title: Abnormality of gait as a predictor of non-Alzheimer's dementia.
abstract: BACKGROUND
  Neurologic abnormalities affecting gait occur early in several types of non-Alzheimer's dementias, but their value in predicting the development of dementia is uncertain.
  
  
  METHODS
  We analyzed the relation between neurologic gait status at base line and the development of dementia in a prospective study involving 422 subjects older than 75 years of age who lived in the community and did not have dementia at base line. Cox proportional-hazards regression analysis was used to calculate hazard ratios with adjustment for potential confounding demographic, medical, and cognitive variables.
  
  
  RESULTS
  At enrollment, 85 subjects had neurologic gait abnormalities of the following types: unsteady gait (in 31 subjects), frontal gait (in 12 subjects), hemiparetic gait (in 11 subjects), neuropathic gait (in 11 subjects), ataxic gait (in 10 subjects), parkinsonian gait (in 8 subjects), and spastic gait (in 2 subjects). During follow-up (median duration, 6.6 years), there were 125 newly diagnosed cases of dementia, 70 of them cases of Alzheimer's disease and 55 cases of non-Alzheimer's dementia (47 of which involved vascular dementia and 8 of which involved other types of dementia). Subjects with neurologic gait abnormalities had a greater risk of development of dementia (hazard ratio, 1.96 [95 percent confidence interval, 1.30 to 2.96]). These subjects had an increased risk of non-Alzheimer's dementia (hazard ratio, 3.51 [95 percent confidence interval, 1.98 to 6.24]), but not of Alzheimer's dementia (hazard ratio, 1.07 [95 percent confidence interval, 0.57 to 2.02]). Of non-Alzheimer's dementias, abnormal gait predicted the development of vascular dementia (hazard ratio, 3.46 [95 percent confidence interval, 1.86 to 6.42]). Among the types of abnormal gait, unsteady gait predicted vascular dementia (hazard ratio, 2.61), as did frontal gait (hazard ratio, 4.32) and hemiparetic gait (hazard ratio, 13.13).
  
  
  CONCLUSIONS
  The presence of neurologic gait abnormalities in elderly persons without dementia at base line is a significant predictor of the risk of development of dementia, especially non-Alzheimer's dementia.
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. jverghes@aecom.yu.edu
authors.forename: Joe
authors.initials: J
authors.lastname: Verghese
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
authors.forename: Charles B
authors.initials: CB
authors.lastname: Hall
authors.forename: Gail
authors.initials: G
authors.lastname: Kuslansky
authors.forename: Mindy J
authors.initials: MJ
authors.lastname: Katz
authors.forename: Herman
authors.initials: H
authors.lastname: Buschke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis; D001344:Autopsy; D015331:Cohort Studies; D003704:Dementia / Q000150:complications* / Q000175:diagnosis; D005260:Female; D020233:Gait Disorders, Neurologic / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D012306:Risk