Relationship Between Cognitive Function and Gait Performance in Older Adults with Mild Neurological Impairments

Abstract

Background: Cognitive decline and gait disturbances commonly coexist in older adults with mild neurological impairments, reflecting shared underlying neural pathways and increasing vulnerability to functional decline and falls. Understanding how cognitive deficits relate to gait performance in early neurological conditions is essential for informing screening, rehabilitation strategies, and preventive care. Objective: To examine the association between cognitive function and gait performance in older adults with mild neurological impairments using validated cognitive and gait assessment tools. Methods: A cross-sectional study was conducted involving 130 older adults with clinically confirmed mild neurological impairments. Cognitive function was assessed using the Mini-Mental State Examination and Montreal Cognitive Assessment, while gait performance was evaluated using the 10-Meter Walk Test, Timed Up and Go, and stride variability derived from wearable sensors. Statistical analyses included group comparisons and correlation analyses, with significance set at p ≤ 0.05. Results: Lower cognitive scores were significantly associated with poorer gait outcomes, including slower gait speed (r = 0.58, p < 0.001), longer Timed Up and Go times (r = –0.62, p < 0.001), and increased stride variability (r = –0.41, p < 0.001). Individuals with reduced cognitive scores demonstrated markedly slower gait (–0.18 m/s) and higher stride variability (+1.2%) compared with cognitively preserved participants. Conclusion: Cognitive performance is strongly associated with gait mobility and stability in older adults with mild neurological impairments, underscoring the importance of early cognitive screening and integrated cognitive–motor intervention strategies.