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Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease
Sheridan PL, Solomont J, Kowall N, Hausdorff JM.. Journal of the American Geriatrics Society, 2003-11-01
Topic: Brain imaging, connectivity and assessment
Objectives To evaluate how cognitive function and divided attention affect gait in Alzheimer's disease (AD). Design Cross-sectional intervention study with subjects serving as their own controls. Setting Inpatient unit and outpatient clinic for patients with dementia located at a Veterans Affairs Medical Center. Participants Twenty-eight patients diagnosed with probable AD. Intervention Performance of a cognitive task (repeating random digits) while walking. Measurements Neuropsychological measures including clock drawing, verbal fluency, and digit span were obtained along with the Clinical Dementia Rating and Mini-Mental State Examination, the measures of dementia severity. Gait speed and stride-to-stride variability of gait rhythm were measured, once during normal walking and once during dual-task walking. Results During usual walking, subjects walked slowly and with greater gait variability than older adults without AD. Gait speed was significantly reduced (P<.012) and gait variability increased with dual-task walking (P<.007). The effect on gait variability was larger than the effect on gait speed (P<.015). Executive and neuropsychological function were significantly (P<.02) associated with the increased gait variability that occurred when walking with divided attention but not with gait speed or usual, single-task walking measures of gait. Conclusion Divided attention markedly impairs the ability of patients with AD to regulate the stride-to-stride variations in gait timing. This susceptibility to distraction and its effect on stride time variability, a measure of gait unsteadiness, could partially explain the predilection to falling observed in patients with dementia. The results also support the concept that persons with AD have significant impairments in the cognitive domain of attention and that locomotor function relies upon cognitive, especially executive, function.
Key findings
- Results During usual walking, subjects walked slowly and with greater gait variability than older adults without AD.
- Gait speed was significantly reduced (P<.012) and gait variability increased with dual-task walking (P<.007).
- Executive and neuropsychological function were significantly (P<.02) associated with the increased gait variability that occurred when walking with divided attention but not with gait speed or usual, single-task walking measures of gait.
- The results also support the concept that persons with AD have significant impairments in the cognitive domain of attention and that locomotor function relies upon cognitive, especially executive, function.
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Study details
- Study designcross-sectional
- Evidence strengthLow
How this study scored 43/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 25 of the 58 points we could judge it on, which is 43 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 14687395) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 25 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 25 of the 58 points we could judge it on is 43 out of 100. |
| Total | 43 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Sheridan, P. L., Solomont, J., Kowall, N., & Hausdorff, J. M. (2003). Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease. Journal of the American Geriatrics Society. https://doi.org/10.1046/j.1532-5415.2003.51516.x
Vancouver
Sheridan PL, Solomont J, Kowall N, Hausdorff JM. Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease. Journal of the American Geriatrics Society. 2003. doi:10.1046/j.1532-5415.2003.51516.x. PMID: 14687395.
BibTeX
@article{sheridan2003-14687395,
author = {Sheridan, P. L. and Solomont, J. and Kowall, N. and Hausdorff, J. M.},
title = {{Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease}},
journal = {Journal of the American Geriatrics Society},
year = {2003},
doi = {10.1046/j.1532-5415.2003.51516.x},
pmid = {14687395},
url = {https://doi.org/10.1046/j.1532-5415.2003.51516.x}
}
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