<p>This article presents a modern approach to gait impairments in Parkinson’s disease, which arise as a result of systemic changes in the body caused by a combination of progression of the disease and a natural aging process – multisensory impairment. The interplay between cognitive and motor impairments, or motor-cognitive deficit, plays a key role in these changes. The complexity of making a diagnosis of gait impairment is discussed; this arises from the need to differentiate the cause in each individual case, particularly given the inadequacy of classical antiparkinsonian therapy, the presence of cognitive impairment of different levels of severity, including visuospatial disorders, and comorbidities. The proposed role of changes in gait pattern and motor activity as a possible marker of the progression of cognitive impairment is discussed. Comprehensive diagnosis and treatment using modern techniques are shown to have a role in the assessment and treatment of advanced gait impairment in Parkinson’s disease. The article presents our own data, which serve as the basis for drawing attention to the need for a combination of drug and non-drug methods in the treatment of high-level gait disorders in Parkinson’s disease, particularly transcranial magnetic stimulation, exercises on an interactive ergometric system, and the use of anticholinesterase drugs.</p>