Functional objective parameters which may discriminate patients with mild cognitive impairment from cognitively healthy individuals: a systematic review and meta-analysis using an instrumented kinematic assessment.

Iván José Fuentes-Abolafio, Brendon Stubbs, Luis Miguel Pérez-Belmonte, María Rosa Bernal-López, Ricardo Gómez-Huelgas, Antonio Cuesta-Vargas

Journal: Age and ageing 2021;50(2):380-393

PMID: 33000147

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Abstract

BACKGROUND

a systematic review in 2015 showed kinematic gait and balance parameters which can discriminate patients with mild cognitive impairment (MCI) from cognitively healthy individuals.

OBJECTIVE

this systematic review and meta-analysis aims to summarise and synthesise the evidence published after the previous review about the functional objective parameters obtained by an instrumented kinematic assessment which could discriminate patients with MCI from cognitively healthy individuals, as well as to assess the level of evidence per outcome.

METHODS

major electronic databases were searched from inception to August 2019 for cross-sectional studies published after 2015 examining kinematic gait and balance parameters, which may discriminate patients with MCI from cognitively healthy individuals. Meta-analysis was carried out for each parameter reported in two or more studies.

RESULTS

Ten cross-sectional studies with a total of 1,405 patients with MCI and 2,277 cognitively healthy individuals were included. Eight of the included studies reported a low risk of bias. Patients with MCI showed a slower gait speed than cognitively healthy individuals. Thus, single-task gait speed (d = -0.44, 95%CI [-0.60 to -0.28]; P < 0.001), gait speed at fast pace (d = -0.48, 95%CI [-0.72 to -0.24]; P < 0.001) and arithmetic dual-task gait speed (d = -1.20, 95%CI [-2.12 to -0.28]; P = 0.01) were the functional objective parameters which best discriminated both groups.

CONCLUSION

the present review shows kinematic gait parameters which may discriminate patients with MCI from cognitively healthy individuals. Most of the included studies reported a low risk of bias, but the grading of recommendations assessment, development and evaluation criteria showed a low level of evidence per outcome.

Address: Departamento de Fisioterapia, Universidad de Málaga, España, Instituto de Investigación Biomédica de Málaga (IBIMA), Grupo de Clinimetría (F-14), Málaga, Spain.; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.; Positive Ageing Research Institute (PARI), Faculty of Health Social Care and Education, Anglia Ruskin University, Chelmsford, UK.; Internal Medicine Department, Instituto de Investigación Biomédica de Malaga (IBIMA), Regional University Hospital of Málaga, Málaga, Spain.; Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Campus de Excelencia Internacional (CEI) Andalucía Tech, Málaga, Spain.; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.; CIBER Fisio-patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.; School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Queensland, Australia.

DOI: 10.1093/ageing/afaa135

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MeSH Terms: Biomechanical Phenomena, Cognitive Dysfunction, Cross-Sectional Studies, Gait, Humans, Walking Speed