Combining Physical and Cognitive Functions to Discriminate Level of Gait Independence in Hospitalized Patients with Alzheimer's Disease

Introduction: Both physical and cognitive functions are required to be assessed to determine the level of gait independence in patients with Alzheimer's disease (AD); nonetheless, a method to achieve this assessment has not been established. This study aimed to investigate the accuracy of an assessment method that combined muscle strength, balance ability, and cognitive function parameters in discriminating the level of gait independence in a real-world setting in hospitalized patients with AD. Methods: In this cross-sectional study, 63 patients with AD (mean age: 86.1 +/- 5.8 years) were classified into three groups according to their gait level: independent, modified independent (independent walking with walking aids), and dependent groups. Discrimination accuracy was calculated for single items of muscle strength, balance ability, and cognitive function tests and for combinations of each. Results: The combined accuracy of muscle strength, balance ability, and cognitive function had a positive predictive value of 100.0% and a negative predictive value of 67.7% between the independent and modified independent groups. The positive and negative predictive values were 100.0% and 72.4 %, respectively, between the modified independent and dependent groups. Conclusion: This study emphasizes the importance of assessing the level of gait independence in a real-world setting in patients with AD from the perspective of both physical and cognitive functions and proposes a novel method for discriminating an optimal state.