Sheridan Pamela L, Hausdorff Jeffrey M
Behavioral Neurology Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Dement Geriatr Cogn Disord. 2007;24(2):125-37. doi: 10.1159/000105126. Epub 2007 Jul 4.
Alzheimer's disease (AD) is generally understood as primarily affecting cognition while sparing motor function, at least until the later stages of the disease. Studies reported over the past 10 years, however, have documented a prevalence of falls in AD patients significantly higher than in age-matched normal elders; also persons with AD have been observed to have different walking patterns with characteristics that increase gait instability. Recent work in cognitive neuroscience has begun to demonstrate the necessity of intact cognition, particularly executive function, for competent motor control. We put the pieces of this puzzle together and review the current state of knowledge about gait and cognition in general along with an exploration of the association between dementia, gait impairment and falls in AD. We also briefly examine the current treatment of gait instability in AD, mainly exercise, and propose a new approach targeting cognition.
阿尔茨海默病(AD)通常被认为主要影响认知功能,而运动功能不受影响,至少在疾病的晚期之前是这样。然而,过去10年报道的研究记录了AD患者跌倒的发生率显著高于年龄匹配的正常老年人;还观察到AD患者有不同的行走模式,其特征会增加步态不稳。认知神经科学的最新研究已开始证明,完整的认知功能,尤其是执行功能,对于有效的运动控制是必要的。我们将这些线索整合在一起,回顾了关于步态和认知的总体知识现状,并探讨了痴呆、步态障碍与AD患者跌倒之间的关联。我们还简要研究了目前AD患者步态不稳的治疗方法,主要是运动,并提出了一种针对认知的新方法。