Colleagues, the following may be of interest to some. Best regards,
Kathrynne
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NEW ENGLAND JOURNAL OF MEDICINE
Volume 347:1761-1768 November 28, 2002 Number 22
Abnormality of Gait as a Predictor of Non-Alzheimer's Dementia
Joe Verghese, M.D., Richard B. Lipton, M.D., Charles B. Hall, Ph.D., Gail
Kuslansky, Ph.D., Mindy J. Katz, M.P.H., and Herman Buschke, M.D.
ABSTRACT
Background
Neurologic abnormalities affecting gait occur early in several types of
non-Alzheimer's dementias, but their value in predicting the development
of dementia is uncertain.
Methods
We analyzed the relation between neurologic gait status at base line and
the development of dementia in a prospective study involving 422 subjects
older than 75 years of age who lived in the community and did not have
dementia at base line. Cox proportional-hazards regression analysis was
used to calculate hazard ratios with adjustment for potential confounding
demographic, medical, and cognitive variables.
Results
A at enrollment, 85 subjects had neurologic gait abnormalities of the
following types: unsteady gait (in 31 subjects), frontal gait (in 12
subjects), hemiparetic gait (in 11 subjects), neuropathic gait (in 11
subjects), ataxic gait (in 10 subjects), parkinsonian gait (in 8
subjects), and spastic gait (in 2 subjects). During follow-up (median
duration, 6.6 years), there were 125 newly diagnosed cases of dementia, 70
of them cases of Alzheimer's disease and 55 cases of non-Alzheimer's
dementia (47 of which involved vascular dementia and 8 of which involved
other types of dementia). Subjects with neurologic gait abnormalities had
a greater risk of development of dementia (hazard ratio, 1.96 [95 percent
confidence interval, 1.30 to 2.96]). These subjects had an increased risk
of non-Alzheimer's dementia (hazard ratio, 3.51 [95 percent confidence
interval, 1.98 to 6.24]), but not of Alzheimer's dementia (hazard ratio,
1.07 [95 percent confidence interval, 0.57 to 2.02]). Of non-Alzheimer's
dementias, abnormal gait predicted the development of vascular dementia
(hazard ratio, 3.46 [95 percent confidence interval, 1.86 to 6.42]). Among
the types of abnormal gait, unsteady gait predicted vascular dementia
(hazard ratio, 2.61), as did frontal gait (hazard ratio, 4.32) and
hemiparetic gait (hazard ratio, 13.13).
Conclusions
The presence of neurologic gait abnormalities in elderly persons without
dementia at base line is a significant predictor of the risk of
development of dementia, especially non-Alzheimer's dementia.
--
Kathrynne Holden, MS, RD < [log in to unmask] >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/
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