Gait disorders in patients with cognitive impairment or dementia

Cognitive impairment and dementia are common in aging. In recent years, there is a growing body of evidence that suggests that gait is reliant on cognitive function and that gait impairments and falls are affected by a wide spectrum of age-associated changes in cognitive function. Several studies have suggested that gait abnormalities can already be present in the early stages of cognitive decline, even before dementia has been diagnosed. In this chapter, we describe the relationship between gait and cognition as a function of the severity of cognitive decline. We begin with a review of the current understanding of age-associated changes in both cognition and motor function and the interrelation between these domains in older adults. We then review reports on gait changes in mild cognitive impairment, dementia, and Alzheimer's disease dementia, as well as alterations of motor function throughout the course of cognitive decline. Finally, we summarize information on therapeutic interventions designed to improve gait and reduce fall risk based on the interactions between gait and cognitive function.