Altered Gait and Early Cognitive Impairment Symptoms

The Way You Walk Is the Way You Think

I’ve been fol­low­ing the research of Joe Vergh­ese, MD, who is the recent­ly-appoint­ed head of Geri­atrics at Mon­te­fiore Med­ical Cen­ter in the Bronx.

Some of his research looks at pat­terns of walk­ing to pre­dict the onset of demen­tia.  It turns out that peo­ple in their 70’s with observ­able alter­ations from nor­mal gait are more like­ly to suf­fer from non-Alzheimer’s types of cog­ni­tive decline than those whose walk­ing is nor­mal.

This insight is extreme­ly inter­est­ing to me.  But prob­a­bly not for the rea­sons that Dr. Vergh­ese might imag­ine.

(I’m guess­ing here, but) he might be think­ing about the “med­ical” rea­sons why some­one has changes in gait: com­pro­mised cir­cu­la­tion, nerve dam­age, or brain dete­ri­o­ra­tion of the areas involved with move­ment pro­cess­ing.  Any of these con­di­tions would increase the risk for demen­tia, and altered walk­ing would be an ear­ly warn­ing sign of future prob­lems.

That’s impor­tant.  But one of my deep inter­ests (going back to my days study­ing dance) is in the mean­ing of vari­a­tions of move­ment qual­i­ty, even when they’re not relat­ed to overt med­ical pathol­o­gy.

Move­ment behav­ior reflects brain activ­i­ty.  I’m over­sim­pli­fy­ing here, but peo­ple with lim­it­ed, inflex­i­ble, or inef­fec­tive move­ment capa­bil­i­ties are peo­ple whose brains are not being stim­u­lat­ed in diverse ways, with more rigid pat­terns of nerve sig­nal pro­cess­ing.

The brain of a healthy indi­vid­ual has extra­or­di­nary plas­tic­i­ty.   You can acquire a new lan­guage, mas­ter a musi­cal instru­ment, or learn a new dance step.  You can train your brain waves to coor­di­nate them­selves with reg­u­lar mind­ful­ness med­i­ta­tion, or repro­gram your emo­tion­al reac­tions with cog­ni­tive-behav­ioral ther­a­py.

All these are healthy signs of adapt­able brain mech­a­nisms.  When we lose our adapt­abil­i­ty our health – in this case our neu­ro­log­i­cal health – plum­mets.

My research plan would be to see if indi­vid­u­als who have an altered pat­tern of gait can learn (or re-learn) to walk with more grace, bal­ance and flow.  And if they can, does the learn­ing process pro­tect them from demen­tia?

Research has already proven that the walk­ing speed of an old­er per­son is a good pre­dic­tor of longevi­ty.  And phys­i­cal exer­cise is one of the best ways to pro­tect your­self from cog­ni­tive decline.

Nat­u­ral­ly, when most sci­en­tists talk about walk­ing speed and phys­i­cal exer­cise, they relate them to basic phys­i­o­log­i­cal vari­ables such as mus­cle strength and heart and lung capac­i­ty.

Those mea­sures of phys­i­cal fit­ness are impor­tant.  But walk­ing speed also reflects move­ment skill.

We all learn to walk ear­ly in child­hood.  Soon there­after, the orga­niz­ing schemes in the brain and spinal cord that con­trol walk­ing go on auto-pilot.  Most of us nev­er again think about the com­plex move­ment inte­gra­tion that goes into cre­at­ing a smooth, effi­cient pat­tern of walk­ing.

But I do.  And as part of my ther­a­peu­tic work I often train peo­ple in basic move­ment and pos­tur­al skills such as walk­ing.

Learn­ing a prop­er pat­tern of gait takes stress off the joints of the feet, knees, and low back.  It serves as a back­ground for improv­ing your fit­ness, because all of your move­ments become more effi­cient.

But equal­ly impor­tant­ly, move­ment skills train­ing stim­u­lates your brain.  That’s at the core of build­ing health, enjoy­ing life, and pre­vent­ing demen­tia.


Deepen Your Body of Knowledge

The val­ue of move­ment vari­a­tion


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website,, provides more information about his approach.

Please contact him at or at 212-400-9663.

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