Poor balance predicts Alzheimer's

NewsBot · May 23, 2006

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The BBC are reporting:
Poor balance predicts Alzheimer's

Problems with walking and balance may be the first sign of Alzheimer's disease, say US researchers.
A study of 2,288 elderly people found that such physical symptoms were associated with an increased risk of developing dementia.

Researchers from the University of Washington said they believed that exercise could help to stall the progression of the disease.

Their study appears in Archives of Internal Medicine.

Previous research has suggested that exercise may reduce the risk of Alzheimer's - possibly by boosting blood flow to the brain. Researchers monitored patients every two years for signs of physical and mental decline.

At the start of the study, none of the participants had any sign of dementia but after six years 319 individuals had developed dementia - 221 of them had Alzheimer's disease.

Those with good physical performance scores at the start of the investigation were three times less likely to develop dementia than those with poor scores.

The researchers assessed physical function using a variety of tests.

The first indicators of future dementia appeared to be problems with walking and balance. A weak hand grip was a later sign.

Study leader Dr Eric Larson said: "We were surprised to find that physical changes can precede declines in thinking.

"If confirmed, this study might also help explain the association of physical exercise with a reduced risk of dementia, suggesting that exercise, by improving and maintaining physical function, might benefit cognitive function through a connection between the two."

Exercise

A previous study by Dr Larson had shown that regular exercise reduced the risk of dementia and Alzheimer's disease by up to 40%.

He added: "Physical and mental performance may go hand in hand, and anything you can do to improve one is likely to improve the other."

Harriet Millward, deputy chief executive, Alzheimer's Research Trust said anything that helped to diagnose Alzheimer's at an early age would be useful.

"This is the first study relating dementia to physical function rather than intensity or regularity of exercise.

"It suggests that people who can't do some physical tasks as well may be at higher risk of developing dementia.

"It is too early to say whether some of the tests the researchers used, such as gait or handgrip, might be used to help diagnose Alzheimer's," she added.

Dr Susanne Sorensen, head of research at the Alzheimer's Society said: " "The studies findings are constant with the Alzheimer's Society's message that leading a healthy life may reduce your risk of developing dementia," she added."
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Admin2 · May 23, 2006

Alzheimer's

Related threads:
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Assessment of Gait and Balance

Tuckersm · May 24, 2006

This is the Abstract

Performance-Based Physical Function and Future Dementia in Older People
Li Wang, MS; Eric B. Larson, MD, MPH; James D. Bowen, MD; Gerald van elle, PhD

Background: The association of physical function with progression to dementia has not been well investigated.We aimed to determine whether physical function is associated with incident dementia and Alzheimer disease (AD).

Methods: We performed a prospective cohort study of 2288 persons 65 years and older without dementia. Patients were enrolled from 1994 to 1996 and followed up through October 2003. Main outcome measures included incident dementia and AD.

Results: During follow-up 319 participants developed dementia (221 had AD). The age-specific incidence rate of dementia was 53.1 per 1000 person-years for participants who scored lower on a performance-based physical function test at baseline (<10 points) compared with 17.4 per 1000 person-years for those who scored higher (>10 points). A 1-point lower performance-based physical function score was associated with an increased risk of dementia (hazard ratio, 1.08; 95% confidence interval, 1.03-1.13; P<.001), an ncreased risk of AD (hazard ratio, 1.06; 95% confidence interval, 1.01-1.12; P=.01), and an increased rate of decline in the Cognitive Ability Screening Instrument scores (0.11 point per year; 95% confidence interval, 0.08-0.14; P<.001) after adjusting for age, sex, years of education, baseline cognitive function, APOE ε4 allele, family history of AD, depression, coronary heart disease, and cerebrovascular disease.

Conclusions: Lower levels of physical performance were associated with an increased risk of dementia and AD. The study suggests that poor physical function may precede the onset of dementia and AD and higher levels of physical function may be associated with a delayed onset.

Arch Intern Med. 2006;166:1115-1120
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NewsBot · Feb 4, 2014

A longitudinal study of gait function and characteristics of gait disturbance in individuals with Alzheimer's disease
Ylva Cederval, Kjartan Halvorsen, Anna Cristina Åberg
Gait & Posture; Article in Press

Highlights
•We performed a longitudinal laboratory gait study in people with Alzheimer's disease.
•A simultaneous cognitive task affected gait distinctively, already at baseline.
•The dual-task cost for gait speed reminded stable during the 2-year follow-up period.
•Three main types of common observable dual-task gait disturbances were identified.
•The results give new insight into how dual-tasking affects gait in dementia.
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Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n=21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p<0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.
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