Nonnekes Jorik, Post Erik, Imbalzano Gabriele, Bloem Bastiaan R
Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Rehabilitation; Centre of Expertise for Parkinson & Movement Disorders, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands.
J Neurol. 2025 Mar 7;272(4):257. doi: 10.1007/s00415-025-12995-4.
Walking may appear to be a simple motor task, but is in fact a very complex behavior that involves virtually all levels of the nervous system. In daily clinical practice, subtle gait changes are commonly observed as we grow older, and these are often attributed to aging itself (the term "senile gait" was coined for this). However, growing evidence suggests that such age-related gait changes should not be regarded as a mere consequence of aging, but rather as indicators of underlying age-related disease. Numerous studies have shown that gait changes can be present for years during an otherwise prodromal phase of many progressive neurological disorders. As such, gait changes serve as clinical biomarkers of disease-related dysfunction in the neurological structures involved in gait control. We elaborate on the potential for gait to be exploited as an early warning system for underlying pathology. We also discuss the importance of such a proactive approach: an earlier diagnosis can lead to timely installment of symptomatic support, and sometimes start of prophylactic treatment. This can help reduce disability, and possibly increase survival because age-related gait disturbances are associated with increased mortality in the general population.
行走看似是一项简单的运动任务，但实际上是一种非常复杂的行为，几乎涉及神经系统的各个层面。在日常临床实践中，随着年龄增长，我们通常会观察到细微的步态变化，这些变化往往被归因于衰老本身（“衰老步态”这一术语就是为此而创造的）。然而，越来越多的证据表明，这种与年龄相关的步态变化不应仅仅被视为衰老的结果，而应被视为潜在的与年龄相关疾病的指标。大量研究表明，在许多进行性神经疾病的前驱期，步态变化可能会持续数年。因此，步态变化是参与步态控制的神经结构中与疾病相关功能障碍的临床生物标志物。我们详细阐述了将步态用作潜在病理学预警系统的可能性。我们还讨论了这种积极主动方法的重要性：早期诊断可以及时提供症状支持，有时还可以开始预防性治疗。这有助于减少残疾，并可能提高生存率，因为与年龄相关的步态障碍与普通人群死亡率增加有关。
