Abstract
BackgroundGait impairments are common in patients with Alzheimer’s disease. Cholinesterase inhibitors are used to treat the symptoms of patients with Alzheimer’s disease, but they have not been shown to reduce the severity of Alzheimer’s disease-related gait disorders.MethodsThis was a prospective, single-arm, open-label, non-randomized study. The aim of the present study was to determine the effect of the acetylcholinesterase inhibitor rivastigmine on gait in 21 newly diagnosed patients with mild to moderate Alzheimer’s disease. The outcome variables were velocity, stride length, and cadence during single-task and dual-task gait trials. The subjects were also assessed with the Mini-Mental State Examination, Alzheimer’s Disease Cooperative Study Activities of Daily Living, Functional Assessment Staging, and Geriatric Depression Scale.ResultsAfter 12 weeks of treatment with rivastigmine, gait velocity was significantly improved in the dual-task gait trials; gait velocity was increased from 40.59 ± 13.59 m/min at baseline to 46.88 ± 12.73 m/min when counting backward from 100 in steps of 7 while walking, and gait velocity was increased from 37.06 ± 15.57 m/min at baseline to 42.03 ± 14.02 m/min when naming animals while walking. In the single-task gait trials, which consisted only of walking at their usual pace or at a fast pace, gait velocity was not increased by rivastigmine administration.ConclusionOur findings indicated that rivastigmine improved gait in subjects with mild to moderate Alzheimer’s disease during dual-task trials. The observed enhancement of dual-task gait might be caused by an improvement of cognitive function rather than motor function.Trial registrationUMIN, UMIN000025869. Registered December 16, 2016, https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000029744
Highlights
Gait impairments are common in patients with Alzheimer’s disease
Adverse events One participant collided with another person while riding a crowded train and fractured his left humerus; he underwent open fusion for the fracture and recovered without sequelae
The present study showed that rivastigmine improved gait velocity under dual-task conditions in subjects with mild to moderate Alzheimer’s disease (AD)
Summary
Gait impairments are common in patients with Alzheimer’s disease. Cholinesterase inhibitors are used to treat the symptoms of patients with Alzheimer’s disease, but they have not been shown to reduce the severity of Alzheimer’s disease-related gait disorders. Alzheimer’s disease (AD) is the most common neurodegenerative disorder and one of the leading causes of death in old age [1]. Gait abnormalities are commonly observed in patients with AD and increase in frequency and severity over time [3]. Gait disorders decrease mobility and increase the risk of falling [4]. The consequences of gait disorders and associated falls can be severe, including fractures, worsening of mobility, loss of independence, and increased cardiovascular morbidity and mortality [5]. The presence of gait abnormalities in AD is important for predicting faster cognitive decline, institutionalization, and death [6]
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