Falls, Cognitive Impairment, and Gait Performance: Results From the GOOD Initiative
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Auteurs : Gilles Allali [États-Unis, Suisse] ; Cyrille P. Launay [France] ; Helena M. Blumen [États-Unis] ; Michele L. Callisaya [Australie] ; Anne-Marie De Cock [Belgique] ; Reto W. Kressig [Suisse] ; Velandai Srikanth [Australie] ; Jean-Paul Steinmetz [Luxembourg (pays)] ; Joe Verghese [États-Unis] ; Olivier Beauchet [Canada, France]Source :
- Journal of the American Medical Directors Association [ 1525-8610 ] ; 2016.
Abstract
Falls are highly prevalent in individuals with cognitive decline. The complex relationship between falls and cognitive decline (including both subtype and severity of dementia) and the influence of gait disorders have not been studied. This study aimed to examine the association between the subtype (Alzheimer disease [AD] versus non-AD) and the severity (from preclinical to moderate dementia) of cognitive impairment and falls, and to establish an association between falls and gait parameters during the course of dementia.
Multicenter cross-sectional study.
“Gait, cOgnitiOn & Decline” (GOOD) initiative.
A total of 2496 older adults (76.6 ± 7.6 years; 55.0% women) were included in this study (1161 cognitively healthy individuals [CHI], 529 patients with mild cognitive impairment [MCI], 456 patients with mild dementia, and 350 with moderate dementia) from 7 countries.
Falls history was collected retrospectively at baseline in each study. Gait speed and stride time variability were recorded at usual walking pace with the GAITRite system.
The prevalence of individuals who fall was 50% in AD and 64% in non-AD; whereas it was 25% in CHIs. Only mild and moderate non-AD dementia were associated with an increased risk for falls in comparison with CHI. Higher stride time variability was associated with falls in older adults without dementia (CHI and each MCI subgroup) and mild non-AD dementia, whereas lower gait speed was associated with falls in all participant groups, except in mild AD dementia. When gait speed was adjusted for, higher stride time variability was associated with falls only in CHIs (odds ratio 1.14;
These findings suggest that non-AD, but not AD dementia, is associated with increased falls in comparison with CHIs. The association between gait parameters and falls also differs across cognitive status, suggesting different mechanisms leading to falls in older individuals with dementia in comparison with CHIs who fall.
Url:
DOI: 10.1016/j.jamda.2016.10.008
PubMed: 27914848
PubMed Central: 5366266
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Kressig</name><affiliation wicri:level="1"><nlm:aff id="A10">University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel</wicri:regionArea></affiliation></author><author><name sortKey="Srikanth, Velandai" sort="Srikanth, Velandai" uniqKey="Srikanth V" first="Velandai" last="Srikanth">Velandai Srikanth</name><affiliation wicri:level="1"><nlm:aff id="A5">Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Menzies Institute of Medical Research, University of Tasmania, Tasmania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A6">Department of Medicine, Peninsula Health, Melbourne, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine, Peninsula Health, Melbourne, Victoria</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">Central Clinical School, Medicine, Monash University, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Central Clinical School, Medicine, Monash University, Victoria</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A12">Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria</wicri:regionArea></affiliation></author><author><name sortKey="Steinmetz, Jean Paul" sort="Steinmetz, Jean Paul" uniqKey="Steinmetz J" first="Jean-Paul" last="Steinmetz">Jean-Paul Steinmetz</name><affiliation wicri:level="1"><nlm:aff id="A13">Centre for Memory and Mobility, Luxembourg city, Luxembourg</nlm:aff><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Centre for Memory and Mobility, Luxembourg city</wicri:regionArea></affiliation></author><author><name sortKey="Verghese, Joe" sort="Verghese, Joe" uniqKey="Verghese J" first="Joe" last="Verghese">Joe Verghese</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation></author><author><name sortKey="Beauchet, Olivier" sort="Beauchet, Olivier" uniqKey="Beauchet O" first="Olivier" last="Beauchet">Olivier Beauchet</name><affiliation wicri:level="1"><nlm:aff id="A14">Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A15">Biomathics, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Biomathics, Paris</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27914848</idno><idno type="pmc">5366266</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366266</idno><idno type="RBID">PMC:5366266</idno><idno type="doi">10.1016/j.jamda.2016.10.008</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">001D69</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D69</idno><idno type="wicri:Area/Pmc/Curation">001C25</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001C25</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Falls, Cognitive Impairment, and Gait Performance: Results From the GOOD Initiative</title><author><name sortKey="Allali, Gilles" sort="Allali, Gilles" uniqKey="Allali G" first="Gilles" last="Allali">Gilles Allali</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neurology, Geneva University Hospital and University of Geneva, Geneva</wicri:regionArea></affiliation></author><author><name sortKey="Launay, Cyrille P" sort="Launay, Cyrille P" uniqKey="Launay C" first="Cyrille P." last="Launay">Cyrille P. Launay</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers</wicri:regionArea></affiliation></author><author><name sortKey="Blumen, Helena M" sort="Blumen, Helena M" uniqKey="Blumen H" first="Helena M." last="Blumen">Helena M. Blumen</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation></author><author><name sortKey="Callisaya, Michele L" sort="Callisaya, Michele L" uniqKey="Callisaya M" first="Michele L." last="Callisaya">Michele L. Callisaya</name><affiliation wicri:level="1"><nlm:aff id="A5">Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Menzies Institute of Medical Research, University of Tasmania, Tasmania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A6">Department of Medicine, Peninsula Health, Melbourne, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine, Peninsula Health, Melbourne, Victoria</wicri:regionArea></affiliation></author><author><name sortKey="De Cock, Anne Marie" sort="De Cock, Anne Marie" uniqKey="De Cock A" first="Anne-Marie" last="De Cock">Anne-Marie De Cock</name><affiliation wicri:level="1"><nlm:aff id="A7">epartment of Geriatric Medicine, General Hospital ST Maarten, Mechelen, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>epartment of Geriatric Medicine, General Hospital ST Maarten, Mechelen</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A8">Department of Geriatrics, University of Antwerp, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Geriatrics, University of Antwerp, Antwerp</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A9">Department of Primary an Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Primary an Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp</wicri:regionArea></affiliation></author><author><name sortKey="Kressig, Reto W" sort="Kressig, Reto W" uniqKey="Kressig R" first="Reto W." last="Kressig">Reto W. Kressig</name><affiliation wicri:level="1"><nlm:aff id="A10">University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel</wicri:regionArea></affiliation></author><author><name sortKey="Srikanth, Velandai" sort="Srikanth, Velandai" uniqKey="Srikanth V" first="Velandai" last="Srikanth">Velandai Srikanth</name><affiliation wicri:level="1"><nlm:aff id="A5">Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Menzies Institute of Medical Research, University of Tasmania, Tasmania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A6">Department of Medicine, Peninsula Health, Melbourne, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine, Peninsula Health, Melbourne, Victoria</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">Central Clinical School, Medicine, Monash University, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Central Clinical School, Medicine, Monash University, Victoria</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A12">Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria</wicri:regionArea></affiliation></author><author><name sortKey="Steinmetz, Jean Paul" sort="Steinmetz, Jean Paul" uniqKey="Steinmetz J" first="Jean-Paul" last="Steinmetz">Jean-Paul Steinmetz</name><affiliation wicri:level="1"><nlm:aff id="A13">Centre for Memory and Mobility, Luxembourg city, Luxembourg</nlm:aff><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Centre for Memory and Mobility, Luxembourg city</wicri:regionArea></affiliation></author><author><name sortKey="Verghese, Joe" sort="Verghese, Joe" uniqKey="Verghese J" first="Joe" last="Verghese">Joe Verghese</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx</wicri:cityArea></affiliation></author><author><name sortKey="Beauchet, Olivier" sort="Beauchet, Olivier" uniqKey="Beauchet O" first="Olivier" last="Beauchet">Olivier Beauchet</name><affiliation wicri:level="1"><nlm:aff id="A14">Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A15">Biomathics, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Biomathics, Paris</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of the American Medical Directors Association</title><idno type="ISSN">1525-8610</idno><idno type="eISSN">1538-9375</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">Falls are highly prevalent in individuals with cognitive decline. The complex relationship between falls and cognitive decline (including both subtype and severity of dementia) and the influence of gait disorders have not been studied. This study aimed to examine the association between the subtype (Alzheimer disease [AD] versus non-AD) and the severity (from preclinical to moderate dementia) of cognitive impairment and falls, and to establish an association between falls and gait parameters during the course of dementia.</p></sec><sec id="S2"><title>Design</title><p id="P2">Multicenter cross-sectional study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">“Gait, cOgnitiOn & Decline” (GOOD) initiative.</p></sec><sec id="S4"><title>Participants</title><p id="P4">A total of 2496 older adults (76.6 ± 7.6 years; 55.0% women) were included in this study (1161 cognitively healthy individuals [CHI], 529 patients with mild cognitive impairment [MCI], 456 patients with mild dementia, and 350 with moderate dementia) from 7 countries.</p></sec><sec id="S5"><title>Measurements</title><p id="P5">Falls history was collected retrospectively at baseline in each study. Gait speed and stride time variability were recorded at usual walking pace with the GAITRite system.</p></sec><sec id="S6"><title>Results</title><p id="P6">The prevalence of individuals who fall was 50% in AD and 64% in non-AD; whereas it was 25% in CHIs. Only mild and moderate non-AD dementia were associated with an increased risk for falls in comparison with CHI. Higher stride time variability was associated with falls in older adults without dementia (CHI and each MCI subgroup) and mild non-AD dementia, whereas lower gait speed was associated with falls in all participant groups, except in mild AD dementia. When gait speed was adjusted for, higher stride time variability was associated with falls only in CHIs (odds ratio 1.14; <italic>P</italic> = .012), but not in MCI or in patients with dementia.</p></sec><sec id="S7"><title>Conclusions</title><p id="P7">These findings suggest that non-AD, but not AD dementia, is associated with increased falls in comparison with CHIs. The association between gait parameters and falls also differs across cognitive status, suggesting different mechanisms leading to falls in older individuals with dementia in comparison with CHIs who fall.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100893243</journal-id><journal-id journal-id-type="pubmed-jr-id">30377</journal-id><journal-id journal-id-type="nlm-ta">J Am Med Dir Assoc</journal-id><journal-id journal-id-type="iso-abbrev">J Am Med Dir Assoc</journal-id><journal-title-group><journal-title>Journal of the American Medical Directors Association</journal-title></journal-title-group><issn pub-type="ppub">1525-8610</issn><issn pub-type="epub">1538-9375</issn></journal-meta><article-meta><article-id pub-id-type="pmid">27914848</article-id><article-id pub-id-type="pmc">5366266</article-id><article-id pub-id-type="doi">10.1016/j.jamda.2016.10.008</article-id><article-id pub-id-type="manuscript">NIHMS843718</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Falls, Cognitive Impairment, and Gait Performance: Results From the GOOD Initiative</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Allali</surname><given-names>Gilles</given-names></name><degrees>MD, PhD</degrees><pmc-comment>gilles.allali@hcuge.ch </pmc-comment>
<xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A2">b</xref><xref rid="FN1" ref-type="author-notes">*</xref></contrib><contrib contrib-type="author"><name><surname>Launay</surname><given-names>Cyrille P.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Blumen</surname><given-names>Helena M.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Callisaya</surname><given-names>Michele L.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A5">e</xref><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>De Cock</surname><given-names>Anne-Marie</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">g</xref><xref ref-type="aff" rid="A8">h</xref><xref ref-type="aff" rid="A9">i</xref></contrib><contrib contrib-type="author"><name><surname>Kressig</surname><given-names>Reto W.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A10">j</xref></contrib><contrib contrib-type="author"><name><surname>Srikanth</surname><given-names>Velandai</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A5">e</xref><xref ref-type="aff" rid="A6">f</xref><xref ref-type="aff" rid="A11">k</xref><xref ref-type="aff" rid="A12">l</xref></contrib><contrib contrib-type="author"><name><surname>Steinmetz</surname><given-names>Jean-Paul</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A13">m</xref></contrib><contrib contrib-type="author"><name><surname>Verghese</surname><given-names>Joe</given-names></name><degrees>MBBS</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Beauchet</surname><given-names>Olivier</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A14">n</xref><xref ref-type="aff" rid="A15">o</xref></contrib><contrib contrib-type="author"><collab>the Biomathics Consortium</collab></contrib></contrib-group><aff id="A1"><label>a</label>Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York</aff><aff id="A2"><label>b</label>Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland</aff><aff id="A3"><label>c</label>Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers, France</aff><aff id="A4"><label>d</label>Department of Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY</aff><aff id="A5"><label>e</label>Menzies Institute of Medical Research, University of Tasmania, Tasmania, Australia</aff><aff id="A6"><label>f</label>Department of Medicine, Peninsula Health, Melbourne, Victoria, Australia</aff><aff id="A7"><label>g</label>epartment of Geriatric Medicine, General Hospital ST Maarten, Mechelen, Belgium</aff><aff id="A8"><label>h</label>Department of Geriatrics, University of Antwerp, Antwerp, Belgium</aff><aff id="A9"><label>i</label>Department of Primary an Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium</aff><aff id="A10"><label>j</label>University Center for Medicine of Aging, Felix Platter Hospital and University of Basel, Basel, Switzerland</aff><aff id="A11"><label>k</label>Central Clinical School, Medicine, Monash University, Victoria, Australia</aff><aff id="A12"><label>l</label>Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia</aff><aff id="A13"><label>m</label>Centre for Memory and Mobility, Luxembourg city, Luxembourg</aff><aff id="A14"><label>n</label>Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada</aff><aff id="A15"><label>o</label>Biomathics, Paris, France</aff><author-notes><corresp id="FN1"><label>*</label>Address correspondence to Gilles Allali, MD, PhD, Department of Neurology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, Geneva 1211, Switzerland</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>20</day><month>1</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>30</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="ppub"><day>01</day><month>4</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>4</month><year>2017</year></pub-date><volume>18</volume><issue>4</issue><fpage>335</fpage><lpage>340</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.jamda.2016.10.008</pmc-comment>
<abstract><sec id="S1"><title>Objectives</title><p id="P1">Falls are highly prevalent in individuals with cognitive decline. The complex relationship between falls and cognitive decline (including both subtype and severity of dementia) and the influence of gait disorders have not been studied. This study aimed to examine the association between the subtype (Alzheimer disease [AD] versus non-AD) and the severity (from preclinical to moderate dementia) of cognitive impairment and falls, and to establish an association between falls and gait parameters during the course of dementia.</p></sec><sec id="S2"><title>Design</title><p id="P2">Multicenter cross-sectional study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">“Gait, cOgnitiOn & Decline” (GOOD) initiative.</p></sec><sec id="S4"><title>Participants</title><p id="P4">A total of 2496 older adults (76.6 ± 7.6 years; 55.0% women) were included in this study (1161 cognitively healthy individuals [CHI], 529 patients with mild cognitive impairment [MCI], 456 patients with mild dementia, and 350 with moderate dementia) from 7 countries.</p></sec><sec id="S5"><title>Measurements</title><p id="P5">Falls history was collected retrospectively at baseline in each study. Gait speed and stride time variability were recorded at usual walking pace with the GAITRite system.</p></sec><sec id="S6"><title>Results</title><p id="P6">The prevalence of individuals who fall was 50% in AD and 64% in non-AD; whereas it was 25% in CHIs. Only mild and moderate non-AD dementia were associated with an increased risk for falls in comparison with CHI. Higher stride time variability was associated with falls in older adults without dementia (CHI and each MCI subgroup) and mild non-AD dementia, whereas lower gait speed was associated with falls in all participant groups, except in mild AD dementia. When gait speed was adjusted for, higher stride time variability was associated with falls only in CHIs (odds ratio 1.14; <italic>P</italic> = .012), but not in MCI or in patients with dementia.</p></sec><sec id="S7"><title>Conclusions</title><p id="P7">These findings suggest that non-AD, but not AD dementia, is associated with increased falls in comparison with CHIs. The association between gait parameters and falls also differs across cognitive status, suggesting different mechanisms leading to falls in older individuals with dementia in comparison with CHIs who fall.</p></sec></abstract><kwd-group><kwd>Falls</kwd><kwd>gait disorders</kwd><kwd>dementia</kwd><kwd>mild cognitive impairment</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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