Changes in gait function associated with cerebral small vessel disease-related cognitive impairment during dual-task walking: a systematic review and meta-analysis.
Tianqing Li, Xiaoya Liu, Tianyu Meng et al.
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In 30 seconds
This systematic review and meta-analysis examined whether dual-task (DT) gait measures distinguish people with cerebral small vessel disease-related cognitive impairment (CSVD-CI) from cognitively unimpaired controls, and compared DT with single-task (ST) assessment. The review included nine studies reporting DT outcomes and eight reporting ST outcomes; four reported both. DT assessment discriminated the groups more effectively than ST assessment. Under DT conditions, CSVD-CI was associated with significantly slower gait speed (p = 0.014), greater stride time variability (p = 0.027), and higher dual-task costs (p < 0.001).
Key findings
- DT gait assessment discriminated CSVD-CI from cognitively unimpaired controls more effectively than ST assessment.
- Under DT conditions, gait speed was significantly slower in CSVD-CI (p = 0.014).
- CSVD-CI was associated with greater stride time variability (p = 0.027) and higher dual-task costs (p < 0.001).
- Subgroup and sensitivity analyses suggested that CSVD imaging characteristics may contribute to between-study heterogeneity; these findings were exploratory.
Why it matters
Gait assessment under added cognitive demand may reveal cognitive-motor differences that are less evident during ordinary walking. The findings identify gait speed, stride time variability, and dual-task costs as candidate behavioral indicators for further study, while underscoring that their screening and predictive value has not yet been established.
What to keep in mind
The review reports heterogeneity in gait metrics, imaging criteria, and cognitive paradigms. The authors describe imaging-related subgroup findings as exploratory and call for standardized diagnostic and inclusion criteria in future studies.