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Gangstörungen und Stürze

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Neurogeriatrie

Zusammenfassung

Gangstörungen und Sturzgefahr können die Mobilität und die Lebensqualität entscheidend vermindern und führen durch Immobilisierung zu zunehmender Einschränkung. Von neurogeriatrischem Interesse ist, dass pathologische Gangmuster oft auf neurologischen Erkrankungen basieren, die diagnostizierbar sind und dadurch teilweise einer Behandlung zugänglich werden. Eine „senile Gangstörung“ sollte keinesfalls als natürliche Folge des Alters angesehen werden, sondern zum Anlass für spezifische Diagnostik genommen werden. Die Gefahr, sich im Alter durch einen Sturz erheblich zu verletzen, ist hoch. Daher werden in dem Artikel Strategien zur Bestimmung der Sturzgefahr aufgeführt und eine konsequente Evaluation der Risikofaktoren vorgeschlagen.

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Literatur

  • Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB (2009) Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001–2004. Arch Intern Med 169(10):938–944

    Google Scholar 

  • American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults (2014) Recommendations abstracted from the American Geriatrics Society Consensus statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 62:147–152

    Google Scholar 

  • Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291(16):1999–2006

    Google Scholar 

  • Bloem BR, Haan J, Lagaay AM, Beek W van, Wintzen AR, Roos RA (1992) Investigation of gait in elderly subjects over 88 years of age. J Geriatr Psychiatry Neurol 5(2):78–84

    Google Scholar 

  • Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM (1999) Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc 47(7):850–853

    Google Scholar 

  • Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, Tylavsky FA, Brach JS, Satterfield S, Bauer DC, Visser M, Rubin SM, Harris TB, Pahor M (2005) Prognostic value of usual gait speed in well-functioning older people–results from the Health, Aging and Body Composition Study. J Am Geriatr Soc 53(10):1675–1680

    Google Scholar 

  • Crispo JA, Willis AW, Thibault DP, Fortin Y, Hays HD, McNair DS, Bjerre LM, Kohen DE, Perez-Lloret S, Mattison DR, Krewski D (2016) Associations between Anticholinergic Burden and Adverse Health Outcomes in Parkinson Disease. PLoS One 11(3):e0150621

    Google Scholar 

  • Di Rosa M, Hausdorff JM, Stara V, Rossi L, Glynn L, Casey M, Burkard S, Cherubini A (2017) Concurrent validation of an index to estimate fall risk in community dwelling seniors through a wireless sensor insole system: A pilot study. Gait Posture 55:6–11

    Google Scholar 

  • Dietz V (2013) Clinical treatment of spasticity–spastic movement disorders. Nervenarzt 84(12):1508–1511

    Google Scholar 

  • Dijk PT van, Meulenberg OG, Sande HJ van de, Habbema JD (1993) Falls in dementia patients. Gerontologist 33(2):200–204

    Google Scholar 

  • Ebersbach G, Grust U, Ebersbach A, Wegner B, Gandor F, Kuhn AA (2015) Erratum to: amplitude-oriented exercise in Parkinson’s disease: a randomized study comparing LSVT-BIG and a short training protocol. J Neural Transm (Vienna) 122(2):257

    Google Scholar 

  • Espay AJ, Da Prat GA, Dwivedi AK, Rodriguez-Porcel F, Vaughan JE, Rosso M, Devoto JL, Duker AP, Masellis M, Smith CD, Mandybur GT, Merola A, Lang AE (2017) Deconstructing normal pressure hydrocephalus: Ventriculomegaly as early sign of neurodegeneration. Ann Neurol 82(4):503–513

    Google Scholar 

  • Farley BG, Koshland GF (2005) Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp Brain Res 167(3):462–467

    Google Scholar 

  • Fielding RA, Guralnik JM, King AC, Pahor M, McDermott MM, Tudor-Locke C, Manini TM, Glynn NW, Marsh AP, Axtell RS, Hsu FC, Rejeski WJ, group Ls (2017) Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: results from the LIFE study randomized trial. PLoS One 12(8):e0182155

    Google Scholar 

  • Fietzek UM, Schroeteler FE, Ziegler K, Zwosta J, Ceballos-Baumann AO (2014) Randomized cross-over trial to investigate the efficacy of a two-week physiotherapy programme with repetitive exercises of cueing to reduce the severity of freezing of gait in patients with Parkinson’s disease. Clin Rehabil 28(9):902–911

    Google Scholar 

  • Foss AJ, Harwood RH, Osborn F, Gregson RM, Zaman A, Masud T (2006) Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial. Age Ageing 35(1):66–71

    Google Scholar 

  • Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21(2):69–72

    Google Scholar 

  • Grisso JA, Schwarz DF, Wolfson V, Polansky M, LaPann K (1992) The impact of falls in an inner-city elderly African-American population. J Am Geriatr Soc 40(7):673–678

    Google Scholar 

  • Harwood RH, Foss AJ, Osborn F, Gregson RM, Zaman A, Masud T (2005) Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. Br J Ophthalmol 89(1):53–59

    Google Scholar 

  • Henderson EJ, Lord SR, Brodie MA, Gaunt DM, Lawrence AD, Close JC, Whone AL, Ben-Shlomo Y (2016) Rivastigmine for gait stability in patients with Parkinson’s disease (ReSPonD): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol 15(3):249–258

    Google Scholar 

  • Holt S, Schmiedl S, Thürmann PA (2010) Potentiell inadaequate Medikation für ältere Menschen: Die PRICUS-Liste. Dt Ärztebl 107(31–32):534–551

    Google Scholar 

  • Jacobs AH (2018) Alterspharmakologie. Auf dem Weg zur weisen Therapieentscheidung. Arzneimitteltherapie (4):117–118

    Google Scholar 

  • Jöbges M, Heuschkel G, Pretzel C, Illhardt C, Renner C, Hummelsheim H (2004) Repetitive training of compensatory steps: a therapeutic approach for postural instability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 75(12):1682–1687

    Google Scholar 

  • Kenny RA, Richardson DA, Steen N, Bexton RS, Shaw FE, Bond J (2001) Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE). J Am Coll Cardiol 38(5):1491–1496

    Google Scholar 

  • Krafczyk S, Tietze S, Swoboda W, Valkovic P, Brandt T (2006) Artificial neural network: a new diagnostic posturographic tool for disorders of stance. Clin Neurophysiol 117(8):1692–1698

    Google Scholar 

  • Laufer Y, Hausdorff JM, Ring H (2009) Effects of a foot drop neuroprosthesis on functional abilities, social participation, and gait velocity. Am J Phys Med Rehabil 88(1):14–20

    Google Scholar 

  • Leipzig RM, Cumming RG, Tinetti ME (1999a) Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 47(1):30–39

    Google Scholar 

  • Leipzig RM, Cumming RG, Tinetti ME (1999b) Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 47(1):40–50

    Google Scholar 

  • Lundin-Olsson L, Nyberg L, Gustafson Y (1997) “Stops walking when talking” as a predictor of falls in elderly people. Lancet 349(9052):617

    Google Scholar 

  • Miskin N, Patel H, Franceschi AM, Ades-Aron B, Le A, Damadian BE, Stanton C, Serulle Y, Golomb J, Gonen O, Rusinek H, George AE, Alzheimer’s Disease Neuroimaging I (2017) Diagnosis of normal-pressure hydrocephalus: use of traditional measures in the era of volumetric mr imaging. Radiology 285(1):197–205

    Google Scholar 

  • Montero-Odasso M, Muir-Hunter SW, Oteng-Amoako A, Gopaul K, Islam A, Borrie M, Wells J, Speechley M (2015) Donepezil improves gait performance in older adults with mild Alzheimer’s disease: a phase II clinical trial. J Alzheimers Dis 43(1):193–199

    Google Scholar 

  • Nakagawa HB, Ferraresi JR, Prata MG, Scheicher ME (2017) Postural balance and functional independence of elderly people according to gender and age: cross-sectional study. Sao Paulo Med J 135(3):260–265

    Google Scholar 

  • Nikolaus T, Bach M (2003) Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. J Am Geriatr Soc 51(3):300–305

    Google Scholar 

  • Panel of Prevention of Falls American Geriatric Society (2011) Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 59(1):148–157

    Google Scholar 

  • Perez-Ros P, Martinez-Arnau FM, Malafarina V, Tarazona-Santabalbina FJ (2016) A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: a before-after non-randomised intervention study. Maturitas 94:155–160

    Google Scholar 

  • Plate A, Klein K, Pelykh O, Singh A, Bötzel K (2016) Anticipatory postural adjustments are unaffected by age and are not absent in patients with the freezing of gait phenomenon. Exp Brain Res 234(9):2609–2618

    Google Scholar 

  • Porthouse J, Cockayne S, King C, Saxon L, Steele E, Aspray T, Baverstock M, Birks Y, Dumville J, Francis R, Iglesias C, Puffer S, Sutcliffe A, Watt I, Torgerson DJ (2005) Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 330(7498):1003

    Google Scholar 

  • Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, Sims-Gould J, Loughin M (2013) Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. The Lancet 381(9860):47–54

    Google Scholar 

  • Rubenstein LZ (2006) Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 35(2):ii37–ii41

    Google Scholar 

  • Schniepp R, Strupp M, Wuehr M, Jahn K, Dieterich M, Brandt T, Feil K (2016) Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series. Cerebellum Ataxias 3:8

    Google Scholar 

  • Schniepp R, Trabold R, Romagna A, Akrami F, Hesselbarth K, Wuehr M, Peraud A, Brandt T, Dieterich M, Jahn K (2017) Walking assessment after lumbar puncture in normal-pressure hydrocephalus: a delayed improvement over 3 days. J Neurosurg 126(1):148–157

    Google Scholar 

  • Schooten KS van, Pijnappels M, Rispens SM, Elders PJ, Lips P, Daffertshofer A, Beek PJ, Dieen JH van (2016) Daily-life gait quality as predictor of falls in older people: A 1-year prospective cohort study. PLoS One 11(7):e0158623

    Google Scholar 

  • Shah KN, Lin FV, Yu F, McMahon JM (2017) Activity engagement and physical function in old age sample. Arch Gerontol Geriatr 69:55–60

    Google Scholar 

  • Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, Kenny RA (2003) Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ 326(7380):73

    Google Scholar 

  • Snijders AH, Warrenburg BP van de, Giladi N, Bloem BR (2007) Neurological gait disorders in elderly people: clinical approach and classification. Lancet Neurol 6(1):63–74

    Google Scholar 

  • Strupp M, Teufel J, Zwergal A, Schniepp R, Khodakhah K, Feil K (2017) Aminopyridines for the treatment of neurologic disorders. Neurol Clin Pract 7(1):65–76

    Google Scholar 

  • Sudarsky L (2001) Gait disorders: prevalence, morbidity, and etiology. Adv Neurol 87:111–117

    Google Scholar 

  • Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707

    Google Scholar 

  • Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, Koch ML, Trainor K, Horwitz RI (1994) A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 331(13):821–827

    Google Scholar 

  • Velde N van der, Stricker BH, Pols HA, Cammen TJ van der (2007) Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol 63(2):232–237

    Google Scholar 

  • Viccaro LJ, Perera S, Studenski SA (2011) Is timed up and go better than gait speed in predicting health, function, and falls in older adults? J Am Geriatr Soc 59(5):887–892

    Google Scholar 

  • Warren M, Ganley KJ, Pohl PS (2016) The association between social participation and lower extremity muscle strength, balance, and gait speed in US adults. Prev Med Rep 4:142–147

    Google Scholar 

  • Whitney J, Jackson SHD, Martin FC (2017) Feasibility and efficacy of a multi-factorial intervention to prevent falls in older adults with cognitive impairment living in residential care (ProF-Cog). BMC Geriatr 2017(17):115

    Google Scholar 

  • Yen TH, Lin LF, Wei TS, Chang KH, Wang YH, Liou TH (2014) Delphi-based assessment of fall-related risk factors in acute rehabilitation settings according to the International Classification of Functioning, Disability and Health. Arch Phys Med Rehabil 95(1):50–57

    Google Scholar 

  • Zieschang T, Schwenk M, Becker C, Uhlmann L, Oster P, Hauer K (2017) Falls and physical activity in persons with mild to moderate dementia participating in an intensive motor training: randomized controlled trial. Alzheimer Dis Assoc Disord 31(4):307–314

    Google Scholar 

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Authors and Affiliations

  1. Neurologische Uniklinik, Ludwig-Maximilians-Universität München Klinikum Großhadern, München, Deutschland

    Kai Bötzel

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  1. Kai Bötzel
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Editors and Affiliations

  1. Klinik für Neurologie, UKSH, Campus Kiel, Kiel, Germany

    Walter Maetzler

  2. Lehrstuhl für Geriatrie, Universitätsklinikum Essen, Geriatriezentrum Haus Berge, Contilia Group, Essen, Germany

    Richard Dodel

  3. Klinik für Geriatrie mit Neurologie, Johanniter Krankenhaus Bonn, Bonn, Germany

    Andreas H. Jacobs

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Bötzel, K. (2019). Gangstörungen und Stürze. In: Maetzler, W., Dodel, R., Jacobs, A. (eds) Neurogeriatrie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57358-7_9

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  • DOI: https://doi.org/10.1007/978-3-662-57358-7_9

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