Presidential symposium: Gait speed and cognitive impairment as an emerging geriatric syndrome

Gait and cognitive impairments are ubiquitous in older adults and often coexist in the same individual, even in the clinical absence of overt neurological conditions. Both conditions represent independent risk factors for dementia, falls and disability. However, until recently, clinicians and researchers have evaluated and treated cognitive and mobility dysfunction in older individuals as separate problems. This approach has led to gaps in our understanding of the motor-cognitive interactions and of the potential underlying mechanisms that can affect pathways to disability in aging. Emerging evidence indicates that gait is not a merely automated motor activity, but rather a task that requires executive function and attention as well as judgment of external and internal cues. Six recognized experts in the field from 3 different IAGG regions will participate in this symposium. First, we will examine clinical evidence from large-scale studies that demonstrate that individuals with cognitive and gait impairments in absence of overt neurological diseases may represent a phenotype with an increased risk of developing dementia, falls, and disability. Second, mechanistic evidence from brain structural and metabolic imaging studies and functional near infrared spectroscopy in healthy older adults and older adults with neurodegenerative diseases will be summarized. In conclusion, a roundtable debate will discuss whether there is sufficient evidence to support the idea that gait and cognitive impairments among older individuals in the absence of an overt neurological disease represent a distinct phenotype caused by shared mechanisms.