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Gait Changes with Anti-Dementia Drugs: A Prospective, Open-Label Study Combining Single and Dual Task Assessments in Patients with Alzheimer’s Disease

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Abstract

Background

No comparison of anti-dementia drugs-related gait changes has been previously conducted combining single and dual task assessments.

Objectives

(1) To quantify and compare gait changes among patients with possible or probable Alzheimer’s disease before and after the use of acetylcholinesterase inhibitors (i.e., donepezil, galantamine, rivastigmine) or memantine, and among controls with possible or probable Alzheimer’s disease using no anti-dementia drugs; and (2) to determine whether gait changes differed between acetylcholinesterase inhibitors and memantine.

Methods

A total of 86 patients with mild-to-moderate possible or probable Alzheimer’s disease were included in this quasi-experimental study (19 patients using acetylcholinesterase inhibitors, 36 patients using memantine and 31 age- and gender-matched patients without anti-dementia drugs). Mean values and coefficient of variation of walking speed and stride time were measured with the GAITRite® system while usual walking and while walking with backward counting.

Results

In single task, patients using memantine had a greater decrease in coefficient of variation of stride time (−2.3 %) compared to those using acetylcholinesterase inhibitors (1.3 %, P = 0.043) and no anti-dementia drugs (1.6 %, P = 0.026). In dual task, patients using acetylcholinesterase inhibitors had a greater decrease in coefficient of variation of stride time (−5.5 %) compared to those using memantine (2.0 %, P = 0.002) and no anti-dementia drugs (4.1 %, P = 0.05).

Conclusions

Our findings showed a double dissociation in the effect of anti-dementia drugs on gait variability in patients with possible or probable Alzheimer’s disease: memantine improves gait variability while single tasking, whereas acetylcholinesterase inhibitors improves gait variability while dual tasking.

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Acknowledgments

We are grateful to the participants for their cooperation.

Disclosure

Conflict of interest Prof. Beauchet: served as an unpaid consultant for Ipsen Pharma company, and serves as an unpaid associate editor for Gériatrie, Psychologie et Neuropsychiatrie du Vieillissement. He has no relevant financial interest in this manuscript. Dr. Annweiler: served as an unpaid consultant for Ipsen Pharma company, and serves as an unpaid associate editor for Gériatrie, Psychologie et Neuropsychiatrie du Vieillissement and for the Journal of Alzheimer’s Disease. He has no relevant financial interest in this manuscript. Dr Launay has no conflicts of interest to disclose. Dr Allali has no conflicts of interest to disclose. Dr Herrmann has no conflicts of interest to disclose.

Authors contribution

Beauchet has full access to the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analyses. Study concept and design: Beauchet and Annweiler. Acquisition of data: Launay, Annweiler and Beauchet. Analysis and interpretation of data: Beauchet, Allali, Herrmann and Launay. Drafting of the manuscript: Beauchet, Annweiler and Allali. Critical revision of the manuscript for important intellectual content: Allali and Launay. Obtained funding: Beauchet Statistical expertise: Herrmann and Beauchet. Administrative, technical, or material support: Beauchet. Study supervision: Annweiler.

Sponsor’s role

The study was financially supported by Lundbeck and Novartis France pharmaceutical companies. The sponsors had no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Division of Geriatric Medicine, Department of Neuroscience, UPRES EA 4638, UNAM, Angers University Hospital, 49933, Angers Cedex 9, France

    Olivier Beauchet, Cyrille P. Launay & Cedric Annweiler

  2. Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland

    Gilles Allali

  3. Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland

    François R. Herrmann

  4. Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada

    Cedric Annweiler

Authors
  1. Olivier Beauchet
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  2. Cyrille P. Launay
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  3. Gilles Allali
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  4. François R. Herrmann
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  5. Cedric Annweiler
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Corresponding author

Correspondence to Olivier Beauchet.

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Beauchet, O., Launay, C.P., Allali, G. et al. Gait Changes with Anti-Dementia Drugs: A Prospective, Open-Label Study Combining Single and Dual Task Assessments in Patients with Alzheimer’s Disease. Drugs Aging 31, 363–372 (2014). https://doi.org/10.1007/s40266-014-0175-3

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  • DOI: https://doi.org/10.1007/s40266-014-0175-3

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