Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.
Bernard Auvinet, Claude Touzard, François Montestruc and 2 others
PMID 28143497WHAT IT FOUND
When older adults counted backwards while walking, their stride regularity suffered most.
This change helped distinguish peripheral from central gait disorders, but the walking patterns did not match diagnoses or memory scores.
Key findings
01In 103 older adults, dual-task cost differed between pathological subgroups, with the lowest values in musculoskeletal disease and the highest values in mild cognitive impairment and central nervous system disease.
02The gait instability subgroup, defined as feeling unsteady without falls, memory complaints, or obvious gait disorder, included 46 patients.
03Phenotypes based on quartiles of dual-task stride frequency and stride regularity included 30, 47, and 26 patients, and did not differ by MMSE or diagnoses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The cautious gait subgroup had only 8 patients, so comparisons involving that group are unstable. The study was mainly descriptive and did not correct for multiple comparisons, so some significant findings may be chance. Only 77 of 103 patients had brain MRI, because of contraindications or refusal. Cognition was screened only with the Mini Mental State Examination, which may miss executive problems. All participants could walk unaided, so results may not apply to patients who cannot walk independently. The authors say dual-task cost cut-offs are not known and the results need replication and follow-up. Pathological groups were heterogeneous, so dual-task cost could not separate specific central disorders such as mild cognitive impairment, vascular encephalopathy, or Alzheimer's disease.
Declared interests
The supplied text does not report funding or conflicts of interest.
The easy way to misread this
Do not use the motor phenotypes or dual-task cost to diagnose the cause of an older patient's gait disorder. The phenotypes did not match diagnoses or memory scores, and the paper says clinical cut-offs and value still need replication.