Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals: the Taizhou imaging study

Gait disturbance is considered to be a significant clinical manifestation of cerebral small vessel disease (CSVD). We aimed to investigate the association between different imaging markers of CSVD or total CSVD burden and gait disturbance in a community-dwelling population. In the cross-sectional Taizhou Imaging Study (TIS), 314 participants free of neurological disorders underwent MRI scanning and gait assessment with quantitative wearable devices as well as clinical rating scales. In linear regression, after adjustment for demographics and vascular risks, total CSVD burden was associated with prolonged 3-m walking (beta=0.118, P=0.035), shorter stride length (beta=-0.106, P=0.042), and poorer Timed-Up-and-Go (TUG) performance (beta=0.146, P=0.009). Lacunes were positively associated with 3-m walking (beta=0.118, P=0.037) and duration of TUG test (beta=0.112, P=0.047). White matter hyperintensities and cerebral microbleeds were associated with prolonged stride time (beta=0.134, P=0.024) and increased stance phase time percentage (beta=0.115, P=0.038), respectively. Logistic regression revealed that participants with high CSVD burden or more lacunes were more likely to have an impaired gait velocity and an impaired TUG test. These results suggest that total CSVD burden and CSVD imaging markers are associated with gait disturbance among community-dwelling elderly people. Different CSVD imaging markers may cause gait disturbance through different pathways.