Your Walking Pattern Could Help Doctors Catch A Deadly Brain Disease Earlier

Walking Test May Distinguish Parkinson’s From A Far Deadlier Diagnosis

Millions of people living with Parkinson’s disease (PD) share a diagnosis that, for some, may actually be something else entirely. A related but far more aggressive brain disorder called dementia with Lewy bodies (DLB) often looks nearly identical to Parkinson’s in its earliest stages, leaving patients and families waiting months or even years for clarity. Now, a new study finds that watching how a person walks could offer a useful early clue for telling the two conditions apart, even at the very start of either disease.

That distinction matters enormously. People with Parkinson’s disease can live relatively well for 10 to 20 years after diagnosis. Those with dementia with Lewy bodies face a median survival of fewer than five years. Getting the diagnosis right early could change everything about how a patient is treated, monitored, and supported.

Researchers from the University of Waterloo and the University of Sydney set out to test whether measurable differences in walking patterns could separate early-stage Parkinson’s from early-stage dementia with Lewy bodies. Their findings, published in the journal Gait & Posture, show those differences are real, detectable, and potentially useful as a diagnostic tool.

Walking Patterns Reveal Early Differences Between Parkinson’s Disease and Lewy Body Dementia

For the study, researchers recruited 26 people with early-stage Parkinson’s, 20 with early-stage dementia with Lewy bodies, and 16 healthy older adults as a comparison group. All patients had been diagnosed within the previous five years, and a neurologist confirmed every diagnosis before testing began. Participants walked across a 6-meter pressure-sensor walkway under three conditions: at their own natural pace, while counting backward from 100 by ones, and while subtracting sevens from 100, a much harder mental task. All patients took their regular medications during testing.

During ordinary, self-paced walking, the differences between the two groups were clear. People with dementia with Lewy bodies walked significantly slower, took shorter steps, and kept each foot on the ground longer per step compared to those with Parkinson’s. Walking speed and step length were among the strongest distinguishing signals, followed by step timing and how consistent each step was. Together, these measures could distinguish between the two groups with moderate accuracy, though the researchers caution that larger studies are needed before gait analysis could serve as a standalone diagnostic tool.

People with DLB also tended to take wider steps than those with Parkinson’s, a trend that fell just short of statistical significance but showed a moderate effect in the data. Widening one’s steps is a natural way to improve balance, and the pattern may reflect early balance challenges or a compensatory response to postural instability, even before more obvious symptoms emerge.

Why Gait Analysis Could Improve Early Parkinson’s Disease Diagnosis

Both Parkinson’s and dementia with Lewy bodies involve the buildup of an abnormal protein called alpha-synuclein, so why would they produce different walking patterns? Researchers suggest this may be because in DLB, that protein damage may spread more widely across the brain’s cortex at an earlier stage. Prior research has linked slower walking to reduced brain tissue volume in areas like the frontal cortex, basal ganglia, and cerebellum, while shorter steps are associated with deterioration in regions involved in planning and spatial awareness. If DLB patients have more widespread early brain changes, those changes may well show up in how they move.

One of the study’s more intriguing tests involved asking participants to walk while doing mental math. Researchers expected that harder cognitive tasks would expose even greater gait differences between the groups, essentially overloading the brain’s ability to compensate. That hypothesis mostly did not hold up. The authors found that increasing the difficulty of the walking-while-thinking task did not expose additional gait differences between the Parkinson’s and DLB groups.

There was, however, a notable finding buried in that result. A quarter of the DLB patients could not complete the harder subtraction task at all, while every Parkinson’s patient finished. That inability may itself be a useful clinical signal, suggesting the harder test could still help tell the two conditions apart, just not in the way researchers originally anticipated.

When the team analyzed only the easier counting task, where all participants could finish, additional walking differences did emerge. DLB patients showed greater inconsistency in both step length and how long each foot stayed planted per step, patterns not apparent during ordinary walking alone. Even a mild mental challenge, it appears, can surface motor differences that simple gait testing misses.

Early Gait Testing Could Help High-Risk Parkinson’s Disease Patients, Too

Both Parkinson’s and dementia with Lewy bodies are often preceded by a condition called isolated REM sleep behavior disorder, in which people physically act out their dreams during sleep. Individuals with this disorder face a high risk of eventually developing one of these neurological diseases. Tracking changes in their walking patterns over time might one day serve as an early warning system, flagging neurodegeneration before more obvious symptoms appear.

Walking is something most people do without a second thought. For neurologists trying to separate two diseases with vastly different outlooks, a person’s gait may carry more diagnostic information than a routine office visit ever could. As movement-tracking tools become more accessible, a short walk down a hallway could eventually become a practical addition to early testing.

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Disclaimer: This article is based on a single peer-reviewed study with a small sample size. Findings are preliminary and should not be used to self-diagnose or alter any medical treatment. Consult a qualified healthcare provider with any questions about neurological symptoms or conditions.

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