Journal of Neurology

, Volume 252, Issue 3, pp 300–306

Clinical characteristics of elderly patients with a cautious gait of unknown origin

Authors

    • Depts. of Physical Therapy, Neurology and Diagnostic Imaging Sackler Faculty of Medicine Tel-Aviv University
    • Movement Disorders UnitTel-Aviv Sourasky Medical Center
  • T. Herman
    • Depts. of Physical Therapy, Neurology and Diagnostic Imaging Sackler Faculty of Medicine Tel-Aviv University
    • Movement Disorders UnitTel-Aviv Sourasky Medical Center
  • I. I. Reider-Groswasser
    • Section of Neuro-radiologyDept. of Imaging Tel-Aviv Sourasky Medical Center
    • Depts. of Physical Therapy, Neurology and Diagnostic Imaging Sackler Faculty of Medicine Tel-Aviv University
  • T. Gurevich
    • Depts. of Physical Therapy, Neurology and Diagnostic Imaging Sackler Faculty of Medicine Tel-Aviv University
    • Movement Disorders UnitTel-Aviv Sourasky Medical Center
  • J. M. Hausdorff
    • Depts. of Physical Therapy, Neurology and Diagnostic Imaging Sackler Faculty of Medicine Tel-Aviv University
    • Division on AgingHarvard Medical School
    • Movement Disorders UnitTel-Aviv Sourasky Medical Center
ORIGINAL COMMUNICATION

DOI: 10.1007/s00415-005-0641-2

Cite this article as:
Giladi, N., Herman, T., Reider-Groswasser, I.I. et al. J Neurol (2005) 252: 300. doi:10.1007/s00415-005-0641-2

Abstract

Objective

To evaluate and systematically characterize a group of older adults with disturbed gait of unknown origin.

Design

Cross–sectional study.

Setting

Outpatient clinic in a movement disorders unit.

Participants

Twenty–five patients (mean age 78.4 years) with a disturbed gait of unknown origin were compared with twenty–eight age matched ”healthy” controls (mean age 78.2).

Measurement

Detailed medical history, geriatric and neurological assessments.

Results

Patients walked more slowly (P < 0.0001) and with shorter strides (P < 0.0001) compared with controls. Muscle strength was lower, and static and dynamic balance and gait performance were worse among the patients (P < 0.0001). The patients also tended to be more depressed (P < 0.0001),more anxious (P < 0.002), had a greater fear of falling (P < 0.0001) and had lower scores on the Mini–Mental State Examination (P < 0.005). There was no difference in the frequency of cerebellar or pyramidal signs in the two groups. However, neurological testing revealed that extrapyramidal (P < 0.0001) and frontal release signs (P < 0.0001) were more common among the patients. Neuroradiological findings were rare among the patients and they did not explain the changes in gait speed or fear of falling.

Conclusions

Older adults with a disturbed gait of unknown origin appear to share common characteristics. They walk more slowly than “healthy” controls with increased unsteadiness and with excessive fear of falling. The extrapyramidal, frontal lobe, and limbic systems apparently play an important role, to different degrees, in what can be viewed as a multisystem neurodegenerative syndrome clearly different from ”aging.”

Key words

gaitdisequilibriumfear of fallingaging
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Copyright information

© Steinkopff Verlag 2005