Gait Analysis with an Integrated Mobile Robot and Wearable Sensor System Reveals Associations Between Cognitive Ability and Dynamic Balance in Older Adults

Gait abnormalities and postural instability have been linked to cognitive decline in older adults, however the causal relationships between cognitive capacity and gait is still an open problem. Emerging portable technologies may help elucidate these connections by enabling gait analysis in out-of-the-lab settings, with higher sensitivity than timed gait assessment tests. The purpose of this work was to evaluate the associations between cognitive ability (Montreal Cognitive As-sessment scores) and measures of gait and balance disturbance (spatiotemporal gait parameters, dynamic margin of stability) in a group of older adults, under a dual-task walking paradigm, using an integrated gait analysis system that features a mobile robot and in-shoe sensors. Results of hierarchical regression analyses adjusted for age and gender indicated that decline in cognitive ability in older adults is independently associated with more conservative overground gait patterns (i.e., smaller absolute values of the anteroposterior margin of stability) and increased gait variability (i.e., larger coefficients of variation in stride time and stride velocity) when performing dual-task walking. These results provide proof-of-concept validation of the applicability of integrated robotic and wearable sensors technologies to out-of-the-lab gait analysis in older adults.