Complex Gait Is Related to Cognitive Functioning in Older People: A Cross-Sectional Study Providing an Innovative Test

Abstract

Background: Many studies have demonstrated an inverse relationship between gait performance and cognitive im- pairment. The main purposes of this study were: (1) to design and validate a complex gait test (CGT) in older people, (2) to analyze the effects of age and sex on CGT, and (3) to analyze the association between CGT performance and physical functioning and cognitive measures. Methods: A total of 279 older people (60–97 years) were analyzed in 2019. Fitness tests, gait performance, and several cognitive measures such as the Trail-Walking Test and Montreal Cognitive Assessment were used. Results: The CGT reported adequate reliability and validity parameters. In the test-retest analysis, the intra- class correlation coefficient was 0.868 (p < 0.001). There was a significant correlation between the CGT and Trail-Walking Test (r = 0.592; p < 0.001). The linear regression analysis showed that the CGT was associated with the Montreal Cog-" "nitive Assessment (R2 = 0.357; p = 0.001). The binary logistic regression analysis revealed that a high CGT score was a risk factor for mild cognitive impairment (odds ratio 1.201, 95% CI 1.081–1.334; p = 0.001). The ROC curve of the mild cogni- tive impairment was predicted by the CGT performance (area under the curve = 0.768, 95% CI 0.647–0.889; p < 0.001), reaching the cut-off point at 20.25 s. Conclusions: The CGT showed good reliability and validity and may serve as a po- tential biomarker in mild cognitive impairment prediction in older adults aged 60–97 years.