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J Am Med Dir Assoc. 2016 Jun 1;17(6):482-90. doi: 10.1016/j.jamda.2015.12.092. Epub 2016 Feb 4.

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis.

Author information

1
Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis, Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Center of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Quebec, Canada. Electronic address: olivier.beauchet@mcgill.ca.
2
Division of Geriatrics, Department of Neuroscience, Angers University Hospital, Angers, France.
3
Menzies Institute of Medical Research, University of Tasmania, Hobart, Australia; Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Victoria, Australia.
4
Department of Geriatrics and Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp and AZ St Maarten Mechelen, Antwerp, Belgium.
5
Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
6
Department University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel, Switzerland.
7
Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Victoria, Australia.
8
Center for Memory and Mobility (CeM(2)), Luxembourg City, Luxembourg.
9
Division of Cognitive and Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY.
10
Division of Cognitive and Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY; Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Abstract

BACKGROUND:

Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia.

METHODS:

An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms "Gait" OR "Gait Disorders, Neurologic" OR "Gait Apraxia" OR "Gait Ataxia" AND "Dementia" OR "Frontotemporal Dementia" OR "Dementia, Multi-Infarct" OR "Dementia, Vascular" OR "Alzheimer Disease" OR "Lewy Body Disease" OR "Frontotemporal Dementia With Motor Neuron Disease" (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values.

RESULTS:

Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P < .001 for any dementia, pooled HR = 1.79 with P < .001 for VaD, HR = 1.89 with P value < .001 for non-AD]. Findings were weaker for predicting AD (HR = 1.03 with P value = .004).

CONCLUSIONS:

This meta-analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD.

KEYWORDS:

Epidemiology; dementia; gait disorders/ataxia; motor control

PMID:
26852960
PMCID:
PMC5319598
DOI:
10.1016/j.jamda.2015.12.092
[Indexed for MEDLINE]
Free PMC Article

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