Snijders Anke H, van de Warrenburg Bart P, Giladi Nir, Bloem Bastiaan R
Department of Neurology and Parkinson Center Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
Lancet Neurol. 2007 Jan;6(1):63-74. doi: 10.1016/S1474-4422(06)70678-0.
Gait disorders are common and often devastating companions of ageing, leading to reductions in quality of life and increased mortality. Here, we present a clinically oriented approach to neurological gait disorders in the elderly population. We also draw attention to several exciting scientific developments in this specialty. Our first focus is on the complex and typically multifactorial pathophysiology underlying geriatric gait disorders. An important new insight is the recognition of gait as a complex higher order form of motor behaviour, with prominent and varied effects of mental processes. Another relevant message is that gait disorders are not an unpreventable consequence of ageing, but implicate the presence of underlying diseases that warrant specific diagnostic tests. We next discuss the core clinical features of common geriatric gait disorders and review some bedside tests to assess gait and balance. We conclude by proposing a practical three-step approach to categorise gait disorders and we present a simplified classification system based on clinical signs and symptoms.
步态障碍在老年人中很常见，且常常是严重影响生活的伴随症状，会导致生活质量下降和死亡率上升。在此，我们提出一种针对老年人群神经源性步态障碍的临床导向方法。我们还将关注该领域一些令人振奋的科学进展。我们首先聚焦于老年步态障碍复杂且通常为多因素的病理生理学。一个重要的新认识是将步态视为一种复杂的高级运动行为形式，心理过程对其有显著且多样的影响。另一个相关要点是，步态障碍并非衰老不可避免的结果，而是意味着存在需要进行特定诊断测试的潜在疾病。接下来，我们将讨论常见老年步态障碍的核心临床特征，并回顾一些用于评估步态和平衡的床边检查。最后，我们提出一种实用的三步法对步态障碍进行分类，并基于临床体征和症状给出一个简化的分类系统。
