Prevalence and severity of gait disorders in Alzheimer's and non-Alzheimer's dementias.
OBJECTIVE
To compare the prevalence, severity, and type of gait and balance disorders in Alzheimer's disease (AD), vascular dementia (VaD), Parkinson's disease with dementia (PDD), dementia with Lewy bodies (DLB), Parkinson's disease without dementia (PD), and age-matched controls.


METHODS
Cross-sectional.


METHODS
Secondary care clinics in geriatric psychiatry, neurology, and geriatrics.


METHODS
Two hundred forty-five participants aged 65 and older (AD, n=40; VaD, n=39; PDD, n=46; DLB, n=32; PD, n=46; and controls, n=42).


METHODS
Prevalence and severity of gait and balance disorders were assessed using the Tinetti gait and balance scale. The types of gait disorders in each diagnostic group were classified using the Nutt et al. classification.


RESULTS
Gait and balance disorders were more common with PDD (93%), VaD (79%), and DLB (75%) than with PD (43%) and AD (25%) and in controls (7%). The risk of gait and balance disorder was higher in the non-Alzheimer's dementia groups (VaD, PDD, and DLB) than in the AD group (odds ratio=15 (95% confidence interval=6-37). If a gait disorder was present in mild dementia (Cambridge Examination for Mental Disorders of the Elderly cognitive subsection score >65), this was diagnostic of non-Alzheimer's dementia, with sensitivity of 78% and specificity of 100%. Non-Alzheimer's dementia groups had worse Tinetti gait and balance scores than the AD group (all P<.001). The types of gait disorders discriminated between non-Alzheimer's dementias.


CONCLUSIONS
The findings support the idea that gait and balance assessment may augment the diagnostic evaluation of dementia.
Allan
Louise M
LM
Institute for Aging and Health, University of Newcastle upon Tyne, United Kingdom. louise.allan@ncl.ac.uk
Ballard
Clive G
CG
Burn
David J
DJ
Kenny
Rose Anne
RA
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology*; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D020961:Lewy Body Disease / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology; D004856:Postural Balance