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

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    Abstract

    © 2019 Elsevier Inc. 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.
    Original languageEnglish
    Article number110652
    JournalExperimental Gerontology
    Volume124
    DOIs
    Publication statusPublished - 1 Sep 2019

    Keywords

    • Cardiovascular
    • Diabetes
    • Disability
    • Gait speed
    • Walking

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