Physiological and Cognitive Determinants of Gait Variability of Asian Population: The Yishun Study

Abstract

<b><i>Introduction:</i></b> Gait variability is associated with frailty, dementia, and falls. Studies on the association of physiological and cognitive factors with gait variability have seldom included middle-aged adults, even though these adults already experienced loss of muscular strength and postural stability. This study aimed a) to examine and compare the trend of gait variability in men and women, across the adult age spectrum, and b) to identify and compare the contributions of physiological and cognitive factors to gait variability. <b><i>Methods:</i></b> This was a population-based cross-sectional study at a single center. A random sample of 507 community-dwelling, well-functioning adults aged 21–90 years were studied. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physiological factors examined included visual contrast sensitivity (VCS), postural sway, hand reaction time, handgrip strength (HGS), knee extensor strength, and gait variability (coefficient of variation [CoV]). Multivariable regression models were used to examine the association between physiological and cognitive performance with gait CoV. <b><i>Results:</i></b> Women walked with greater stride width CoV (<i>p</i> &#x3c; 0.01) and double support time (DST) CoV (<i>p</i> &#x3c; 0.01) than men. The stride width (<i>p</i> = 0.01) and DST variability (<i>p</i> = 0.03) were significantly higher in older men as compared to men in younger age-groups. Gait speed accounted for most of the gait CoV variances and attenuated the effects of physiological performance and/or attention cognition on most gait variability, except for CoV of DST and stride width. Adults with better VCS (β = −0.19), faster hand reaction (β = 0.12), and greater HGS (β = −0.15) had lower variability in step length. <b><i>Conclusion:</i></b> The trends of stride width CoV and DST CoV across adult age spectrum were different between men and women. Greater stride width variability was partly attributed to greater HGS, possibly to better control lateral stability during walking. Physiological factors outweigh cognition in regulating most of the gait CoV in this study. They are modifiable and potential targets for healthy aging program.