Gait in Cerebral Small Vessel Disease, Pre-dementia, and Dementia: A Systematic Review

Overview

Journal Int J Stroke

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2022 Jul 7

PMID 35797006

Authors

Helena M Blumen

Oshadi Jayakody

Joe Verghese

Affiliations

Soon will be listed here.

Abstract

Background: The interrelationships between gait, cerebral small vessel disease (CSVD), and cognitive impairments in aging are not well-understood-despite their common co-occurrence.

Objective: To systematically review studies of gait impairment in CSVD, pre-dementia, and dementia, and to identify key gaps for future research and novel pathways toward intervention.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search strategy was implemented in PubMed to identify relevant studies. Potential articles (n = 263) published prior to 1 December 2021 were screened by two reviewers. Studies with sample sizes >20 and including some adults over > 65 years (n = 202) were included.

Results: The key findings were that (1) adverse gait and cognitive outcomes were associated with several (rather than select) CSVD pathologies distributed across the brain, and (2) poor gait and CSVD pathologies were more strongly associated with dementia with a vascular, rather than an Alzheimer's disease-related, cause.

Discussion: A better understanding of the interrelationships between gait performance in CSVD, pre-dementia, and dementia requires studies examining (1) comprehensive patterns in the clinical manifestations of CSVD, (2) racially/ethnically diverse samples, (3) samples followed for extended periods of time or across the adult life span, (4) non-traditional CSVD neuroimaging markers (e.g. resting-state functional magnetic resonance imaging (fMRI)), and (5) continuous (e.g. wearable sensors) and complex (e.g. dual-task) walking performance.

Citing Articles

Wearable sensors and machine learning fusion-based fall risk prediction in covert cerebral small vessel disease.

Zhou Y, Zhang D, Ji Y, Bu S, Hu X, Zhao C Front Neurosci. 2025; 19:1493988.

PMID: 40046433 PMC: 11879974. DOI: 10.3389/fnins.2025.1493988.

Mapping the neural substrate of high dual-task gait cost in older adults across the cognitive spectrum.

Ali P, Dinomais M, Labriffe M, Pieruccini-Faria F, Montero-Odasso M, Bartha R Brain Struct Funct. 2025; 230(1):25.

PMID: 39755775 PMC: 11700055. DOI: 10.1007/s00429-024-02873-6.

Artificial intelligence-assisted oculo-gait measurements for cognitive impairment in cerebral small vessel disease.

Chen H, Du H, Yi F, Wang T, Yang S, Pan Y Alzheimers Dement. 2024; 20(12):8516-8526.

PMID: 39410879 PMC: 11667535. DOI: 10.1002/alz.14288.

White Matter Hyperintensities Are Associated with Slower Gait Speed in Older Adults without Dementia.

Vazquez J, Verghese J, Barzilai N, Milman S, Blumen H Neurodegener Dis. 2024; 1-9.

PMID: 39025052 PMC: 11747921. DOI: 10.1159/000538944.

Meso-cortical pathway damage in cognition, apathy and gait in cerebral small vessel disease.

Li H, Jacob M, Cai M, Kessels R, Norris D, Duering M Brain. 2024; 147(11):3804-3816.

PMID: 38709856 PMC: 11531843. DOI: 10.1093/brain/awae145.

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