Quantcast
Get breaking news alerts via email

Click here to manage your alerts
Changes in gait may be early signs of dementia
First Published Jul 15 2012 11:10 am • Last Updated Jul 15 2012 11:11 am

A slow or uneven gait in older patients may be more than the effect of advancing age, according to three studies that found walking disorders in the elderly also may be early signs of Alzheimer’s disease.

The studies sampled a combined 4,000 people, finding that pace, rhythm and the size of steps changed with neurological illness, according to information presented at the Alzheimer’s Association International Conference in Vancouver.

Join the Discussion
Post a Comment

Watching an older patient walk into an exam room may offer a first clue that psychological evaluation needs to be done, said William Thies, chief medical and scientific officer for the Chicago-based Alzheimer’s Association. Since people with Alzheimer’s are more likely to suffer a debilitating fall than healthy peers, this simple observation may help patients get the right care and prevent injury and disability.

"One of the attractions for me is that observing gait is not particularly high-tech and can be done in simple ways," Thies said. "We have lots of primary care physicians sometimes having difficulty picking out patients that need further evaluation. This is a potential tool -- not for diagnosis, but for knowing who needs more evaluation."

One study of more 1,100 people with an average age of 77 found that people with Alzheimer’s disease walked more slowly and with a more irregular pattern of steps as their minds declined. Even people with a pre-Alzheimer’s condition, called mild cognitive impairment, walked more sluggishly and variably than the normal elderly, according to the study led by Stephanie Bridenbaugh, from the Basel Mobility Center in Switzerland.

Computerized Analysis

Bridenbaugh’s group used a computerized pad that patients walk on to detect minute variations in their gaits. While a general practitioner probably wouldn’t have that available in the office, asking patients to count backward by two while they walked and observing any changes in their stride could be helpful, she said. Though everyone walks more slowly while counting backward, troubles with balance or an unusual stride become more obvious when double-tasking.

Additionally, the double-task analysis may help doctors figure out which adults are walking more slowly because of pain, rather than brain changes, she said.

Another study of more than 1,200 people over age 49, found that the rhythm of a person’s stride was associated with information processing speed. The ability to control and regulate behavior, called executive function, was associated with stride length. Memory wasn’t correlated with any aspect of walking, according to the study led by Mohammad Ikram, a researcher at Erasmus Medical Center in Rotterdam, the Netherlands.

Dementia Link


story continues below
story continues below

"Future studies should explore the link between gait and dementia," Ikram said. "Can we use gait to predict dementia? If so, how long before cognitive symptoms?"

A third study evaluated patients over multiple visits. It found that those who had slower steps and smaller strides had larger declines in thinking, memory and executive processing, according to the study led by Rodolfo Savica from the Mayo Clinic in Rochester, Minnesota.

"Motor and cognitive function may be part of the same spectrum of the disease," Savica said. "These motor changes happen before the memory changes."

Most older adults walk more slowly as they age, the doctors said. Any analysis of a person’s stride should take into account the full medical work-up, Savica said. It’s important to know whether patients are walking more slowly because they have an arthritic knee or a bone disease, he said.



Copyright 2014 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Top Reader Comments Read All Comments Post a Comment
Click here to read all comments   Click here to post a comment


About Reader Comments


Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting "Flag comment as inappropriate". If you've recently registered with Disqus or aren't seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account.
See more about comments here.
Staying Connected
Videos
Jobs
Contests and Promotions
  • Search Obituaries
  • Place an Obituary

  • Search Cars
  • Search Homes
  • Search Jobs
  • Search Marketplace
  • Search Legal Notices

  • Other Services
  • Advertise With Us
  • Subscribe to the Newspaper
  • Login to the Electronic Edition
  • Frequently Asked Questions
  • Contact a newsroom staff member
  • Access the Trib Archives
  • Privacy Policy
  • Missing your paper? Need to place your paper on vacation hold? For this and any other subscription related needs, click here or call 801.204.6100.