Abstract
BackgroundOur primary objective was to determine the relationship between global cognitive function and specific domains of gait and balance in a cohort of Parkinson’s disease (PD) subjects. In a secondary analysis, we determined whether specific cognitive domains correlated with gait and balance performance.MethodsFourteen PD subjects (mean age 61.1 ± 7.8 years) were recruited from the Rush University Medical Center Movement Disorders clinic. Subjects underwent clinical assessment using the motor subsection of the Unified Parkinson’s Disease Rating Scale (UPDRS) followed by quantitative gait and balance assessments using the APDM Mobility Lab™ system (Mobility Lab, APDM Inc., Portland, OR). Subjects completed global cognitive testing using the Mattis Dementia Rating Scale (MDRS) as well as domain specific cognitive measures. Spearman’s rho was used to assess correlations between cognitive measures and gait and balance function, with False Discovery Rate (FDR) correction for multiple comparisons.ResultsGlobal cognitive function had the strongest correlation with stride velocity (r = 0.816, p = 0.001), turn duration (r = −0.806, p = 0.001), number of steps to turn (r = −0.830, p = 0.001), and mean velocity of postural sway in the medio-lateral direction (r = −0.726, p = 0.005). A significant correlation was found between processing speed and two turning measures (turn duration, r = −0.884, p = 0.001; number of steps to turn, r = −0.954, p < 0.001), but no other associations were found between specific cognitive domains and gait domains.ConclusionsThis pilot study provides preliminary data regarding the association between global cognitive function and pace-related measures of gait, turning, and postural sway. Furthermore, reduced processing speed was found to be associated with difficulty in performing turns.
Highlights
Our primary objective was to determine the relationship between global cognitive function and specific domains of gait and balance in a cohort of Parkinson’s disease (PD) subjects
* Correspondence: gian_d_pal@rush.edu; Gian_Pal@rush.edu 1Department of Neurological Sciences, Rush University, Chicago, IL, USA 3Rush University Medical Center, 1725 West Harrison Street, Suite 755, Chicago, IL 60612, USA Full list of author information is available at the end of the article. Clinical rating scales, such as the Unified Parkinson’s disease Rating Scale (UPDRS) [8], and measures derived from such scales, such as the postural instability/gait disturbance (PIGD) score, have been used to examine the relationship between cognitive and motor impairment [9]
The mean Mattis Dementia Rating Scale (MDRS) Total score was 132.2 ± 8.3, indicating that subjects varied between largely intact cognition and mild cognitive impairment
Summary
Our primary objective was to determine the relationship between global cognitive function and specific domains of gait and balance in a cohort of Parkinson’s disease (PD) subjects. Especially prefrontal lobe dysfunction, has been linked to motor disability in PD but these relationships remain unclear [5,6,7] Clinical rating scales, such as the Unified Parkinson’s disease Rating Scale (UPDRS) [8], and measures derived from such scales, such as the postural instability/gait disturbance (PIGD) score, have been used to examine the relationship between cognitive and motor impairment [9]. These clinical scales are subject to rater judgment and provide only limited detail because the ordinal fixed scores (0–4) force raters into a limited number of item choices without the ability to quantify disease impairment or disability as continuous measures. These clinical scales have had limited ability to elucidate the relationship between cognition and gait and balance [10]
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