February 2013

Diabetes, cognitive deficits impair gait in older adults, but neuropathy does not

In the moment: Diabetes

By Emily Delzell

Type 2 diabetes affects gait parameters in older adults, and impaired cognition further reduces performance, according to investigators from Ghent University in Belgium who studied 101 patients living in community and residential care settings.

Participants included 56 patients with diabetes (half had peripheral neuropathy, half did not) and 45 controls. Investigators, who e-published the results on February 2 in the Archives of Physical Medicine and Rehabilitation, estimated cognitive impairment and recorded spatiotemporal gait parameters under three conditions: simple, counting backwards by three from 40, and reciting animal names.

Compared with controls, patients with diabetes walked slower, took shorter strides, and showed more gait variability, especially during dual-task conditions. Patients with both diabetes and cognitive impairment  also had shorter double support time than those without cognitive deficits. Gait patterns did not differ between patients with and without neuropathy.

Compared with normal walking, dual-task conditions affected all gait parameters similarly in all groups. Backward counting affected gait more than animal naming in patients with diabetes compared with controls.


Roman de Mettelinge T, Delbaere K, Calders P, et al. The impact of peripheral neuropathy and cognitive decrements on gait in older adults with type II diabetes mellitus. Arch Phys Med Rehabil 2013 Feb 2 [Epub ahead of print]

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