Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals: the Taizhou imaging study.

Peixi Li,Weimin Ye,Weijun Tang,Qiang Dong,Qi Yang,Li Jin,Yingzhe Wang,Ding Ding,Ziyu Yuan,Kexun Zhang,Yanfeng Jiang,Min Fan,Mei Cui,Zhen Zhu,Xingdong Chen

doi:10.18632/aging.102779

Abstract

Gait disturbance is considered to be a significant clinical manifestation of cerebral small vessel disease (CSVD). We aimed to investigate the association between different imaging markers of CSVD or total CSVD burden and gait disturbance in a community-dwelling population. In the cross-sectional Taizhou Imaging Study (TIS), 314 participants free of neurological disorders underwent MRI scanning and gait assessment with quantitative wearable devices as well as clinical rating scales. In linear regression, after adjustment for demographics and vascular risks, total CSVD burden was associated with prolonged 3-m walking (β=0.118, P=0.035), shorter stride length (β=-0.106, P=0.042), and poorer Timed-Up-and-Go (TUG) performance (β=0.146, P=0.009). Lacunes were positively associated with 3-m walking (β=0.118, P=0.037) and duration of TUG test (β=0.112, P=0.047). White matter hyperintensities and cerebral microbleeds were associated with prolonged stride time (β=0.134, P=0.024) and increased stance phase time percentage (β=0.115, P=0.038), respectively. Logistic regression revealed that participants with high CSVD burden or more lacunes were more likely to have an impaired gait velocity and an impaired TUG test. These results suggest that total CSVD burden and CSVD imaging markers are associated with gait disturbance among community-dwelling elderly people. Different CSVD imaging markers may cause gait disturbance through different pathways.

Highlights

Gait disturbance is among the major causes of chronic disability in elderly populations [1] and can lead to consequences limited to falls, and including loss of independence and shortening of life [2]
Cerebral small vessel disease (CSVD), which is characterized by neuroimaging features including recent small subcortical infarcts, lacunes, white matter hyperintensities (WMH), perivascular spaces (PVS), cerebral microbleeds (CMBs) and brain atrophy, has been widely considered as one of the most important vascular causes of gait disturbance [4]
Some previous studies have demonstrated that WMH [5,6,7,8,9], lacunes [8, 10] and CMBs [11] were associated with gait disturbance, but other studies found that lacunes [5, 7, 9], CMBs [5, 7, 9] and PVS [7, 9] were not associated with motor performance

Summary

Introduction

Gait disturbance is among the major causes of chronic disability in elderly populations [1] and can lead to consequences limited to falls, and including loss of independence and shortening of life [2]. Cerebral small vessel disease (CSVD), which is characterized by neuroimaging features including recent small subcortical infarcts, lacunes, white matter hyperintensities (WMH), perivascular spaces (PVS), cerebral microbleeds (CMBs) and brain atrophy, has been widely considered as one of the most important vascular causes of gait disturbance [4]. Recent studies have demonstrated that the total CSVD burden might better capture the overall effect of CSVD on cognitive function [13, 14], but the relationship between total CSVD burden and gait pattern in independently living elderly people is still unknown

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Results