Using Walking Patterns to Diagnose Specific Dementia Type

For the first time, scientists at Newcastle University have shown that people with Alzheimer’s disease or Lewy body dementia have unique walking patterns that signal subtle differences between the two conditions.

The research, published today in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, shows that people with Lewy body dementia change their walking steps more – varying step time and length – and are asymmetric when they move, in comparison to those with Alzheimer’s disease.

It is a first significant step towards establishing gait as a clinical biomarker for various subtypes of the disease and could lead to improved treatment plans for patients.

Useful diagnostic tool

Dr Ríona McArdle, Post-Doctoral Researcher at Newcastle University’s Faculty of Medical Sciences, led the Alzheimer’s Society-funded research.

She said: “The way we walk can reflect changes in thinking and memory that highlight problems in our brain, such as dementia.

“Correctly identifying what type of dementia someone has is important for clinicians and researchers as it allows patients to be given the most appropriate treatment for their needs as soon as possible.

“The results from this study are exciting as they suggest that walking could be a useful tool to add to the diagnostic toolbox for dementia.

“It is a key development as a more accurate diagnosis means that we know that people are getting the right treatment, care and management for the dementia they have.”

Current diagnosis of the two types of dementia is made through identifying different symptoms and, when required, a brain scan.

For the study, researchers analysed the walk of 110 people, including 29 older adults whose cognition was intact, 36 with Alzheimer’s disease and 45 with Lewy body dementia.

The participants took part in a simple walking test at the Gait Lab of the Clinical Ageing Research Unit, an NIHR-funded research initiative jointly run by Newcastle Hospitals NHS Foundation Trust and Newcastle University.

Participants moved along a walkway – a mat with thousands of sensors inside – which captured their footsteps as they walked across it at their normal speed and this revealed their walking patterns.

People with Lewy body dementia had a unique walking pattern in that they changed how long it took to take a step or the length of their steps more frequently than someone with Alzheimer’s disease, whose walking patterns rarely changed.

When a person has Lewy body dementia, their steps are more irregular and this is associated with increased falls risk. Their walking is more asymmetric in step time and stride length, meaning their left and right footsteps look different to each other.

Scientists found that analysing both step length variability and step time asymmetry could accurately identify 60% of all dementia subtypes – which has never been shown before.

Further work will aim to identify how these characteristics enhance current diagnostic procedures, and assess their feasibility as a screening method. It is hoped that this tool will be available on the NHS within five years.

Pioneering study

Dr James Pickett, Head of Research at Alzheimer’s Society, said: “In this well conducted study we can see for the first time that the way we walk may provide clues which could help us distinguish between Alzheimer’s disease and Lewy body dementia.

“This research – funded by the Alzheimer’s Society – is pioneering for dementia. It shows promise in helping to establish a novel approach to accurately diagnose different types of dementia.

“We know that research will beat dementia, and provide invaluable support for the 850,000 people living with the condition in the UK today. It’s now vital that we continue to support promising research of this kind.

“We look forward to seeing larger, longer studies to validate this approach and shed light on the relationship between a person’s gait and dementia diagnosis.”

Dementia describes different brain disorders that triggers loss of brain function and these conditions are usually progressive and eventually severe.

It is estimated by the Alzheimer’s Society that people living with dementia in the UK will rise to more than one million by 2025.

Source: Newcastle University


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The Benefits of Running vs. Walking

Sally Wadyka wrote . . . . . . .

Running and walking are both excellent forms of exercise. Those who regularly do either typically have healthier hearts, stronger bones, and lower body weights than their sedentary counterparts.

The current Physical Activity Guidelines, issued by the U.S. Department of Health and Human Services, call for a minimum of 150 to 300 minutes per week of moderate activity or 75 to 150 minutes of vigorous activity.

So does it matter whether you get those minutes walking or running? Arguments can made for both—and which is right for you depends on your goals and your current fitness level.

If You Want to Maximize Calorie Burning

“The key difference between running and walking is how many calories you are burning—not per mile, but per minute of exercise,” says Paul D. Thompson, M.D., chief of cardiology at Hartford Hospital and and a professor of medicine and preventive cardiology at the University of Connecticut.

For a 160-pound person, walking at a brisk, 3.5-mph pace for 30 minutes will burn about 156 calories. But running at a 6-mph pace for that same 30 minutes will burn more than double the calories (about 356).

“Running is a less efficient movement, and it’s more demanding on the body, so it burns more calories per minute,” says Thompson. “But if you’ve got the time to walk long enough to burn the equivalent calories, then walking is fine.”

That said, if your ultimate goal is to lose weight, chances are neither running nor walking alone is going to do the trick. “Exercise on its own is not the best way to lose weight,” says Thompson. “Research has shown that it needs to be done along with calorie restriction.”

If You Want to Improve Heart Health

Running makes the heart work harder than walking, so it stands to reason that it would also make it healthier. But the answer again may come down to how much time you have.

In a 2013 study that analyzed data from the nearly 50,000 people involved in the National Runners’ Health Study II and National Walkers’ Health Study, researchers found that runners’ risk of cardiovascular disease was 4.5 percent lower than those who were inactive.

But walkers who expended the same amount of energy as runners daily—burned the same amount of calories—had a risk level that was 9 percent lower than those who were inactive.

If You Want to Reduce Belly Fat

You can help decrease how much fat you store in your middle if you pick up the pace by interspersing some stretches of all-out sprinting with your jog or walk.

High-intensity interval training (HIIT)—a workout in which you alternate short bursts of activity at close to your peak heart rate with easier bouts—can help eat away at belly fat. A 2018 analysis of 39 studies, published in the journal Sports Medicine, concluded that HIIT reduced what’s called visceral fat by 1.8 percent.

This is important because visceral fat is located deep in the abdominal cavity, surrounding organs such as the liver and pancreas. That means the fat can trigger a variety of metabolic changes, including increased insulin resistance and higher triglyceride levels.

“Reducing visceral fat, even without losing weight, can improve overall health,” says Carol Ewing Garber, Ph.D., a professor of biobehavioral studies at Columbia University Teachers College. (Garber was not involved in the 2018 study.)

HIIT is also a great way to ease yourself into a running regimen, says Garber.

“Running is often a big step up in intensity from walking, so it’s best to add it into your routine gradually,” she says. “By alternating higher intensity intervals of running with lower-intensity walking intervals you’ll reap the benefits without putting excessive stress on your body.”

If You’re Worried About Your Joints

Runners pound the pavement, but running doesn’t necessarily lead to more arthritis than walking, according to recent research.

In a study published in 2017 in the journal Arthritis Care & Research, almost 59 percent of non-runners had osteoarthritis in their knees compared with 53 percent of the runners; for the group that reported running the most, the prevalence dropped to about 51 percent.

Another study, published in 2013, that analyzed data from the National Runners’ Health Study found that those who ran more than 1.2 miles per day had a 15 percent lower risk of osteoarthritis and a 35 percent lower risk of hip replacement than those who were less active.

The researchers theorize that one of the reasons for fewer joint issues among the runners is that, as a whole, the runners had lower body mass indexes (BMI) than the walkers. Lower weight means less stress on the joints—even during a high-impact activity like running.

“Running gets the reputation for causing injuries because many people who are just starting to run try to do too much too quickly,” Garber says. “And they often get injured as a result.”

If you want to progress from walking to running, do it slowly, gradually increasing your speed, distance, and the frequency of your runs.

So Should You Walk or Run?

Running may be more high-intensity and calorie-burning than walking, but walking is a great way to ease into exercise—no matter what your current health status—and make sure you’re staying physically active every day.

The bottom line is that getting exercise of any kind is beneficial—provided you stick with it.

“The best exercise is the one you are going to do,” says Thompson. “There are additional benefits to be gained from running, but what’s most important from a public health point of view is that everyone gets out and does some kind of exercise.”

Source: Consumer Reports

Older Adults Who Have Slower Walking Speeds May Have Increased Risk for Dementia

As of 2015, nearly 47 million people around the world had dementia, a memory problem significant enough to affect your ability to carry out your usual tasks. The most common cause of dementia is Alzheimer’s disease, but other forms exist, too.

Because there’s currently no cure for dementia, it’s important to know about the risk factors that may lead to developing it. For example, researchers have learned that older adults with slower walking speeds seem to have a greater risk of dementia than those with faster walking speeds. Recently, researchers from the United Kingdom teamed up to learn more about changes in walking speed, changes in the ability to think and make decisions, and dementia. They published their study in the Journal of the American Geriatrics Society.

The researchers examined information collected from the English Longitudinal Study of Aging. The study included adults aged 60 and older who lived in England. In their study, the researchers used information collected from 2002 to 2015. They assessed participants’ walking speed on two occasions in 2002-2003 and in 2004-2005, and whether or not the participants developed dementia after the tests from 2006-2015. Then, they compared the people who had developed dementia with those who had not.

Researchers discovered that of the nearly 4,000 older adults they studied, those with a slower walking speed had a greater risk of developing dementia. And people who experienced a faster decline in walking speed over a two-year period were also at higher risk for dementia. People who had a poorer ability to think and make decisions when they entered the study—and those whose cognitive (thinking) abilities declined more quickly during the study—were also more likely to be diagnosed with dementia.

The researchers concluded that older adults with slower walking speeds, and those who experienced a greater decline in their walking speed over time, were at increased risk for dementia. But, the researchers noted, changes in walking speed and changes in an older adult’s ability to think and make decisions do not necessarily work together to affect the risk of developing dementia.

Source: The AGS Foundation for Health in Aging


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Arm Exercise Improves Walking Ability after Stroke

A new study shows that arm exercises may improve walking ability months and even years after having a stroke. The study, the first to test the influence of arm training on post-stroke leg function, is published ahead of print in the Journal of Neurophysiology. It was chosen as an APSselect article for February.

Researchers from the University of Victoria in British Columbia, Canada, worked with a group of older adults who had had a stroke between 7 months and 17 years prior to the study. The volunteers participated in three 30-minute, moderate-intensity arm cycling training sessions each week for five weeks. The research team measured the volunteers’ physical abilities before and after arm training using several standardized scales and tests of physical function, including:

  • Six Minute Walk, which measures how far a person can walk in six minutes;
  • Timed 10 Meter Walk, which measures how quickly a person can walk 10 meters; and the
  • Timed Up and Go, which measures the time it takes to stand up from a seated position, walk 10 feet, turn around, walk back and sit down again.

The researchers also tested electrical activity in the muscles and stretch reflexes in the lower legs and wrists during both arm cycling and walking tests.

The participants improved their performance significantly on all of the walking tests—as much as 28 percent in the Timed Up and Go test. Several volunteers had less tightness in their muscles after completing the arm cycling trial, but there was no significant change in grip strength. Nerve activity increased during arm cycling as well. “Arm cycling training activated interlimb networks that contribute to the coordination of rhythmic walking,” the researchers wrote. In other words, nerves in the arms activated and adapted to improve function of the spinal cord in other areas of the body, such as the legs, affected by stroke.

These results could have a large impact on stroke rehabilitation, even years after injury. “Although improvements in walking may not be as robust as those from other training modalities, they do highlight the integral role that training the arms can have on rehabilitation of human locomotion,” the research team wrote.

Source: American Physiological Society


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A Daily Walk Is Good for Seniors’ Brain Health

Alan Mozes wrote . . . . . . .

With New Year’s Day fast approaching, one small, new study suggests that seniors interested in preserving their brain health might want to add walking to the top of their resolution list.

Why? A team of investigators from University of California, Los Angeles (UCLA) found that adults over the age of 60 who are already struggling with memory issues are better able to focus and process information if they walk more than 4,000 steps a day (roughly 2 miles).

“We looked at how physical activity affects thickness of brain structures and also cognitive [thinking] performance of adults over the age of 60,” explained study author Prabha Siddarth.

Siddarth noted that brain thickness is considered to be “an early and sensitive marker of brain health.”

The study revealed that those who walked more than 4,000 steps each day had thicker areas of the brain known to be critical to thought processing.

What’s more, such avid walkers demonstrated “better cognitive functioning” than those who walked 4,000 steps or less, she said.

Siddarth is a biostatistician in the department of psychiatry and biobehavioral sciences with the Semel Institute for Neuroscience and Human Behavior and Longevity Center at UCLA.

To explore the potential mental health benefits of walking, the team focused on 26 men and women between the ages of 61 and 88. Nearly 70 percent were women.

While none suffered from dementia, all complained about memory issues.

For one week, all were outfitted with an accelerometer, to track activity patterns.

Participants were then divided into two groups: those who walked more than 4,000 steps per day and those who walked less. (The less active group was older, at an average age of 77, compared with the more active group, at an average age of 68.)

In addition, MRI brain scans were conducted and each participant underwent a battery of mental health tests to assess memory skills, learning skills, verbal skills, attention and information-processing abilities, decision-making function and the ability to execute a task.

The investigators found that those who walked in excess of 4,000 steps per day had thicker brain measurements in the area of the hippocampus and surrounding regions. Collectively, greater brain thickness in such regions has previously been linked to better thinking and memory.

In terms of information-processing speed, the ability to pay attention, and the ability to make plans and meet goals, those in the 4,000-plus group also demonstrated a “substantial” leg up over the less mobile group, said Siddarth, though the degree of the advantage varied.

But she said it remains unclear whether walking even more — above 4,000 steps — might further improve mental health. “This is something we are working on to see if more exercise leads to more improvement, and also to see if this is paralleled in brain thickness measures,” Siddarth said.

The study authors noted that the finding is an association, rather than proof that daily walking actually protects the brain.

This latter point was seconded by Adam Woods, assistant director of the University of Florida’s Center for Cognitive Aging and Memory (CAM), in Gainesville.

“I think caution is warranted when interpreting [these] results as causal,” Woods said. He added that the findings stem from just a small group of people whose activity patterns were only correlated with brain function, rather than shown to affect it.

Woods also pointed out that “neither of these findings is novel. Prior work has shown that persons with higher physical activity have correlated differences in brain volume and cognitive performance,” he said.

Woods, who also serves as director of the CAM Neurophysiology and Neuromodulation Research Core at the McKnight Brain Institute, said that “these results suffer from the classic ‘chicken or the egg’ conundrum. Did higher walking lead to increased hippocampal volume and better cognition in these people, or did better cognition and larger hippocampal volume drive their increased physical activity?”

So for now, he concluded, the finding in “no way speaks to whether physical activity could improve cognition and brain volume.”

The findings were published online recently in the Journal of Alzheimer’s Disease.

Source: HealthDay


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