Continuous gait monitoring discriminates community-dwelling mild Alzheimer's disease from cognitively normal controls

Alzheimers Dement (N Y). 2021 Feb 5;7(1):e12131. doi: 10.1002/trc2.12131. eCollection 2021.

Abstract

Introduction: Few studies have explored whether gait measured continuously within a community setting can identify individuals with Alzheimer's disease (AD). This study tests the feasibility of this method to identify individuals at the earliest stage of AD.

Methods: Mild AD (n = 38) and cognitively normal control (CNC; n = 48) participants from the University of Kansas Alzheimer's Disease Center Registry wore a GT3x+ accelerometer continuously for 7 days to assess gait. Penalized logistic regression with repeated five-fold cross-validation followed by adjusted logistic regression was used to identify gait metrics with the highest predictive performance in discriminating mild AD from CNC.

Results: Variability in step velocity and cadence had the highest predictive utility in identifying individuals with mild AD. Metrics were also associated with cognitive domains impacted in early AD.

Discussion: Continuous gait monitoring may be a scalable method to identify individuals at-risk for developing dementia within large, population-based studies.

Keywords: Alzheimer's disease; accelerometer; digital biomarker; gait.