The Correlation between Cognition Screening Scores and Gait Status from Three-Dimensional Gait Analysis

BACKGROUND AND PURPOSE: Gait impairment in patients with cognitive decline has received considerable attention over the past several decades. However, gait disturbance in dementia is often underdiagnosed. The Mini Mental State Examination (MMSE) is the most widely used screening test for dementia, and the Montreal Cognitive Assessment (MoCA) has been developed for more accurate assessments of mild cognitive impairment (MCI). The purpose of this study was to determine the correlation between gait status and the scores on these screening tests for dementia. METHODS: We recruited 18 patients with MCI and 19 patients with early-stage dementia. All of the participants were examined using the Korean versions of the MMSE and MoCA developed for screening dementia (MMSE-DS and MoCA-K, respectively) and a neuropsychological test to determine cognitive function. A three-dimensional motion-capture system was used to perform objective measurements of gait in all participants. We evaluated the correlation between the screening scores and gait parameters. RESULTS: The MoCA-K score was significantly correlated with the walking speed (r=0.408, p<0.05) and stride length (r=0.334, p<0.05). After adjusting for age, the MoCA-K score remained correlated with the walking speed (r=0.331, p<0.05), whereas the MMSE-DS score (r=0.264, p=0.11) and stride length (r=0.206, p=0.22) were not. The neuropsychological test revealed that walking speed and stride length were significantly correlated with memory and frontal lobe function. CONCLUSIONS: We found that the MoCA-K reflects the gait status in patients with cognitive decline more accurately than does the MMSE-DS. Our results suggest that the MoCA-K has more advantages than the MMSE-DS as a screening tool for dementia.