Morris Rosie, Lord Sue, Lawson Rachael A, Coleman Shirley, Galna Brook, Duncan Gordon W, Khoo Tien K, Yarnall Alison J, Burn David J, Rochester Lynn
Institute of Neuroscience.
Newcastle Institute for Ageing.
J Gerontol A Biol Sci Med Sci. 2017 Nov 9;72(12):1656-1662. doi: 10.1093/gerona/glx071.
Dementia is significant in Parkinson's disease (PD) with personal and socioeconomic impact. Early identification of risk is of upmost importance to optimize management. Gait precedes and predicts cognitive decline and dementia in older adults. We aimed to evaluate gait characteristics as predictors of cognitive decline in newly diagnosed PD.
One hundred and nineteen participants recruited at diagnosis were assessed at baseline, 18 and 36 months. Baseline gait was characterized by variables that mapped to five domains: pace, rhythm, variability, asymmetry, and postural control. Cognitive assessment included attention, fluctuating attention, executive function, visual memory, and visuospatial function. Mixed-effects models tested independent gait predictors of cognitive decline.
Gait characteristics of pace, variability, and postural control predicted decline in fluctuating attention and visual memory, whereas baseline neuropsychological assessment performance did not predict decline.
This provides novel evidence for gait as a clinical biomarker for PD cognitive decline in early disease.
痴呆在帕金森病（PD）中较为显著，会对个人和社会经济产生影响。早期识别风险对于优化管理至关重要。步态在老年人中先于并预测认知能力下降和痴呆。我们旨在评估步态特征作为新诊断帕金森病认知能力下降的预测指标。
对119名在诊断时招募的参与者在基线、18个月和36个月时进行评估。基线步态通过映射到五个领域的变量来表征：步速、节奏、变异性、不对称性和姿势控制。认知评估包括注意力、波动注意力、执行功能、视觉记忆和视觉空间功能。混合效应模型测试了认知能力下降的独立步态预测指标。
步速、变异性和姿势控制的步态特征预测了波动注意力和视觉记忆的下降，而基线神经心理学评估表现并未预测下降。
这为步态作为早期疾病中帕金森病认知能力下降的临床生物标志物提供了新证据。
