If your first thought after reading that is one of confusion, you’re not alone. After all, isn’t it obvious that as we age, our gait, along with just about every other natural process, slows down? We chatted with a couple of experts about these newly-released findings to learn what your walking speed can—and can’t—tell you about your brain health.
How does gait relate to cognition?
The new study of nearly 17,000 adults over age 65 found that “dual decliners”—aka people who walk about five percent (or more) slower each year and show signs of memory decline—were more likely to develop dementia than those who displayed just one of those two qualities.
Board-certified geriatrician Maryjo Lynn Cleveland, MD, an associate professor of gerontology and geriatric medicine at Wake Forest University School of Medicine, points out that it’s common knowledge that as folks age, they tend to decline functionally and/or cognitively. While functional decline may show up in the form of stiffer legs, slower walking speeds, or a tendency to fall more often, cognitive decline most often reveals itself as forgetfulness.
While both of these types of decline are fairly typical, Dr. Cleveland says that, even with this study, we don’t currently have enough information to truly determine if there’s a real relationship between walking speed and cognition. “That’s why there is so much work currently being done in this area,” she says.
What causes a slower gait as we age?
Before automatically assuming that a slower gait means that you or a loved one is developing dementia, we need to understand just how involved walking is.
Physical therapist Sandra Gail Frayna, who is the founder of Hudson Premier Physical Therapy & Sports in New Jersey, says that walking involves balance, rhythm, motion, and muscle coordination—all of which require a certain level of thought, even if subconsciously. “The cerebellum, which is responsible for balance and postural adjustments and coordination, also controls gait,” she says.
“Walking is an extremely complicated task that involves multiple parts of the brain that integrate balance, vision, hearing, a sense of where we are in space, and clearly demands an intact cognitive component (for example: Can I get across this street in time before traffic starts?),” Dr. Cleveland explains. “It may be that frailty causes slower gait speed, or the intersection of loss of the ability to integrate all these components as seamlessly as when we were younger.”
Still, a declining walking speed doesn’t necessarily point to a proclivity for dementia, nor does dementia automatically equate to a reduction in movement.
“We have all known people who are very cognitively impaired (have dementia) but who get around without difficulty,” Dr. Cleveland says. “Conversely, we know people who have significant problems with mobility and are ‘sharp as a tack.’” As such, she maintains that cognition and gait must be independent of each other.
“That said, near the end of life, all people with dementia will lose the ability to walk, yet not all people who lose the ability to walk have dementia,” she adds.
Do other physical signs point to dementia?
Although the jury is still out on whether or not walking speed truly goes hand-in-hand with a potential to develop dementia, Dr. Cleveland says that certain vascular risk factors (like hypertension, diabetes, and inactivity) are thought to increase someone’s likelihood to develop dementia.
And then there’s family history. “Genes play a large part in the potential risk for dementia,” Frayna says.
How to keep your brain healthy as you age
If you’re concerned that you or a loved one might be at risk for developing dementia, keep in mind that there are things we can do to keep our brains healthy as we age.
“Geriatricians (and neurologists and others) generally believe that we will all be better off trying to prevent dementia than treating it,” Dr. Cleveland says. “Lifestyle interventions have some data and continue to be studied as ways to prevent cognitive decline. These include a ‘mind’ or ‘Mediterranean diet,’ a significant amount of exercise (both aerobic and weight training), a good night’s sleep, meaningful work (not necessarily paid, just a reason to get out of bed each day), and cognitive and social stimulation (which has taken a beating during Covid).” Additionally, she says that keeping blood pressure in an optimal range (ideally a systolic of 130 or under) can also reduce or delay the onset of cognitive loss.
Overall, you should aim to cultivate a healthy body and mind, and in doing so, you’ll have a better chance of avoiding cognitive decline.
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