Background: Many studies have demonstrated an inverse relationship between gait performance and cognitive impairment. The main purposes of this study were: (1) to design and validate a complex gait test (CGT) in older people, (2) to analyze the effects of age and sex on CGT, and (3) to analyze the association between CGT performance and physical functioning and cognitive measures. Methods: A total of 279 older people (60–97 years) were analyzed in 2019. Fitness tests, gait performance, and several cognitive measures such asthe Trail-Walking Test and Montreal Cognitive Assessment were used. Results: The CGT reported adequate reliability and validity parameters. In the test-retest analysis, the intra-class correlation coefficient was 0.868 (p < 0.001). There was a significant correlation between the CGT and Trail-Walking Test (r = 0.592; p < 0.001). The linear regression analysis showed that the CGT was associated with the Montreal Cognitive Assessment (R2 = 0.357; p =0.001). The binary logistic regression analysis revealed that a high CGT score was a risk factor for mild cognitive impairment (odds ratio 1.201, 95% CI 1.081–1.334; p = 0.001). The ROC curve of the mild cognitive impairment was predicted by the CGT performance (area under the curve = 0.768, 95% CI 0.647–0.889; p < 0.001), reaching the cut-off point at 20.25 s. Conclusions: The CGT showed good reliability and validity and may serve as a potential biomarker in mild cognitive impairment prediction in older adults aged 60–97 years.

1.
Clouston
SA
,
Brewster
P
,
Kuh
D
,
Richards
M
,
Cooper
R
,
Hardy
R
, et al
The dynamic relationship between physical function and cognition in longitudinal aging cohorts
.
Epidemiol Rev
.
2013
;
35
(
1
):
33
50
.
[PubMed]
0193-936X
2.
Sofi
F
,
Valecchi
D
,
Bacci
D
,
Abbate
R
,
Gensini
GF
,
Casini
A
, et al
Physical activity and risk of cognitive decline: a meta-analysis of prospective studies
.
J Intern Med
.
2011
Jan
;
269
(
1
):
107
17
.
[PubMed]
0954-6820
3.
Jernigan
TL
,
Archibald
SL
,
Fennema-Notestine
C
,
Gamst
AC
,
Stout
JC
,
Bonner
J
, et al
Effects of age on tissues and regions of the cerebrum and cerebellum
.
Neurobiol Aging
.
2001
Jul-Aug
;
22
(
4
):
581
94
.
[PubMed]
0197-4580
4.
Wise
RA
.
Dopamine, learning and motivation
.
Nat Rev Neurosci
.
2004
Jun
;
5
(
6
):
483
94
.
[PubMed]
1471-003X
5.
Rittweger
J
,
Kwiet
A
,
Felsenberg
D
.
Physical performance in aging elite athletes—challenging the limits of physiology
.
J Musculoskelet Neuronal Interact
.
2004
Jun
;
4
(
2
):
159
60
.
[PubMed]
1108-7161
6.
Nascimbeni
A
,
Caruso
S
,
Salatino
A
,
Carenza
M
,
Rigano
M
,
Raviolo
A
, et al
Dual task-related gait changes in patients with mild cognitive impairment
.
Funct Neurol
.
2015
Jan-Mar
;
30
(
1
):
59
65
.
[PubMed]
1971-3274
7.
Ahlskog
JE
,
Geda
YE
,
Graff-Radford
NR
,
Petersen
RC
.
Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging
.
Mayo Clin Proc
.
2011
Sep
;
86
(
9
):
876
84
.
[PubMed]
0025-6196
8.
Barnes
JN
.
Exercise, cognitive function, and aging
.
Adv Physiol Educ
.
2015
Jun
;
39
(
2
):
55
62
.
[PubMed]
1043-4046
9.
Erickson
KI
,
Hillman
CH
,
Kramer
AF
.
Physical activity, brain, and cognition. Vol. 4
.
Curr Opin Behav Sci
.
2015
;
4
:
27
32
. 2352-1546
10.
Enright
PL
,
McBurnie
MA
,
Bittner
V
,
Tracy
RP
,
McNamara
R
,
Arnold
A
, et al;
Cardiovascular Health Study
.
The 6-min walk test: a quick measure of functional status in elderly adults
.
Chest
.
2003
Feb
;
123
(
2
):
387
98
.
[PubMed]
0012-3692
11.
Rosso
AL
,
Metti
AL
,
Faulkner
K
,
Redfern
M
,
Yaffe
K
,
Launer
L
, et al
Complex walking tasks and risk for cognitive decline in high functioning older adults
.
J Alzheimers Dis
.
2019
;
71
s1
:
S65
73
.
[PubMed]
1387-2877
12.
De Cock
AM
,
Fransen
E
,
Perkisas
S
,
Verhoeven
V
,
Beauchet
O
,
Remmen
R
, et al
Gait characteristics under different walking conditions: association with the presence of cognitive impairment in community-dwelling older people
.
PLoS One
.
2017
Jun
;
12
(
6
):
e0178566
.
[PubMed]
1932-6203
13.
Klotzbier
TJ
,
Schott
N
.
Cognitive-motor interference during walking in older adults with probable mild cognitive impairment
.
Front Aging Neurosci
.
2017
Dec
;
9
(
DEC
):
350
.
[PubMed]
1663-4365
14.
Mirelman
A
,
Maidan
I
,
Bernad-Elazari
H
,
Shustack
S
,
Giladi
N
,
Hausdorff
JM
.
Effects of aging on prefrontal brain activation during challenging walking conditions
.
Brain Cogn
.
2017
Jul
;
115
:
41
6
.
[PubMed]
0278-2626
15.
Springer
S
,
Giladi
N
,
Peretz
C
,
Yogev
G
,
Simon
ES
,
Hausdorff
JM
.
Dual-tasking effects on gait variability: the role of aging, falls, and executive function
.
Mov Disord
.
2006
Jul
;
21
(
7
):
950
7
.
[PubMed]
0885-3185
16.
Montero-Odasso
M
,
Oteng-Amoako
A
,
Speechley
M
,
Gopaul
K
,
Beauchet
O
,
Annweiler
C
, et al
The motor signature of mild cognitive impairment: results from the gait and brain study
.
J Gerontol A Biol Sci Med Sci
.
2014
Nov
;
69
(
11
):
1415
21
.
[PubMed]
1079-5006
17.
Ble
A
,
Volpato
S
,
Zuliani
G
,
Guralnik
JM
,
Bandinelli
S
,
Lauretani
F
, et al
Executive function correlates with walking speed in older persons: the InCHIANTI study
.
J Am Geriatr Soc
.
2005
Mar
;
53
(
3
):
410
5
.
[PubMed]
0002-8614
18.
Maidan
I
,
Nieuwhof
F
,
Bernad-Elazari
H
,
Reelick
MF
,
Bloem
BR
,
Giladi
N
, et al
The Role of the Frontal Lobe in Complex Walking Among Patients With Parkinson’s Disease and Healthy Older Adults: an fNIRS Study
.
Neurorehabil Neural Repair
.
2016
Nov
;
30
(
10
):
963
71
.
[PubMed]
1545-9683
19.
Raffegeau
TE
,
Kellaher
GK
,
Terza
MJ
,
Roper
JA
,
Altmann
LJ
,
Hass
CJ
.
Older women take shorter steps during backwards walking and obstacle crossing
.
Exp Gerontol
.
2019
Jul
;
122
:
60
6
.
[PubMed]
0531-5565
20.
Malouin
F
,
Richards
CL
,
Jackson
PL
,
Dumas
F
,
Doyon
J
.
Brain activations during motor imagery of locomotor-related tasks: a PET study
.
Hum Brain Mapp
.
2003
May
;
19
(
1
):
47
62
.
[PubMed]
1065-9471
21.
Quan
M
,
Xun
P
,
Chen
C
,
Wen
J
,
Wang
Y
,
Wang
R
, et al
Walking Pace and the Risk of Cognitive Decline and Dementia in Elderly Populations: A Meta-analysis of Prospective Cohort Studies
.
J Gerontol A Biol Sci Med Sci
.
2017
Feb
;
72
(
2
):
266
70
.
[PubMed]
1079-5006
22.
Kikkert
LH
,
Vuillerme
N
,
van Campen
JP
,
Hortobágyi
T
,
Lamoth
CJ
.
Walking ability to predict future cognitive decline in old adults: A scoping review
.
Ageing Res Rev
.
2016
May
;
27
:
1
14
.
[PubMed]
1568-1637
23.
Jones
CJ
,
Rikli
RE
,
Beam
WC
.
A 30-s chair-stand test as a measure of lower body strength in community-residing older adults
.
Res Q Exerc Sport
.
1999
Jun
;
70
(
2
):
113
9
.
[PubMed]
0270-1367
24.
Ruiz
JR
,
España-Romero
V
,
Ortega
FB
,
Sjöström
M
,
Castillo
MJ
,
Gutierrez
A
.
Hand span influences optimal grip span in male and female teenagers
.
J Hand Surg Am
.
2006
Oct
;
31
(
8
):
1367
72
.
[PubMed]
0363-5023
25.
Graham
JE
,
Ostir
GV
,
Fisher
SR
,
Ottenbacher
KJ
.
Assessing walking speed in clinical research: a systematic review
.
J Eval Clin Pract
.
2008
Aug
;
14
(
4
):
552
62
.
[PubMed]
1356-1294
26.
Lawton
MP
,
Brody
EM
.
Assessment of older people: self-maintaining and instrumental activities of daily living
.
Gerontologist
.
1969
;
9
(
3
):
179
86
.
[PubMed]
0016-9013
27.
Porteus
SD
.
Maze test reactions after chlorpromazine
.
J Consult Psychol
.
1957
Feb
;
21
(
1
):
15
21
.
[PubMed]
0095-8891
28.
Maruta
C
,
Guerreiro
M
,
de Mendonça
A
,
Hort
J
,
Scheltens
P
.
The use of neuropsychological tests across Europe: the need for a consensus in the use of assessment tools for dementia
.
Eur J Neurol
.
2011
Feb
;
18
(
2
):
279
85
.
[PubMed]
1351-5101
29.
Krikorian
R
,
Bartok
JA
.
Developmental data for the Porteus Maze test
.
Clin Neuropsychol
.
1998
;
12
(
3
):
305
10
. 1385-4046
30.
Delgado
C
,
Araneda
A
,
Behrens
MI
.
Validation of the Spanish-language version of the Montreal Cognitive Assessment test in adults older than 60 years
.
Neurologia
.
2019
Jul - Aug
;
34
(
6
):
376
85
.
[PubMed]
0213-4853
31.
Pinto
TC
,
Machado
L
,
Bulgacov
TM
,
Rodrigues-Júnior
AL
,
Costa
ML
,
Ximenes
RC
, et al
Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly?
Int Psychogeriatr
.
2019
Apr
;
31
(
4
):
491
504
.
[PubMed]
1041-6102
32.
Tan
JP
,
Li
N
,
Gao
J
,
Wang
LN
,
Zhao
YM
,
Yu
BC
, et al
Optimal cutoff scores for dementia and mild cognitive impairment of the Montreal Cognitive Assessment among elderly and oldest-old Chinese population
.
J Alzheimers Dis
.
2015
;
43
(
4
):
1403
12
.
[PubMed]
1387-2877
33.
Yamada
M
,
Ichihashi
N
.
Predicting the probability of falls in community-dwelling elderly individuals using the trail-walking test
.
Environ Health Prev Med
.
2010
Nov
;
15
(
6
):
386
91
.
[PubMed]
1342-078X
34.
Cohen
J
.
Statistical Power Analysis
.
Curr Dir Psychol Sci
.
1992
;
1
(
3
):
98
101
. 0963-7214
35.
Garcia-Pinillos
F
,
Cozar-Barba
M
,
Munoz-Jimenez
M
,
Soto-Hermoso
V
,
Latorre-Roman
P
.
Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state
.
Psychogeriatrics
.
2016
May
;
16
(
3
):
165
71
.
[PubMed]
1346-3500
36.
Judge
JO
,
Schechtman
K
,
Cress
E
,
Group
FI
.
The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT Group. Frailty and Injury: Cooperative Studies of Intervention Trials
.
J Am Geriatr Soc
.
1996
Nov
;
44
(
11
):
1332
41
.
[PubMed]
0002-8614
37.
Callisaya
ML
,
Blizzard
L
,
Schmidt
MD
,
McGinley
JL
,
Srikanth
VK
.
Sex modifies the relationship between age and gait: a population-based study of older adults
.
J Gerontol A Biol Sci Med Sci
.
2008
Feb
;
63
(
2
):
165
70
.
[PubMed]
1079-5006
38.
Barbieri
FA
,
Simieli
L
,
Orcioli-Silva
D
,
Vitório
R
,
Stella
F
,
Gobbi
LT
.
Variability in obstacle clearance may (not) indicate cognitive disorders in Alzheimer disease
.
Alzheimer Dis Assoc Disord
.
2015
Oct-Dec
;
29
(
4
):
307
11
.
[PubMed]
0893-0341
39.
Hegeman
J
,
Weerdesteyn
V
,
van den Bemt
B
,
Nienhuis
B
,
van Limbeek
J
,
Duysens
J
.
Dual-tasking interferes with obstacle avoidance reactions in healthy seniors
.
Gait Posture
.
2012
Jun
;
36
(
2
):
236
40
.
[PubMed]
0966-6362
40.
Salkovic
D
,
Hobert
MA
,
Bellut
C
,
Funer
F
,
Renno
S
,
Haertner
L
, et al
Evidence for a Selectively Regulated Prioritization Shift Depending on Walking Situations in Older Adults
.
Front Aging Neurosci
.
2017
Apr
;
9
(
APR
):
75
.
[PubMed]
1663-4365
41.
Pieruccini-Faria
F
,
Sarquis-Adamson
Y
,
Montero-Odasso
M
.
Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”
.
Gerontology
.
2019
;
65
(
2
):
164
73
.
[PubMed]
0304-324X
42.
Galna
B
,
Peters
A
,
Murphy
AT
,
Morris
ME
.
Obstacle crossing deficits in older adults: a systematic review
.
Gait Posture
.
2009
Oct
;
30
(
3
):
270
5
.
[PubMed]
0966-6362
43.
McGough
EL
,
Kelly
VE
,
Weaver
KE
,
Logsdon
RG
,
McCurry
SM
,
Pike
KC
, et al
Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition
.
Am J Phys Med Rehabil
.
2018
Apr
;
97
(
4
):
229
35
.
[PubMed]
0894-9115
44.
Forte
R
,
Pesce
C
,
Di Baldassarre
A
,
Shea
J
,
Voelcker-Rehage
C
,
Capranica
L
, et al
How older adults cope with cognitive complexity and environmental constraints during dual-task walking: the role of executive function involvement
.
Int J Environ Res Public Health
.
2019
May
;
16
(
10
):
1835
.
[PubMed]
1661-7827
45.
Eyal
S
,
Kurz
I
,
Mirelman
A
,
Maidan
I
,
Giladi
N
,
Hausdorff
JM
.
Successful Negotiation of Anticipated and Unanticipated Obstacles in Young and Older Adults: Not All Is as Expected
.
Gerontology
.
2020
;
66
(
2
):
187
96
.
[PubMed]
0304-324X
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