Dement Neurocogn Disord.  2018 Jun;17(2):57-65. 10.12779/dnd.2018.17.2.57.

Gait Patterns in Parkinson's Disease with or without Cognitive Impairment

• Kim SM
• Kim DH
• Yang Y
• Ha SW
• Han JH

• KMID: 2442809
• DOI: http://doi.org/10.12779/dnd.2018.17.2.57

Abstract

BACKGROUND AND PURPOSE
Cognitive and gait disturbance are common symptoms in Parkinson's disease (PD). Although the relationship between cognitive impairment and gait dysfunction in PD has been suggested, specific gait patterns according to cognition are not fully demonstrated yet. Therefore, the aim of this study was to investigate gait patterns in PD patients with or without cognitive impairment.
METHODS
We studied 86 patients at an average of 4.8 years after diagnosis of PD. Cognitive impairment was defined as scoring 1.5 standard deviation below age- and education-specific means on the Korean version of the Mini-Mental State Examination (K-MMSE). Three-dimensional gait analysis was conducted for all patients and quantified gait parameters of temporal-spatial data were used. Relationships among cognition, demographic characteristics, clinical features, and gait pattern were evaluated.
RESULTS
Cognitive impairment was observed in 41 (47.7%) patients. Compared to patients without cognitive impairment, patients with cognitive impairment displayed reduced gait speed, step length, and stride length. Among K-MMSE subcategories, "registration,""attention/calculation," and "visuospatial function" were significantly associated with speed, step length, and stride length. However, age, disease duration, Hoehn-Yahr (HY) stage, or Unified Parkinson's Disease Rating Scale (UPDRS) motor score was not significantly related to any gait analysis parameter.
CONCLUSIONS
Our present study shows that cognitive impairment is associated with slow and short-stepped gait regardless of HY stage or UPDRS motor score, suggesting that cognitive impairment may serve as a surrogate marker of gait disturbance or fall in PD patients.

Keyword

Gait; Parkinson's Disease; Cognitive Impairment

MeSH Terms

Biomarkers
Cognition
Cognition Disorders*
Diagnosis
Gait*
Humans
Parkinson Disease*
Biomarkers

Figure

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  Fig. 1 Spatio-temporal gait parameters.

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