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http://dx.doi.org/10.13066/kspm.2017.12.2.129

Assessment of Gait as a Diagnostic Tool for Patients with Dementia  

Lee, Han-Suk (Dept. of Physical Therapy, Eulji University)
Park, Sun-Wook (Dept. of Physical Therapy, Samsung Medical Center)
Publication Information
Journal of the Korean Society of Physical Medicine / v.12, no.2, 2017 , pp. 129-136 More about this Journal
Abstract
PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.
Keywords
Dementia; Assessment; Gait; ROC;
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1 Sperling RA, Karlawish J, Johnson KA. Preclinical Alzheimer disease-the challenges ahead. Nature Reviews Neurology. 2013;9(1):54-8.   DOI
2 Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285.   DOI
3 van Iersel MB, Benraad CE, Rikkert MG. Validity and reliability of quantitative gait analysis in geriatric patients with and without dementia. J Am Geriatr Soc. 2007;55(4): 632-4.   DOI
4 van Iersel MB, Hoefsloot W, Munneke M, et al. Systematic review of quantitative clinical gait analysis in patients with dementia. Zeitschrift fur Gerontologie und Geriatrie. 2004;37(1):27-32.   DOI
5 Verghese J, Robbins M, Holtzer R, et al. Gait dysfunction in mild cognitive impairment syndromes. Journal of the American Geriatrics Society. 2008;56(7):1244-51.   DOI
6 Verghese J, Wang C, Lipton RB, et al. Quantitative gait dysfunction and risk of cognitive decline and dementia. J Neurol Neurosurg Psychiatry. 2007;78(9):929-35.   DOI
7 Verlinden VJ, van der Geest JN, Hofman A, et al. Cognition and gait show a distinct pattern of association in the general population. Alzheimer's & Dementia. 2014;10(3):328-35.   DOI
8 Wittwer JE, Webster KE, Andrews PT, et al. Test-retest reliability of spatial and temporal gait parameters of people with Alzheimer's disease. Gait Posture. 2008;28(3):392-6.   DOI
9 Wittwer JE, Webster KE, Hill K. Reproducibility of gait variability measures in people with Alzheimer's disease. Gait Posture. 2013;38(3):507-10.   DOI
10 Waite L, Grayson D, Piguet O, et al. Gait slowing as a predictor of incident dementia: 6-year longitudinal data from the Sydney Older Persons Study. Journal of the neurological sciences. 2005;229:89-93.
11 Callisaya ML, Blizzard CL, Wood AG, et al. Longitudinal relationships between cognitive decline and gait slowing: the Tasmanian Study of Cognition and Gait. J Gerontol A Biol Sci Med Sci. 2015;70(10):1226-32.   DOI
12 Atkinson HH, Rosano C, Simonsick EM, et al. Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007;62(8):844-50.   DOI
13 Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age and ageing. 1997;26(1):15-9.   DOI
14 Bossers WJ, van der Woude LH, Boersma F, et al. The Groningen Meander Walking Test: a dynamic walking test for older adults with dementia. Phys Ther. 2014;94(2):262-72.   DOI
15 Bruce-Keller AJ, Brouillette RM, Tudor-Locke C, et al. Relationship between cognitive domains, physical performance, and gait in elderly and demented subjects. Journal of Alzheimer's Disease. 2012;30(4):899-908.   DOI
16 Callisaya ML, Beare R, Phan TG, et al. Brain structural change and gait decline: a longitudinal population- based study. J Am Geriatr Soc. 2013;61:1074-9.   DOI
17 de la Torre JC. Alzheimer's disease is incurable but preventable. Journal of Alzheimer's disease. 2010;20(3):861-70.   DOI
18 DeCarli C, Kawas C, Morrison JH, et al. Session II: Mechanisms of age-related cognitive change and targets for intervention: neural circuits, networks, and plasticity. J Gerontol A Biol Sci Med Sci. 2012;67(7):747-53.   DOI
19 Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. The lancet. 2006;366(9503):2112-7.   DOI
20 Fox B, Henwood T, Neville C, et al. Relative and absolute reliability of functional performance measures for adults with dementia living in residential aged care. Int Psychogeriatr. 2014;26(10):1659-67.   DOI
21 Greiner M, Pfeiffer D, Smith R. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Preventive veterinary medicine. 2000;45(1):23-41.   DOI
22 Imtiaz B, Tolppanen A-M, Kivipelto M, et al. Future directions in Alzheimer's disease from risk factors to prevention. Biochemical pharmacology. 2014;88(4):661-70.   DOI
23 Jahn K, Zwergal A, Schniepp R. Gait disturbances in old age. Dtsch Arztebl Int. 2010;107(17):306-16.
24 Kim JH, Oh TY. The Comparison of Characteristics of Foot pressure between Treadmill and Ground walking in Normal person. J Korean soc phys med. 2010;5(1): 53-61.
25 Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in communityresiding older adults. Research quarterly for exercise and sport. 1999;70(2):113-9.   DOI
26 Jung EJ, Kim WB. The Effects of Task Oriented Circuit Exercise on Balance and Cognition in Mild Dementia Patients. J Korean soc phys med. 2014;9(1):83-91.   DOI
27 Kikkert LH, Vuillerme N, van Campen JP, et al. Walking ability to predict future cognitive decline in old adults: A scoping review. Ageing Res Rev. 2016;27:1-14.   DOI
28 Mielke MM, Roberts RO, Savica R, et al. Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo Clinic Study of Aging. J Gerontol A Biol Sci Med Sci. 2013; 68(8):929-37.   DOI
29 Lee H, Hwang K. The Effects of CogPack program on LOTCA and ADL in Elderly with Alzheimer's Dementia. Journal of The Korean Society of Integrative Medicine. 2014;2(3):1-7.   DOI
30 Leffondre K, Touraine C, Helmer C, et al. Interval-censored time-to-event and competing risk with death: is the illness-death model more accurate than the Cox model? International journal of epidemiology. 2013;42(4):1177-86.   DOI
31 Morris JC, Aisen PS, Bateman RJ, et al. Developing an international network for Alzheimer’s research: the Dominantly Inherited Alzheimer Network. Clinical investigation. 2012;2(10):975-84.   DOI
32 Munoz VM, van Kan GA, Cantet C, et al. Gait and balance impairments in Alzheimer disease patients. Alzheimer Disease & Associated Disorders. 2010;24(1):79-84.   DOI
33 Snijders AH, Van De Warrenburg BP, Giladi N, et al. Neurological gait disorders in elderly people: clinical approach and classification. The Lancet Neurology. 2007;6(1):63-74.   DOI
34 Mura T, Dartigues JF, Berr C. How many dementia cases in France and Europe? Alternative projections and scenarios 2010-2050. Eur J Neurol. 2010;17(2):252-9.   DOI
35 Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia. 2013;9(1):63-75.   DOI