Epidemiology of Gait and Daily Functioning

Across the world, people continue to live longer, resulting in increasing numbers of older people. Age-related functional deficiencies, such as problems in gait and daily functioning, will therefore become a major issue for society. People with problems in gait and daily functioning are at high risk to lose independence, which will eventually lead to institutionalization. Furthermore, poor gait and daily functioning are strong risk factors of various morbidities, such as falling, and even death.
However, little remains known on the underlying processes leading to problems in gait and daily functioning. Both gait and daily functioning are complex processes, requiring integration of input from various systems, such as the proprioceptive, vestibular, and visual system. The nervous system has a central role in this integration, with the peripheral nervous system conducting the information, which is subsequently processed by the brain.
Deficiencies of the nervous system, particularly the brain, may therefore have a large impact on gait and daily functioning. With aging and various neurological diseases, such as dementia and Parkinson’s disease, pathology accumulates in the brain. Brain pathology may be visualized as structural brain changes using magnetic resonance imaging (MRI) and as microstructural brain changes with diffusion tensor imaging (DTI). Both structural and microstructural brain changes are known to strongly affect brain functioning, as measured by cognition. However, much less is known on how this loss of brain functioning affects gait and daily functioning.