Gait disorders in patients with sporadic age-depended cerebral small vessel disease: relationship with neuropsychological profile and severity of cognitive impairment

Cerebral small vessel disease (cSVD) is a major medical and social problem, with cognitive impairment (CI) and abnormal gait as its main clinical manifestations. Recent studies have examined the relationship between these symptoms and their contribution to disability in older adults. Objective. To assess the association between non-hemiparetic gait disorders, neuropsychological profiles, and the severity of CI in patients with cSVD. Materials and methods. The study enrolled 124 patients with cSVD (mean age 62±8 years) with Fazekas stage 2—3 white matter hyperintensity, and 30 control volunteers without gait disorders or MRI abnormalities. Groups were matched for age and sex. Cognitive function was evaluated, as well as severity and type of CI. Gait was assessed using the Tinetti test (with «balance» and «gait» subscales and a total score indicating fall risk), the 6-meter walk test, and the Clinical Scale for Assessing Gait Disorders in patients with cSVD. Results. All patients presented with CI of varying severity; 68.5% had gait disorders, and 41.8% were at risk of falls. Patients with gait disturbances had significantly more severe CI (dementia in 36.5% versus 5.1%) and poorer neuropsychological test performance compared with those without abnormal gait. Gait parameters showed the strongest association with overall cognitive function, particularly executive control (‘inhibition’ component) and memory. Conclusions. Gait disorders is closely associated with executive dysfunction, memory impairment, and deterioration of integrative brain activity. Early identification of gait impairment in patients with cSVD can indicate disease progression, CI, and an increased risk of falls.