阿尔茨海默病进行性步态障碍的回顾性研究

K. Bader, J. Lah, A. Levey, Greg J. Esper, W. Wharton, Joe R. Nocera
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摘要

阿尔茨海默病(AD)和轻度认知障碍(MCI)患者在整个疾病进展过程中步态障碍增加。然而,对早期和晚期AD的步态损伤和进展缺乏了解。此外,AD患者以及MCI患者步态障碍的纵向进展缺乏向AD过渡的信息。了解步态病理学和步态损伤的进展对于实施策略至关重要,这些策略可以限制步态相关跌倒、行动障碍和整体功能下降的高发病率。此外,更好地了解步态损伤的进展可以深入了解疾病的过程。因此,本回顾性研究旨在通过横断面和纵向分析,评估MCI与AD诊断和步态参数之间的关系。横断面研究结果表明,与MCI相比,早期和晚期AD的步态速度明显较慢,步长缩短,双肢支撑时间和步长变异性增加。对于纵向数据,步态评估访视之间的平均时间为561±267天。结果表明,从早期AD组和晚期AD组的初始步态评估(访视1)到后续步态评估(访问2),步态损伤都在增加,从访视1到访视2,MCI患者过渡到AD患者的步态特征显著下降。这些发现很重要,因为它们表明这些人群的步态越来越病态,这表明需要早期干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Retrospective Study of Progressive Gait Impairment in Alzheimer’s Disease
Individuals with Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) have increased gait disturbances throughout disease progression. However, an understanding of gait impairment and progression in early versus late AD is lacking. Further, the longitudinal progression of gait impairment in AD as well as in those with MCI that transition to AD is lacking. Understanding gait pathology and progression of gait impairment is critical for implementation of strategies that could limit the high prevalence of gait related falls, mobility disability and decreased overall function. Further, better understanding of the gait impairment progression may provide insight into disease processes. As such, this retrospective study aimed to evaluate, via cross sectional and longitudinal analyses, the relationship between MCI and AD diagnosis and gait parameters. Cross-sectional findings demonstrate significantly slower gait velocity and decreased step length as well as increased double limb support time and step length variability of both early and late AD when compared to MCI. For the longitudinal data the average time between gait assessment visits was 561 ± 267 days. The results demonstrate increasing gait impairment from intial gait assesement (visit 1) to a follow up gait assessment (visit 2) in both the early AD and late AD groups as well as significant decline in the gait profile from visit 1 to visit 2 in those with MCI that transitioned to having AD. These findings are important as they indicate an increasingly pathological gait profile among these populations suggesting need for early intervention.
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