Non-neurological factors are implicated in impairments in gait and mobility among patients in a clinical dementia referral population.
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.
Thomas
Vince Salazar
VS
Division of Geriatric Epidemiology, NEUROTEC, Karolinska Institutet & Stockholm Gerontology Research Center, Stockholm, Sweden. Vince.s.Thomas@neurotec.ki.se
Vandenberg
Edward V
EV
Potter
Jane F
JF
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