The relationship between gait kinematics and cognitive impairment in Parkinson’s disease

Background Gait impairment and cognitive dysfunction are common in Parkinson’s disease (PD), but the interaction between these domains, particularly under dual-task walking, is less well characterised. Objective To examine associations between gait parameters and cognitive domains in PD during single- and dual-task walking. Methods 50 individuals with PD and 21 age-matched healthy controls completed single-task walking and two dual-task conditions, involving naming animals and performing serial subtraction by seven. Gait was recorded using an electronic pressure-sensitive walkway (Zeno™, ProtoKinetics) and analysed for velocity, step length, step time, step length variability, and step time variability. Participants completed cognitive assessments of processing speed, executive function, memory, and language. Associations between gait parameters and cognitive domains were assessed for significant correlations. Results In participants with PD, executive dysfunction, measured by the Trail Making Test Part B (TMT-B), was differentially associated with increased step length variability during dual-task walking. Less robust findings were observed for single-task conditions or other cognitive domains. Conclusion Executive dysfunction appears to relate to impaired control of gait variability under dual-task conditions in PD, consistent with a key role for attentional-executive resources in maintaining stable gait. These findings may help focus future work on specific dual-task interferences relevant to PD progression and gait decline.