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Anti-Dementia Drugs, Gait Performance and Mental Imagery of Gait: A Non-Randomized Open-Label Trial

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Abstract

Background

Few studies have examined the effect of anti-dementia drugs (i.e., acetylcholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists) on gait performance. Past studies have focused on the stride time (i.e., gait cycle duration) but not on the mental imagery of gait.

Objectives

To compare mental imagery of gait and spatiotemporal gait parameters in patients with dementia [i.e., Alzheimer’s disease (AD) and non-AD] before and after the use of anti-dementia drugs (i.e., acetylcholinesterase inhibitors and memantine) and in controls (i.e., patients with dementia who did not take anti-dementia drugs).

Methods

A total of 112 patients (mean age 82.5 ± 4.2 years, 68.8 % female) with mild-to-moderate AD and non-AD dementia were included in this non-randomized open-label trial (n = 56 in the Intervention group, and n = 56 in the Control group matched for age, sex, and stage and type of dementia) nested in a cohort study (mean follow-up 238.5 ± 79.8 days). Mental imagery of gait was assessed with the actual and imagined Timed Up and Go tests (aTUG and iTUG) and the difference between aTUG and iTUG (i.e., delta-TUG). Spatiotemporal gait parameters were measured with the GAITRite® system during normal walking.

Results

Participants in the Intervention group had a longer iTUG time (p < 0.001) and a lower delta-TUG value (p = 0.001) at the follow-up compared with those in the Control group. There was a significant increase in iTUG (p = 0.001) and decrease in delta-TUG (p < 0.001) from baseline to the follow-up only in the Intervention group. Multiple linear regression showed that the use of anti-dementia drugs was associated with a longer iTUG time and a lower delta-TUG value (best performance, p < 0.002).

Conclusions

Our findings showed an improvement in mental imagery of gait with the use of anti-dementia drugs, but no changes in actual gait performance.

Trial registration

NCT01315704.

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Acknowledgments

The authors are grateful to the participants for their cooperation. Dr. Beauchet had 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: Drs. Beauchet and Allali. Acquisition of data: Drs. Beauchet and Annweiler. Analysis and interpretation of data: Drs. Beauchet and Allali. Drafting of the manuscript: Drs. Beauchet and Allali. Critical revision of the manuscript for important intellectual content: Drs. Annweiler, Barden, Liu-Ambrose, Chester, Szturm, Grenier, Léonard, and Bherer. Statistical expertise: Dr. Beauchet. Administrative, technical, or material support: Drs. Beauchet and Annweiler. Study supervision: Drs. Beauchet and Allali.

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada

    Olivier Beauchet

  2. Faculty of Medicine, McGill University, Montreal, QC, Canada

    Olivier Beauchet

  3. Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, QC, Canada

    Olivier Beauchet

  4. Faculty of Kinesiology and Health Studies, Neuromechanical Research Centre, University of Regina, Regina, SK, Canada

    John Barden

  5. Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, BC, Canada

    Teresa Liu-Ambrose

  6. Andrew and Marjorie McCain Human Performance Laboratory, Faculty of Kinesiology, Richard J. Currie Center, University of New Brunswick, Fredericton, NB, Canada

    Victoria L. Chester

  7. Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France

    Cedric Annweiler

  8. University Memory Clinic of Angers, Angers, France

    Cedric Annweiler

  9. UPRES EA 4638, University of Angers, UNAM, Angers, France

    Cedric Annweiler

  10. Department of Medical Biophysics, Center for Functional and Metabolic Mapping, Schulich School of Medicine and Dentistry, Robarts Research Institute, University of Western Ontario, London, ON, Canada

    Cedric Annweiler

  11. Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada

    Tony Szturm

  12. Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QC, Canada

    Sébastien Grenier

  13. Institut universitaire de gériatrie de Sherbrooke (IUGS), Montréal, QC, Canada

    Guillaume Léonard

  14. PERFORM Centre and Department of Psychology, Concordia University, Montreal, QC, Canada

    Louis Bherer

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

    Gilles Allali

Authors
  1. Olivier Beauchet
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  2. John Barden
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  4. Victoria L. Chester
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  8. Guillaume Léonard
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  9. Louis Bherer
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  10. Gilles Allali
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Consortia

Canadian Gait Consortium

Corresponding author

Correspondence to Olivier Beauchet.

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Funding

No funding was received for the preparation of this manuscript.

Conflict of interest

Drs. Beauchet, Barden, Liu-Ambrose, Chester, Annweiler, Szturm, Grenier, Léonard, Louis Bherer, and Allali confirm that they have no conflict of interest.

Ethics approval and consent to participate

The study was conducted in accordance with the ethical standards set forth in the Helsinki Declaration (1983). The local ethical committee of Angers, France approved the study protocol. Informed consent for participation in the study was obtained from all participants. The trial registration number is NCT01315704.

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Beauchet, O., Barden, J., Liu-Ambrose, T. et al. Anti-Dementia Drugs, Gait Performance and Mental Imagery of Gait: A Non-Randomized Open-Label Trial. Drugs Aging 33, 665–673 (2016). https://doi.org/10.1007/s40266-016-0391-0

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  • DOI: https://doi.org/10.1007/s40266-016-0391-0

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