TY - JOUR
T1 - Qualitative neurological gait abnormalities, cardiovascular risk factors and functional status in older community-dwellers without neurological diseases
T2 - The Healthy Brain Project
AU - Inzitari, Marco
AU - Metti, Andrea
AU - Rosano, Caterina
AU - Udina, Cristina
AU - Pérez, Laura M.
AU - Carrizo, Gabriela
AU - Verghese, Joe
AU - Newman, Anne B.
AU - Studenski, Stephanie
AU - Rosso, Andrea L.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/9
Y1 - 2019/9
N2 - 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.
AB - 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.
KW - Cardiovascular
KW - Diabetes
KW - Disability
KW - Gait speed
KW - Walking
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U2 - 10.1016/j.exger.2019.110652
DO - 10.1016/j.exger.2019.110652
M3 - Article
C2 - 31288087
AN - SCOPUS:85068849516
SN - 0531-5565
VL - 124
JO - Experimental Gerontology
JF - Experimental Gerontology
M1 - 110652
ER -