title: Frail elderly patients with dementia go too fast.
abstract: The reason why patients with dementia fall more often and sustain more fractures than patients without dementia remains unclear. Therefore, the relationship between dementia and gait velocity as a marker for mobility and falls in a cohort of frail elderly (mean age of 77.3 years) inpatients was assessed. Patients with dementia were expected to walk slower than patients without dementia. A trend was indeed observed: absolute gait velocity of 0.59 m/s in patients with dementia (n = 63) versus 0.65 m/s in patients without dementia (n = 62; p = 0.19). After adjustment for parkinsonism and walking aids, however, patients with dementia walked 0.44 m/s faster than patients without dementia (p = 0.02). Probable explanations are frontal lobe disinhibition and lack of insight, causing patients with dementia to walk relatively too fast in the context of their frailty. Therefore, the high risk of falls in dementia may be partially explained by the loss of control of gait velocity.
authors.affiliation: Department of Geriatrics, Radboud University Nijmegen Medical Centre, Internal Code 931, PO Box 9101, 6500 HB Nijmegen, The Netherlands. m.vaniersel@ger.umcn.nl
authors.forename: M B
authors.initials: MB
authors.lastname: van Iersel
authors.forename: A L M
authors.initials: AL
authors.lastname: Verbeek
authors.forename: B R
authors.initials: BR
authors.lastname: Bloem
authors.forename: M
authors.initials: M
authors.lastname: Munneke
authors.forename: R A J
authors.initials: RA
authors.lastname: Esselink
authors.forename: M G M Olde
authors.initials: MG
authors.lastname: Rikkert
mesh_terms: D000058:Accidental Falls; D000368:Aged; D001696:Biomechanical Phenomena; D015331:Cohort Studies; D003704:Dementia / Q000150:complications*; D005260:Female; D016330:Frail Elderly; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D016138:Walking