Recipient organisationNIHR Newcastle Biomedical Research Centre
NIHR supportRecorded as supported by this research centre
PeriodMar 2025 — Feb 2028
In plain English
AI plain-English summary
A person with dementia is eight times more likely to fall than someone ageing normally, and gait problems can appear six to twelve years before a diagnosis. This project tackles the widespread but underappreciated problem of physical mobility loss in dementia, which is often treated as an inevitable side effect of cognitive decline rather than a distinct, preventable condition. Walking speed is considered a “sixth vital sign” because it predicts falls, disability, hospitalisation, and death, yet current dementia care rarely assesses or proactively manages mobility. The researchers will define mobility as the ability to walk, with or without aids, and aim to bridge the gap between what people with dementia need and the support they actually receive. If successful, this work could change how dementia care is delivered—shifting from reactive fall prevention to early, targeted interventions that maintain walking ability. That would directly affect everyday life: preserving independence, reducing injury, and supporting people to age in place rather than entering residential care prematurely.
View original technical description
Dementia is a national and global health priority, with an estimated 1 million people living with dementia in the UK and 55 million worldwide. Although primarily considered a neurocognitive disorder, people commonly experience physical mobility changes across the disease course. Gait impairments precede a dementia diagnosis by 6-12 years. Evidence consistently indicates that people with dementia experience significant gait and balance problems across all disease stages and dementia subtypes, restrict activities, may engage in repetitive locomotive behaviours (i.e. wandering) and are eight times more likely to fall than in normal ageing, leading to higher rates of injury, disability and death. Physical mobility changes cannot simply be considered an inevitable consequence of cognitive decline as multiple interacting socio-ecological factors contribute, including but not limited to, high incidence of co-morbidity, patient/carer-related psychological, socio-economic and environmental factors and safety concerns. Our ability to walk is considered the most common and functionally relevant aspect of mobility, as it is fundamental to many activities of daily living and supports ageing in place. Walking speed is considered the “sixth vital sign of health” and walking outcomes such as gait quality and ambulatory activity predict morbidity, mortality, falls, cognitive decline and disability. Walking is also intrinsically linked to a sense of independence, control, and wellbeing in multiple age-related conditions. Walking is important in dementia, deemed the top priority for mobility assessment by an expert group in a modified Delphi study. Therefore, our study will primarily define “mobility” as the ability to walk either unaided or aided, aligned with complementary international ageing research efforts. Using a proactive approach to address mobility changes is essential to prevent premature/excess disability and dependency, and support autonomy and wellbeing
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