Prevalence and burden of gait disorders in elderly men and women aged 60-97 years: a population-based study

Philipp Mahlknecht, Stefan Kiechl, Bastiaan R Bloem, Johann Willeit, Christoph Scherfler, Arno Gasperi, Gregorio Rungger, Werner Poewe, Klaus Seppi, Philipp Mahlknecht, Stefan Kiechl, Bastiaan R Bloem, Johann Willeit, Christoph Scherfler, Arno Gasperi, Gregorio Rungger, Werner Poewe, Klaus Seppi

Abstract

Background: Although gait disorders are common in the elderly, the prevalence and overall burden of these disorders in the general community is not well defined.

Methods: In a cross-sectional investigation of the population-based Bruneck Study cohort, 488 community-residing elderly aged 60-97 years underwent a thorough neurological assessment including a standardized gait evaluation. Gait disorders were classified according to an accepted scheme and their associations to falls, neuropsychological measures, and quality of life were explored.

Results: Overall, 32.2% (95% confidence interval [CI] 28.2%-36.4%) of participants presented with impaired gait. Prevalence increased with age (p<0.001), but 38.3% (95%CI 30.1%-47.3%) of the subjects aged 80 years or older still had a normally preserved gait. A total of 24.0% (95%CI 20.4%-28.0%) manifested neurological gait disorders, 17.4% (14.3%-21.0%) non-neurological gait problems, and 9.2% (6.9%-12.1%) a combination of both. While there was no association of neurological gait disorders with gender, non-neurological gait disorders were more frequent in women (p = 0.012). Within the group of neurological gait disorders 69.2% (95%CI 60.3%-76.9%) had a single distinct entity and 30.8% (23.1%-39.7%) had multiple neurological causes for gait impairment. Gait disorders had a significant negative impact on quantitative gait measures, but only neurological gait disorders were associated with recurrent falls (odds ratio 3.3; 95%CI 1.4-7.5; p = 0.005 for single and 7.1; 2.7-18.7; p<0.001 for multiple neurological gait disorders). Finally, we detected a significant association of gait disorders, in particular neurological gait disorders, with depressed mood, cognitive dysfunction, and compromised quality of life.

Conclusions: Gait disorders are common in the general elderly population and are associated with reduced mobility. Neurological gait disorders in particular are associated with recurrent falls, lower cognitive function, depressed mood, and diminished quality of life.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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