Could the way you walk reveal Alzheimer’s years before symptoms begin?
Researchers are investigating whether subtle changes in gait correspond with the earliest biological signs of the disease.
Tracking changes to gait might help identify early biological markers of Alzheimer’s disease and related dementias.
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By the time Alzheimer’s disease begins affecting a person’s memory, the underlying changes in the brain may have been developing for decades.
That delay limits opportunities for early intervention by the time most people receive a diagnosis. Current diagnostic tools often rely on costly brain imaging, blood tests or cognitive evaluations that are typically performed only after symptoms become noticeable.
A Texas A&M University research team is investigating whether another clue appears much earlier: the way people walk.
Supported by a Dementia and Alzheimer’s Research Initiative (DARI) seed grant, lead researcher Dr. Jenna Yentes, associate professor in the Department of Kinesiology and Sport Management, is studying whether detailed measurements of gait can identify the earliest biological markers of Alzheimer’s disease and related dementias in adults who have not yet developed cognitive symptoms. The work could lay the foundation for a practical tool to identify people who may benefit from further evaluation years before memory loss appears.
“By the time dementia presents and the family is saying, ‘You’re not remembering things,’ or, ‘You’re not acting like yourself,’ the literature suggests that the process of dementia has been happening for decades,” Yentes said. “Something’s going on internally that you can’t visibly see, and then when you see it, so much change has happened with your physiology that you can’t really reverse that progression.”
Previous research has linked changes in walking to Alzheimer’s disease and other forms of dementia, but many of those studies have focused on people who already show cognitive impairment. Yentes and her collaborators instead want to determine whether gait can reveal signs of disease even earlier while adults are still functioning normally.
The study will recruit 50 adults between the ages of 45 and 85 who do not have dementia. Participants will complete cognitive assessments and health questionnaires, provide blood samples, undergo brain MRI scans and participate in detailed gait testing.
During walking assessments, researchers will measure each participant’s preferred and fastest walking speeds using motion capture technology. They will then compare those measurements with brain imaging, blood biomarkers and cognitive assessments to determine how closely gait aligns with the earliest biological signs associated with Alzheimer’s disease.
Among the measurements Yentes’ team will study is gait reserve, or the difference between a person’s normal walking speed and the fastest speed they can comfortably maintain. They will also examine gait variability — the small differences between individual steps that help people adapt to changing environments. Too little variability or too much random variation may reflect changes in the body’s ability to adapt to changing demands.
Yentes said it’s critical to study adults as young as 45 because biological changes associated with Alzheimer’s can begin as much as two decades before symptoms become noticeable.
“We want to be able to see if it is an indicator at the age of 45, 50, 55 or even 60,” she said. “Can we see something there which then would provide a clue that something’s going on and then provide preventative medicine at that point?”
Yentes hopes the findings will eventually inform screening approaches that could be incorporated into routine medical care. She envisions gait becoming another routine health measure — much like heart rate or blood pressure — that could alert physicians when additional evaluation is warranted.
“Every time you go to the doctor’s office, you could walk over an automated mat, and if you track that year after year and all of a sudden you have a huge drop in gait speed, that could be an indication that something’s going on,” she said.
