Association between nutritional status and gait performance in Alzheimer’s disease

Abstract

Abstract Background Alzheimer’s disease (AD) patients have worse nutritional status and gait performance, but the current research is not in-depth, and the relationship between the two is not clear. This study aimed to comprehensively explore the nutrition and gait of AD patients at different stages and the relationship between them. Methods AD patients were consecutively enrolled in this cross-sectional study, and divided into the mild cognitive impairment (MCI) due to AD (AD-MCI) and the dementia due to AD (AD-D) groups. Demographic information, nutritional status and gait performance were compared between the two groups, and the correlation between nutritional status and gait performance was subsequently analyzed by Pearson and Spearman correlation analysis. Results Totals 85 AD patients were included in this study. The AD-D group had lower scores of Mini-nutritional Assessment (MNA) and MNAm, lower levels of blood urea nitrogen, folic acid and vitamin B12, and higher homocysteine level than that in the AD-MCI group (all P < 0.05). AD-D group had slower step speed, shorter step length, and shorter stride length than those in the AD-MCI group (all P < 0.05). AD patients with decreased scores of MNA and MNAm, and declined levels of blood urea nitrogen and vitamin B12 had reduced gait speed and gait cadence, and prolonged step time and stride time, whereas, homocysteine showed the opposite result (all P < 0.05). In the AD-MCI group, the MNA score was negatively correlated with coefficient of variation (CV) of stride length, and the folic acid level was negatively correlated with the CV of stride length and cadence (all P < 0.05). Conclusions AD patients in the dementia stage had worse nutritional status and gait performance than those in the MCI stage, which was associated with worse global cognition and activities of daily living. Poorer nutritional status was associated with higher gait variability in patients at the MCI stage, and with poorer gait performance in patients at the dementia stage. Early identification and intervention of patients with nutritional risk or malnutrition may improve gait performance, thus reducing the risk of falling and cognitive decline, as well as the mortality.