Department of Neurology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Department of Rehabilitation, Juntendo University Urayasu Hospital, Chiba, Japan.
BMC Neurol. 2021 Feb 10;21(1):61. doi: 10.1186/s12883-021-02098-8.
Gait impairments are common in patients with Alzheimer's disease. Cholinesterase inhibitors are used to treat the symptoms of patients with Alzheimer's disease, but they have not been shown to reduce the severity of Alzheimer's disease-related gait disorders.
This was a prospective, single-arm, open-label, non-randomized study. The aim of the present study was to determine the effect of the acetylcholinesterase inhibitor rivastigmine on gait in 21 newly diagnosed patients with mild to moderate Alzheimer's disease. The outcome variables were velocity, stride length, and cadence during single-task and dual-task gait trials. The subjects were also assessed with the Mini-Mental State Examination, Alzheimer's Disease Cooperative Study Activities of Daily Living, Functional Assessment Staging, and Geriatric Depression Scale.
After 12 weeks of treatment with rivastigmine, gait velocity was significantly improved in the dual-task gait trials; gait velocity was increased from 40.59 ± 13.59 m/min at baseline to 46.88 ± 12.73 m/min when counting backward from 100 in steps of 7 while walking, and gait velocity was increased from 37.06 ± 15.57 m/min at baseline to 42.03 ± 14.02 m/min when naming animals while walking. In the single-task gait trials, which consisted only of walking at their usual pace or at a fast pace, gait velocity was not increased by rivastigmine administration.
Our findings indicated that rivastigmine improved gait in subjects with mild to moderate Alzheimer's disease during dual-task trials. The observed enhancement of dual-task gait might be caused by an improvement of cognitive function rather than motor function.
UMIN, UMIN000025869. Registered December 16, 2016, https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000029744.
步态障碍在阿尔茨海默病患者中很常见。乙酰胆碱酯酶抑制剂被用于治疗阿尔茨海默病患者的症状，但它们并不能减轻与阿尔茨海默病相关的步态障碍的严重程度。
这是一项前瞻性、单臂、开放标签、非随机研究。本研究旨在确定乙酰胆碱酯酶抑制剂利凡斯的明对 21 例新诊断为轻度至中度阿尔茨海默病患者的步态的影响。主要结局变量为单任务和双任务步态试验中的速度、步幅和步频。还使用简易精神状态检查、阿尔茨海默病合作研究日常生活活动、功能评估分期和老年抑郁量表对受试者进行评估。
利凡斯的明治疗 12 周后，双任务步态试验中的步态速度明显改善；在双任务步态试验中，从基线时的 40.59±13.59m/min 增加到倒计数 100-7 的速度，为 46.88±12.73m/min，从基线时的 37.06±15.57m/min 增加到步行时说出动物名字的速度，为 42.03±14.02m/min。在仅包括以正常速度或快速行走的单任务步态试验中，利凡斯的明给药并未增加步态速度。
我们的研究结果表明，利凡斯的明改善了轻度至中度阿尔茨海默病患者在双任务试验中的步态。观察到的双任务步态改善可能是认知功能的改善而不是运动功能的改善所致。
UMIN，UMIN000025869。于 2016 年 12 月 16 日注册，https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000029744。
