Abstract
OBJECTIVE: To describe the epidemiology and motoric correlates of isolated tandem gait abnormalities (ITGA) in community-dwelling older-adults. BACKGROUND: There has been limited systematic study of components of the neurological gait examination. Observing patients during straight or tandem walk is essential to assess integrity of the neuroaxis. Tandem walking places different balance or gait demands than straight walking, and can serve as a stressor to unearth subtle mobility problems. DESIGN/METHODS: We examined gait patterns in 391 adults (age蠅65y) participating in the Central Control of Mobility and Aging study. ITGA was diagnosed in the presence of marked sway, loss of balance or falls while walking in tandem without any abnormalities while walking straight. ITGA cases were frequency matched by age and sex to 128 controls with normal (straight and tandem) gait. The groups were compared on quantitative gait (gait velocity, stride length), balance (unipedal stance time, double-support time) and functional measures (Short Physical Performance Battery and 3-step climbing time), applying Bonferroni corrections. RESULTS: 178 out of the 391 participants had tandem gait abnormalities,71 ITGA (mean age 77.9±6.9y, 62% women) and 79 in association with other gait abnormalities. The prevalence of ITGA was 18.2%(95% CI: 14.4-22.0). ITGA cases had worse unipedal stance (20.0 vs. 9.7s, p<0.001) and double-support time (0.33 vs. 0.36s, p=0.002) than controls. There were no significant differences for other gait or functional measures and prevalence of Parkinsonian signs or history of falls. Of the 33 ITGA cases evaluated at the one-year follow-up, 9 (27%) remained ITGA, 12 (36%) developed other gait abnormalities (9 neuropathic, 1 unsteady and 2 Trendlenberg gaits), and 12 (36%) reverted to normal. CONCLUSIONS: ITGA is common in elderly, and is associated with worse balance. Future studies should examine the role of ITGA as a clinical marker of falls and other balance related outcomes in aging. Study Supported by: National Institute on Aging Grant #R01 1R01AG036921-01A1
Disclosure: Dr. Bragin has nothing to disclose. Dr. Nair has nothing to disclose. Dr. Verghese has nothing to disclose.
Wednesday, April 30 2014, 3:00 pm-6:30 pm
- Copyright © 2014 by AAN Enterprises, Inc.
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