Zeitschrift für Gerontologie und Geriatrie

, Volume 45, Issue 1, pp 40–44 | Cite as

Gangveränderungen als Frühindikator einer Demenz

Beiträge zum Themenschwerpunkt

Zusammenfassung

Gangstörungen treten bei Demenz häufiger auf als im Rahmen des physiologischen Alterungsprozesses. Die Prävalenz dieser demenzassoziierten Gangstörungen hängt dabei vom Demenztyp und vom Schweregrad der kognitiven Beeinträchtigung ab. Während bei der vaskulären Demenz schon im Frühstadium klinisch manifeste Gangstörungen zu beobachten sind, zeigen sich diese bei der Alzheimer-Demenz meist erst im späteren Krankheitsverlauf. Mit modernen Methoden des „brain imaging“ wurde gezeigt, dass an Demenz erkrankte Personen vermehrt auf kortikale Aktivität angewiesen sind, um die Gangstabilität in komplexen Situationen aufrechtzuerhalten. Bei Dysfunktionen des Frontal- oder Temporallappens kann die Allokation dieser Ressourcen nicht mehr ausreichend sein. Klinisch lässt sich dies mithilfe von Dual-Task-Paradigmen überprüfen. Übersteigt die Aufmerksamkeitsanforderung die verfügbare Aufmerksamkeitskapazität, kommt es bei Alzheimer-Patienten auch schon im Frühstadium zu quantitativen Gangveränderungen, wie z. B. einer signifikanten Reduktion der Gehgeschwindigkeit und einer Zunahme der Schrittzeitvariabilität. Dies könnte die frühe Diagnose einer Alzheimer-Erkrankung erleichtern.

Schlüsselwörter

Alzheimer-Krankheit Vaskuläre Demenz Gangstörungen, neurologische Körperbalance Altern 

Gait changes as an early indicator of dementia

Abstract

Gait disorders are more common in dementia than in the context of the physiological aging process. Prevalence of dementia-associated gait disturbances depends on the type of dementia and the severity of cognitive impairment. While in vascular dementia gait abnormalities are often clinically apparent at early disease stages, Alzheimer’s disease patients usually have stable gait until late disease stages. With up-to-date ‘‘brain-imaging” methods, it has been demonstrated that people suffering from dementia are more dependent on cortical activity in order to maintain gait stability in complex situations. When dysfunction of the frontal or temporal lobes occurs, allocation of these resources may no longer be sufficient. Dual-task paradigms are useful to test such resources. It has been shown in early Alzheimer’s disease patients that, if the demand of attention exceeds available capacities, quantitative gait changes occur. Relevant parameters seem to be, e.g., walking speed and stride-time variability. Quantitative assessment of gait dysfunction in dementia may, thus, have the potential to serve as a trait marker.

Keywords

Alzheimer disease Vascular dementia Gait disorders, neurologic Postural balance Aging 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • M. Jamour
    • 1
    • 2
  • C. Becker
    • 2
  • M. Synofzik
    • 2
    • 3
  • W. Maetzler
    • 2
    • 3
  1. 1.Geriatrische Rehabilitationsklinik EhingenEhingenDeutschland
  2. 2.Klinik für Geriatrische RehabilitationRobert-Bosch-Krankenhaus StuttgartStuttgartDeutschland
  3. 3.Abteilung für Neurodegenerative ErkrankungenNeurologische UniversitätsklinikTübingenDeutschland

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