Qualitative neurological gait abnormalities, cardiovascular risk factors and functional status in older community-dwellers without neurological diseases: The Healthy Brain Project
Marco Inzitari, Andrea Metti, Caterina Rosano, Cristina Udina, Laura M Pérez, Gabriela Carrizo, Joe Verghese, Anne B Newman, Stephanie Studenski, Andrea L Rosso, Marco Inzitari, Andrea Metti, Caterina Rosano, Cristina Udina, Laura M Pérez, Gabriela Carrizo, Joe Verghese, Anne B Newman, Stephanie Studenski, Andrea L Rosso
Abstract
Background: Neurologic gait abnormalities (NGA) increase risk for falls and dementia, but their pathophysiologic substrates or association with disability have been poorly investigated. We evaluated the association of NGA with clinical characteristics and functional status in older community-dwellers.
Methods: Gait characteristics were measured in older community-dwellers without neurological or psychological diseases participating to the Health Aging Body Composition study. NGA were rated using standardized readings of video-recorded short walks, combined with standard neurological exam. We tested cross-sectional associations with demographics, vascular risk factors, comorbidities, cognitive function and disability.
Results: Of 177 participants (median age [IQR] = 82 [4] years, 55% women, 58% Caucasian), 49 (27.7%) had NGA. The most prevalent sub-types were unsteady (10.7%), hemiparetic (4.5%) and parkinsonian (4%). In multivariable logistic regression models, diabetes was associated with higher risk (OR = 3.24, 95% CI = 1.38-7.59), whereas higher physical activity (OR = 0.89, 95% CI = 0.80-0.99) and gait speed (OR = 0.04, 95% CI = 0.005-0.27) with lower risk of NGA. Prevalence of NGA was associated with difficulty in at least 1 activity of daily living, adjusting for confounders (OR = 2.90, 95% CI = 1.11-7.58). After adjusting for gait speed, this association was attenuated to non-significance (OR = 2.13, 95% CI = 0.71-6.37).
Conclusions: In our sample of community-dwelling older adults without neurological diseases, NGA, detected with a standardized neurological exam, part of usual physicians' training, were common. The relationships with diabetes and reduced physical activity might suggest vascular dysfunction as an underlying contributor to NGA. These results, if confirmed by longitudinal studies, which should also disentangle the relationship between NGA, gait speed and disability, might add information for preventing and managing mobility disability.
Keywords: Cardiovascular; Diabetes; Disability; Gait speed; Walking.
Conflict of interest statement
The authors declare no conflict of interest in relation to the data or topic treated in this work.
Copyright © 2019 Elsevier Inc. All rights reserved.
Source: PubMed