title: Impact of small vessel disease in the brain on gait and balance.
abstract: Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity - WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, 8036, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pinter
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Ritchie
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Fergus
authors.initials: F
authors.lastname: Doubal
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, 8036, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gattringer
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Morris
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Bastin
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Del C Valdés Hernández
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Royle
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: Janie
authors.initials: J
authors.lastname: Corley
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Susana
authors.initials: S
authors.lastname: Muñoz Maniega
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Pattie
authors.affiliation: Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Dickie
authors.affiliation: Department of Neurology, Maastricht University Medical Centre, Maastricht, 6211, Netherlands.
authors.forename: Julie
authors.initials: J
authors.lastname: Staals
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Gow
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Alzheimer Scotland Dementia Research Centre, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Starr
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Deary
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, 8036, Austria.|Division of Neuroradiology, Vascular and Interventional Neuroradiology, Department of Radiology, Medical University of Graz, Graz, 8036, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, 8036, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK.|Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wardlaw
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000254:growth & development; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005684:Gait; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D004856:Postural Balance