Picture a busy clinic at which doctors are faced with two patients. Both show signs of tremors, slowed movement, and slight balance changes. The difficulty is deciding if one patient has early Parkinson’s or dementia with Lewy bodies. And for decades, this has been among neurologists’ most knotty riddles: two disorders, in some fundamental ways strikingly similar, but requiring radically different care strategies.
New work out of the University of Waterloo might have found part of the answer in how we walk. By carefully tracking patterns in people’s movements, scientists identified subtle differences that could help doctors make early diagnoses.
People with early dementia with Lewy bodies walk more slowly, take shorter steps, and have a lower cadence than people with early Parkinson’s disease, the study shows. If anything, these differences became even more pronounced when participants were asked to walk while multitasking, like counting backward.
“We compared stepping patterns between individuals with early dementia with Lewy bodies and people with early Parkinson’s disease to see whether walking behaviour could help distinguish the two conditions and found that they can,” said Dr. Kaylena Ehgoetz Martens, professor in Waterloo’s Department of Kinesiology and Health Sciences and lead author of the study.
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“The findings highlight the promise of measuring movement in a more detailed manner, which could address a significant clinical problem. Because the two diseases look similar in their early stages, patients may receive an incorrect diagnosis, which affects treatment decisions, care planning, and expectations for patients and their families.”
Researchers examined how patients walked under different conditions, both normally and while multitasking. They had 26 people with Parkinson’s disease, 20 people with dementia with Lewy bodies, and 16 healthy older adults walk across a pressure-sensor walkway in three conditions: walking at their own pace, walking while subtracting 1 from 100, and walking while subtracting 7 from 100.
The results were illuminating. During self-paced walking, patients with dementia with Lewy bodies walked slower, took shorter strides, and showed changes in rhythm compared to those who had early Parkinson’s disease. For instance, velocity, step length, stance time, and variability displayed moderate accuracy in distinguishing between the two groups.
Interestingly, the extra cognitive load, making participants subtract numbers while walking, didn’t magnify the differences. The differences in gait between Parkinson’s disease and dementia with Lewy bodies remained stable regardless of whether ones or sevens were subtracted.
The insight is simple but significant: a numerical walking test could become an inexpensive, easily applied device in the clinic. Faster, more accurate diagnoses lead to earlier interventions, better symptom management, and better guidance for caregivers.
“Walking without interference from a secondary task was less effective at identifying differences than walking while multitasking,” Ehgoetz Martens explained. “Asking participants to walk while counting backward revealed changes that weren’t as obvious during regular walking. Ultimately, the goal is to identify individuals sooner, intervene earlier, and improve quality of life before symptoms become more severe.”
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This insight highlights how important attention and movement coordination are to cognitive load, as well as learning more about the interplay of diseases that often confuse one another.” It is a reminder that our movement is profoundly connected to cognition.
The study is part of the Health Futures initiative at Waterloo, which brings together experts in health, engineering, and data science to develop real-world, technology-based solutions. For everything from muscle-wasting diseases to neurodegeneration, it has the potential to make us more accurate, fair, and timely in our diagnoses, simply by capturing clinically relevant information during highly quotidian behaviors such as walking.
Moving forward, the team plans to broaden this approach to other conditions and to people in very early stages of disease, including those at high risk. What started as a detailed examination of gait data could lay the foundation for diagnosing neurological conditions before they fully manifest.
Journal Reference:
- Karen Mathias, Arthur Casagrande Pinto, Luandrya Martins et al. Differentiating gait behaviors between early-stage dementia with Lewy bodies and Parkinson’s disease. Gait & Posture. DOI: 10.1016/j.gaitpost.2025.110034
This was shown first on: https://www.techexplorist.com/walking-patterns-reveal-hidden-clues-dementia-parkinsons/102441/
