Association between Various Brain Pathologies and Gait Disturbance.

Area of Science:

• Neurology
• Gerontology
• Biomedical Science

Background:

• Approximately 30% of older adults experience disrupted gait, a condition linked to increased risks of cognitive decline, disability, dementia, and mortality.
• Many older adults exhibit neuropathologies, prompting research into the connection between subclinical brain changes and gait disturbances.
• Investigating the link between neuropathology and gait is crucial for understanding age-related functional decline.

Purpose of the Study:

• To review and synthesize existing research on the association between various neuropathologies and gait parameters in older adults.
• To identify which neuropathologies are most consistently linked to gait impairment.
• To highlight gaps in current knowledge and suggest future research directions.

Main Methods:

• Systematic review of studies examining the relationship between gait and neuropathologies.
• Analysis of findings related to grey matter atrophy, white matter changes, neuronal activity, and protein aggregation (amyloid, tau).
• Assessment of methodological approaches and study designs, including a focus on longitudinal data.

Main Results:

• Grey matter atrophy showed the most consistent association with poorer gait performance across reviewed studies.
• White matter studies primarily focused on total white matter, suggesting a need for regional analysis.
• Evidence indicates both under- and overactivation in neuronal activity are linked to gait disruption, requiring further clarification.
• Early findings suggest amyloid and tau aggregation negatively impact gait, but more research is needed.

Conclusions:

• Subclinical neuropathologies, particularly grey matter atrophy, are associated with gait disruption in older adults.
• Conflicting results regarding neuronal activity and gait necessitate further investigation.
• Substantial methodological heterogeneity and a lack of longitudinal studies limit current understanding.
• Longitudinal research tracking neuropathology and gait changes is essential for understanding disease trajectories.