant multivariate effect of group in knee peak extension angle (F = 8.77, p < 0.0001) and knee heel strike angle (F = 8.07, p = 0.001) on the right side. Post-hoc comparisons with Bonferroni correction showed a significant increase of 5.91° in knee peak extension angle (p < 0.0001) and a noticeable decrease of 6.21°in knee heel strike angle (p = 0.001) in MCI compared with NC on the right side. However, no significant intergroup difference was found in gait kinetics, including dorsiflexion, plantar flexion, knee flexion, knee extension, hip flexion, and hip extension(p > 0.002).

Conclusion: An increase of right knee peak extension angle and a decrease of right knee heel strike angle during level walking were found among older adults with MCI compared to those with NC.

Keywords: gait; kinematics; kinetics; mild cognitive impairment; subjective cognitive decline.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the recruitment.
FIGURE 2
FIGURE 2
Comparison of right knee kinematics among the three groups (MANCOVA with Bonferroni post-hoc analysis). MANCOVA, multivariate analysis of covariance; MCI, mild cognitive impairment; SCD, subjective cognitive decline; NC, normal cognition; ROM, range of motion. *A trend of difference between groups (0.0008 < p-values < 0.01 for post-hoc tests). **p-Values < 0.0008 for post-hoc tests between MCI and NC groups.
See this image and copyright information in PMC

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