A Rating Scale for Gait Evaluation in Cognitive Deterioration (RSGE-CD): Validation Study

Abstract

A relationship between decline in mobility and walking performance and cognitive impairment exists in the elderly. Therefore, clinical assessment of gait and mobility may be relevant for diagnostic and therapeutic purposes. However, the rating scales used for evaluation of gait disorder in the context of cognitive deterioration were not designed or validated for that setting. The present study was aimed at checking the clinimetric properties of the Rating Scale for Gait Evaluation in Cognitive Deterioration (RSGE-CD), specifically developed for assessment of gait dysfunction across all stages of cognitive decline. Two hundred fifty six subjects were included in the study and classified according to the Global Deterioration Scale (control, subjective/mild cognitive impairment, or dementia). Patients with dementia had a diagnosis of probable Alzheimer's disease (73%) or dementia of combined etiology (27%). Cognitive and functional evaluations, the Tinetti scale, and timed tests were simultaneously applied with the tested scale, which is composed of two subscales: Functional ability and Examination. Exploratory factor analysis showed one factor (70% of the variance). Floor effect and skewness were observed in the control group, whereas internal consistency (Cronbach's alpha = 0.88-0.95), inter-observer and test-retest reliability (intraclass correlation coefficients ≥0.97) were satisfactory. Convergent validity with the other measures was ≥0.60 and the discriminant validity according to classification of subjects by cognitive state and other aspects was also satisfactory (p = 0.0001). The RSGE-CD

Neural Mechanisms of Motor Dysfunction in Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review

“…A study in individuals with probable AD used the Rating Scale for Gait Evaluation in Cognitive Deterioration [ 49 ] to assess gait dysfunction. It was reported that less gray matter volume in clusters in the bilateral primary motor cortices, bilateral medial cingulate gyrus, bilateral insula, and bilateral anterior cerebellum indicated poorer gait [ 50 ] (see Table 4 ).…”

“…Motor tests that incorporate gait, such as gait-cognitive dual tasking, and the timed up-and-go test, were related to degeneration of the primary motor cortex and temporal lobe [ 34, 39, 41 ], as well as degeneration and activation changes of the default mode network (dual tasking) [ 45 ], and less frontal, temporal, and cerebellar volume [ 55 ], periventricular WML [ 43, 56 ], and amyloid deposition in the precuneus and cingulum [ 47 ]. Gait disorders in AD were related to volume loss of motor brain regions such as the primary motor cortex and the cerebellum [ 49 ], subcortical and periventricular WML [ 52 ], and microstructural white matter changes of several white matter projections, including the corticospinal tract [ 50 ].…”

Key factors for the assessment of mobility in advanced dementia: A consensus approach

“…In the present study, both were deemed feasible to assess in people with advanced dementia. Clinically, they can be evaluated by observation and rated based on degree of assistance required as in the Rating Scale for Gait Evaluation–Cognitive Deterioration [6,20]. Wheeled mobility was not rated highly as a factor to consider.…”

Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates

“…29 Neuropsychiatric variables: the neuropsychiatric inventory 30 was utilized for the evaluation of neuropsychiatric symptoms. Motor variables: parkinsonism was evaluated using the motor evaluation scale of the Scales for Outcomes in Parkinson’s Disease (SCOPA-Motor), 31 and gait was assessed using the Rating Scale for Gait Evaluation in Cognitive Deterioration (RSGE-CD). 32 Other dementia-related variables: disease duration, memory failure, and falls at symptom onset were obtained from medical records and family interview. Severity of dementia was rated following the Global Deterioration Scale 33 and the Clinical Dementia Rating Scale, sum of boxes score.…”

“…Motor variables: parkinsonism was evaluated using the motor evaluation scale of the Scales for Outcomes in Parkinson’s Disease (SCOPA-Motor), 31 and gait was assessed using the Rating Scale for Gait Evaluation in Cognitive Deterioration (RSGE-CD). 32…”