J Clin Neurol.  2019 Apr;15(2):152-158. 10.3988/jcn.2019.15.2.152.

The Correlation between Cognition Screening Scores and Gait Status from Three-Dimensional Gait Analysis

• Choi J
• Park J
• Lee BI
• Shin KJ
• Yoo S
• Kim H
• Jang W
• Kim JS
• Youn J
• Oh E

• KMID: 2467728
• DOI: http://doi.org/10.3988/jcn.2019.15.2.152

Abstract

BACKGROUND AND PURPOSE
Gait impairment in patients with cognitive decline has received considerable attention over the past several decades. However, gait disturbance in dementia is often underdiagnosed. The Mini Mental State Examination (MMSE) is the most widely used screening test for dementia, and the Montreal Cognitive Assessment (MoCA) has been developed for more accurate assessments of mild cognitive impairment (MCI). The purpose of this study was to determine the correlation between gait status and the scores on these screening tests for dementia.
METHODS
We recruited 18 patients with MCI and 19 patients with early-stage dementia. All of the participants were examined using the Korean versions of the MMSE and MoCA developed for screening dementia (MMSE-DS and MoCA-K, respectively) and a neuropsychological test to determine cognitive function. A three-dimensional motion-capture system was used to perform objective measurements of gait in all participants. We evaluated the correlation between the screening scores and gait parameters.
RESULTS
The MoCA-K score was significantly correlated with the walking speed (r=0.408, p<0.05) and stride length (r=0.334, p<0.05). After adjusting for age, the MoCA-K score remained correlated with the walking speed (r=0.331, p<0.05), whereas the MMSE-DS score (r=0.264, p=0.11) and stride length (r=0.206, p=0.22) were not. The neuropsychological test revealed that walking speed and stride length were significantly correlated with memory and frontal lobe function.
CONCLUSIONS
We found that the MoCA-K reflects the gait status in patients with cognitive decline more accurately than does the MMSE-DS. Our results suggest that the MoCA-K has more advantages than the MMSE-DS as a screening tool for dementia.

Keyword

mild cognitive impairment; cognitive dysfunction; Alzheimer disease; gait analysis; mental status and dementia test

MeSH Terms

Alzheimer Disease
Cognition*
Dementia
Frontal Lobe
Gait*
Humans
Mass Screening*
Memory
Methylenebis(chloroaniline)
Mild Cognitive Impairment
Neuropsychological Tests
Walking
Methylenebis(chloroaniline)

Figure

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  Fig. 1 Correlation between the walking speed and the MoCA score. Walking speed as determined by the three-dimensional motion-capture system was significantly correlated with the score on the MoCA-K in patients with mild cognitive impairment or Alzheimer's disease (r=0.408, p<0.05). MoCA-K: Korean version of the Montreal Cognitive Assessment.

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