Gait Disturbance in Alzheimer's Disease: A Clinical Study

O'Keeffe, Shaun T; Kazeem, H.; Philpott, R. M.; Playfer, Jeremy; Gosney, Margot; Lye, Michael

doi:10.1093/ageing/25.4.313

Cited by 144 publications

(92 citation statements)

References 19 publications

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“…Such difference was found only in the moderate stage of the disease. The same results were described by O'Keeffe et al 25 in an analysis of balance and gait in AD through the Tinetti test, where they encountered dysfunction in balance in 36% of controls, 43% of mild AD, 60% of moderate AD, and 79% of severe AD. In our study, the fallers group achieved lower (although not statistically different) scores in the BBS, except for the moderate AD patients.…”

Section: Discussionsupporting

confidence: 81%

Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity

Kato-Narita

Nitrini

Radanovic

2011

Arq. Neuro-Psiquiatr.

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Objective: To analyze the correlation between balance, falls and loss of functional capacity in mild and moderate Alzheimer's disease(AD). Method: 40 subjects without cognitive impairment (control group) and 48 AD patients (25 mild, 23 moderate) were evaluated with the Berg Balance Scale (BBS) and the Disability Assessment for Dementia (DAD). Subjects answered a questionnaire about falls occurrence in the last twelve months. Results: Moderate AD patients showed poorer balance (p=0.001) and functional capacity (p <0.0001) and it was observed a correlation between falls and balance (r= -0.613; p=0.045). Conclusion: There is a decline of balance related to AD which is a factor associated to the occurrence of falls, albeit not the most relevant one. The loss of functional capacity is associated with the disease's progress but not to a higher occurrence of falls. The balance impairment did not correlate with functional decline in AD patients. Key words: Alzheimer's disease, balance, falls, functional capacity, elderly.Avaliação do equilíbrio na doença de Alzheimer leve e moderada: implicações na capacidade funcional e na ocorrência de quedas RESUMO Objetivo: Analisar a correlação entre déficit de equilíbrio, ocorrência de quedas e prejuízo funcional na doença de Alzheimer (DA). Método: 40 idosos sem comprometimento cognitivo (grupo controle) e 48 idosos com DA (25 leves e 23 moderados), avaliados através da Escala de Equilíbrio de Berg (EEB) e Escala de Avaliação de Incapacidade (EAI), e questionados quanto à ocorrência de quedas nos últimos doze meses. Resultados: O equilíbrio no grupo DA moderada foi pior do que no grupo leve (p=0,001), bem como a capacidade funcional (p<0,0001), sem diferença na ocorrência de quedas entre os grupos. Na DA moderada, houve correlação entre ocorrência de quedas e EEB (r= -0,613; p=0,045). Conclusão: Há um declínio do equilíbrio associado à progressão da DA. O declínio da capacidade funcional não foi associado à maior ocorrência de quedas. O déficit de equilíbrio não se correlacionou ao declínio funcional na DA. Palavras-chave: doença de Alzheimer, equilíbrio, quedas, capacidade funcional, idosos.

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Section: Discussionsupporting

confidence: 81%

Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity

Kato-Narita

Nitrini

Radanovic

2011

Arq. Neuro-Psiquiatr.

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“…Frontal release signs, impaired gait, and increased rigidity may occur more frequently early in the course of dementia. 31,[61][62][63][64][65] In a recent study, gait disturbance was often reported to the family doctor up to five years before dementia was diagnosed. 65 While risk factors for AD in the general population are of interest, it is unclear whether they are relevant in predicting dementia in that subset of the population presenting to a Memory Clinic with mild cognitive impairment.…”

Section: Clinical Risk Factors For Development Of Dementia and Admentioning

confidence: 99%

Can Clinical Data Predict Progression to Dementia in Amnestic Mild Cognitive Impairment?

Fellows

Bergman²,

Wolfson³

et al. 2008

Can. j. neurol. sci.

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314As treatments to alleviate symptoms and to slow the progression of Alzheimer's disease (AD) emerge, an increasingly urgent dilemma for physicians is also developing: which of the many elderly individuals with memory complaints will develop Alzheimer's disease, and would therefore be candidates for preventive therapies? An important goal of current research must be to establish useful pre-clinical diagnostic and predictive guidelines, and this can only emerge from longitudinal follow-up of elderly individuals with mild memory loss. In this paper, we report the clinical characteristics of such a group, with the aim of ABSTRACT: Background: To determine whether clinical data obtained by history and physical examination can predict eventual progression to dementia in a cohort of elderly people with mild cognitive impairment. Methods: A prospective, longitudinal study of a cohort of elderly subjects with amnestic Mild Cognitive Impairment (MCI). Ninety subjects meeting the criteria for amnestic MCI were recruited and followed annually for an average of 3.3 years. Main outcome measure was the development of dementia determined by clinical assessment with confirmatory neuropsychological evaluation. Results: Fifty patients (56%) developed dementia on follow-up. They were older, had lower Mini-mental status exam (MMSE) scores and a shorter duration of symptoms at the time of first assessment. Multivariate logistic regression analysis identified age at symptom onset as the only clinical parameter which distinguished the group that deteriorated to dementia from the group that did not. The odds ratio for age was 1.1 (confidence interval 1.04 -1.18). Conclusions: Patients presenting with amnestic MCI insufficient for the diagnosis of dementia are at high risk of developing dementia on follow-up. In our cohort, 56% were diagnosed with dementia over an average period of 5.9 years from symptom onset. The only clinical predictor for the eventual development of dementia was older age at symptom onset. Clinical features alone were insufficient to predict development of dementia.RÉSUMÉ: Les données cliniques peuvent-elles prédire la progression vers la démence dans l'atteinte cognitive légère avec syndrome amnésique? Contexte : Le but de cette étude était de déterminer si les données cliniques provenant de l'histoire médicale et de l'examen physique peuvent prédire la progression éventuelle vers la démence dans une cohorte de gens âgés ayant une atteinte cognitive légère. Méthodes : Il s'agit d'une étude longitudinale prospective d'une cohorte de sujets âgés ayant une atteinte cognitive légère (ACL). Quatre-vingt-dix sujets rencontrant les critères diagnostiques de l'ACL amnésique ont été recrutés et suivis annuellement pendant 3,3 ans en moyenne. Le critère d'évaluation principal était l'apparition d'une démence selon l'évaluation clinique confirmée par une évaluation neuropsychologique. Résultats : Cinquante patients (56%) ont développé une démence au cours du suivi. Ils étaient plus âgés, avaient des scores MMSE plus bas et u...

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“…Previous studies suggested that impaired balance performance is more evident in AD individuals when compared with controls 10 and declines according to the dementia stage 11 . Similar results were reported by KatoNarita et al 12 when the Berg Balance Scale (BBS) was employed to measure balance performance in mild and moderate AD.…”

mentioning

confidence: 95%

Balance impairment does not necessarily coexist with gait apraxia in mild and moderate Alzheimer’s disease

Pereira

Oliveira

Schultz

et al. 2016

Arq. Neuro-Psiquiatr.

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Currently, there are no studies reporting how much balance impairment coexists with gait apraxia in mild and moderate Alzheimer’s disease (AD). Objectives To assess correlations among gait apraxia, balance impairment and cognitive performance in mild (AD1, n = 30) and moderate (AD2, n = 30) AD. Method The following evaluations were undertaken: gait apraxia (Assessment Walking Skills); balance performance (Berg Balance Scale); Clinical Dementia Rating and Mini-mental State Examination (MMSE). Results While disregarding AD subgroups, Berg Balance Scale and the MMSE correlated significantly with Assessment Walking Skills and 23% of all subjects scored below its cut-off. After stratification, Berg Balance Scale correlated significantly with Assessment Walking Skills in both AD subgroups, and with the MMSE only in AD1. Conclusions Balance impairment does not necessarily coexist with gait apraxia. Gait apraxia is more prevalent in moderate AD when compared with mild AD.

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Gait Disturbance in Alzheimer's Disease: A Clinical Study

Cited by 144 publications

References 19 publications

Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity

Assessment of balance in mild and moderate stages of Alzheimer's disease: implications on falls and functional capacity

Can Clinical Data Predict Progression to Dementia in Amnestic Mild Cognitive Impairment?

Balance impairment does not necessarily coexist with gait apraxia in mild and moderate Alzheimer’s disease

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