Variability in spatial and temporal gait dynamics during aging: a narrative review on the role of the neural system

Gait dynamics, encompassing both spatial and temporal parameters, undergo significant changes with aging, often leading to increased gait variability and, consequentially, a higher risk of falls. While cognitive and musculoskeletal factors have been demonstrated to contribute to these alterations, the role of the neural system is crucial and yet not fully understood. This review aims to synthesize the existing evidence on the age-related deterioration in locomotor functioning, with a specific emphasis on the neural mechanisms involved. Besides summarizing appropriate measures to quantify gait variability, several neural factors including cortical, neurotransmitter, and sensory system degeneration, are explored as key contributors to the observed changes in locomotion during aging. Additionally, the review discusses the potential use of diverse interventions to enhance gait variability during aging to reduce the risk of falls. By elucidating the complex interplay between aging, gait dynamics, and neural function, this review underscores the importance of targeted interventions aimed at preserving neural health to maintain gait stability and reduce fall risk in the aging population. The findings suggest that further research is needed to develop and refine strategies for the early detection and prevention of gait-related impairments linked to neural decline.