Abstract
BackgroundAlthough gait disorders are common in the elderly, the prevalence and overall burden of these disorders in the general community is not well defined.MethodsIn a cross-sectional investigation of the population-based Bruneck Study cohort, 488 community-residing elderly aged 60–97 years underwent a thorough neurological assessment including a standardized gait evaluation. Gait disorders were classified according to an accepted scheme and their associations to falls, neuropsychological measures, and quality of life were explored.ResultsOverall, 32.2% (95% confidence interval [CI] 28.2%–36.4%) of participants presented with impaired gait. Prevalence increased with age (p<0.001), but 38.3% (95%CI 30.1%–47.3%) of the subjects aged 80 years or older still had a normally preserved gait. A total of 24.0% (95%CI 20.4%–28.0%) manifested neurological gait disorders, 17.4% (14.3%–21.0%) non-neurological gait problems, and 9.2% (6.9%–12.1%) a combination of both. While there was no association of neurological gait disorders with gender, non-neurological gait disorders were more frequent in women (p = 0.012). Within the group of neurological gait disorders 69.2% (95%CI 60.3%–76.9%) had a single distinct entity and 30.8% (23.1%–39.7%) had multiple neurological causes for gait impairment. Gait disorders had a significant negative impact on quantitative gait measures, but only neurological gait disorders were associated with recurrent falls (odds ratio 3.3; 95%CI 1.4–7.5; p = 0.005 for single and 7.1; 2.7–18.7; p<0.001 for multiple neurological gait disorders). Finally, we detected a significant association of gait disorders, in particular neurological gait disorders, with depressed mood, cognitive dysfunction, and compromised quality of life.ConclusionsGait disorders are common in the general elderly population and are associated with reduced mobility. Neurological gait disorders in particular are associated with recurrent falls, lower cognitive function, depressed mood, and diminished quality of life.
Highlights
Gait disturbances and subsequent falls are among the major causes of chronic disability in the elderly population and, being a common condition, so far have been subject to relatively few studies assessing overall frequency and clinical characteristics in community-based samples [1,2]
Suggestions to classify gait abnormalities include syndromic approaches based upon the phenomenological features of gait and associated signs and symptoms [2,3,4,5] as well as etiological approaches asking for the neurological cause underlying the respective gait abnormality
We performed specific investigations in the cohort of the ongoing population-based Bruneck Study [9,10,11].Our aims were to assess 1. the prevalence of neurological and non-neurological gait disorders according to a well-defined classification system accounting for sex differences and age trends, 2. the clinical types of gait disorders and their respective severity assessed by quantitative gait measures, 3. the frequency of falls and their association to different types of gait disorders, 4. the association of gait disorders and falls to anxiety, depression, and cognitive decline, and 5. the impact of gait disorders on quality of life
Summary
Gait disturbances and subsequent falls are among the major causes of chronic disability in the elderly population and, being a common condition, so far have been subject to relatively few studies assessing overall frequency and clinical characteristics in community-based samples [1,2]. Using a syndromic classification only, three studies involving samples from the Einstein Aging Study cohort found 16% to 20% of participants aged over 70-years suffering from neurological gait disorders [2,4,8]. These were community-based samples and not recruited as representative population samples [8]. Gait disorders are common in the elderly, the prevalence and overall burden of these disorders in the general community is not well defined
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