Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.
Schulich School of Medicine & Dentistry, Department of Medicine and Division of Geriatric Medicine, London, Ontario, Canada.
Alzheimers Dement. 2021 Aug;17(8):1317-1328. doi: 10.1002/alz.12298. Epub 2021 Feb 16.
Gait impairment is common in neurodegenerative disorders. Specifically, gait variability-the stride-to-stride fluctuations in distance and time-has been associated with neurodegeneration and cognitive impairment. However, quantitative comparisons of gait impairments across the cognitive spectrum of dementias have not been systematically investigated.
Older adults (N = 500) with subjective cognitive impairment, Parkinson disease (PD), mild cognitive impairment (MCI), PD-MCI, Alzheimer's disease (AD), PD-dementia, Lewy body dementia, and frontotemporal dementia, as well cognitive normal controls, who were assessed for their gait and cognitive performance.
Factor analyses grouped 11 quantitative gait parameters and identified four independent gait domains: rhythm, pace, variability, and postural control, for group comparisons and classification analysis. Among these domains, only high gait variability was associated with lower cognitive performance and accurately discriminated AD from other neurodegenerative and cognitive conditions.
Our findings indicate that high gait variability is a marker of cognitive-cortical dysfunction, which can help to identify Alzheimer's disease dementia.
步态障碍在神经退行性疾病中很常见。具体来说，步长和时间的距离波动——步态变异性——与神经退行性变和认知障碍有关。然而，尚未系统地研究认知障碍谱中痴呆症的步态障碍的定量比较。
对 500 名有主观认知障碍、帕金森病 (PD)、轻度认知障碍 (MCI)、PD-MCI、阿尔茨海默病 (AD)、PD-痴呆、路易体痴呆和额颞叶痴呆的老年人以及认知正常对照者进行了步态和认知能力评估。
因子分析将 11 个定量步态参数分组，并确定了四个独立的步态域：节奏、步速、变异性和姿势控制，用于组间比较和分类分析。在这些领域中，只有高步态变异性与较低的认知表现相关，并能准确地区分 AD 与其他神经退行性和认知状况。
我们的研究结果表明，高步态变异性是认知-皮质功能障碍的标志物，有助于识别阿尔茨海默病痴呆症。
