Association of Gait Impairment with Executive Dysfunction and Magnetic Resonance Imaging Brain Findings in Elderly Population.

Abstract

Objectives: The primary objective was to understand the association between gait impairment and executive dysfunction and magnetic resonance imaging (MRI) brain findings in the elderly Indian population. Also, we aimed to assess the association between executive dysfunction (ED) and MRI brain findings in the elderly Indian population. Materials and methods: This was a prospective observational study conducted in the Department of Neurology at a tertiary care facility in Northwest India for a duration of 1 year between October 2021 and September 2022. Results: Patients with hypertension [odds ratio (OR) 2.85, 95% confidence of interval (CI) 1.59-5.10], raised and/or deranged lipid profile (OR 2.19, 95% CI 1.12-4.30), serum creatinine (Sr. creatinine) (OR 2.16, 95% CI 1.85-2.53) and blood urea (OR 2.27, 95% CI 1.92-2.67) were at increased risk of ED. Smoking tobacco was associated with four times increased risk of ED (OR 3.98, 95% CI 2.18-7.26). Of the tests of frontal assessment battery (FAB), the strength of association was highest for motor Luria (OR 34.81, 95% CI 15.84-76.52), followed by the backward digit span test. Patients with ED had decreased step length, abnormal stride width, abnormal cadence, and decreased velocity. Regarding MRI brain findings, atrophy of the occipital lobe was associated with decreased step length; atrophy of the midbrain and cerebellar atrophy were associated with decreased stride width; and midbrain atrophy was associated with cadence. It was found that the basal ganglia and periventricular hyperintensity were associated with step length. Conclusion: The findings contribute to our understanding of the relationship between ED, brain structural changes, and gait abnormalities, highlighting the potential role of smoking, glycemic control (and related risk factors) and brain regions involved in gait control.