title: Non-neurological factors are implicated in impairments in gait and mobility among patients in a clinical dementia referral population.
abstract: Although gait abnormalities have been previously noted in dementia, their non-neurological correlates have not been examined. We used data on 900 consecutive outpatients assessed from 1994 to 1999 in the University of Nebraska Geriatric Assessment Clinic Data Base (UN-GAC) to examine the prevalence of gait disorders and the relationship of gait disorders to physical illness in Alzheimer's disease (AD) and non-AD dementia. Gait disorders were very prevalent at each level of cognitive function [58.7% for CDR=0, 68.0% for CDR=0.5, 57.9% for CDR=1, 68.1% for CDR=2 and 76.9% for CDR=3, p=0.02] and were more frequently observed in AD patients with poorer cognitive function. Among all demented patients, 45.0% of those without gait impairment were ADL independent compared to 11.8% of those with gait impairment. In adjusted logistic regression models, the presence of a gait disorder among AD patients was significantly associated with older age (Odds Ratio (OR)=1.09, 95% Confidence Intervals (CI)=1.04-1.15), special sensory (2.19, 1.17-4.12), and lower GI (3.57, 1.97-6.47) dysfunction. The prevalence of gait disorders is high in even mildly demented persons and associated with common and often treatable organ system dysfunction. Because gait disorders are also associated with a high prevalence of ambulatory disability, attention to co morbid illnesses implicated in gait impairment may reduce the burden of disability in this population.
authors.affiliation: Division of Geriatric Epidemiology, NEUROTEC, Karolinska Institutet & Stockholm Gerontology Research Center, Stockholm, Sweden. Vince.s.Thomas@neurotec.ki.se
authors.forename: Vince Salazar
authors.initials: VS
authors.lastname: Thomas
authors.forename: Edward V
authors.initials: EV
authors.lastname: Vandenberg
authors.forename: Jane F
authors.initials: JF
authors.lastname: Potter
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009329:Nebraska; D012307:Risk Factors