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Balance and gait disorders in a memory clinic population: A prospective observational cross‐sectional study
Author(s) -
Razay George
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.055935
Subject(s) - dementia , medicine , memory clinic , gait , population , normal pressure hydrocephalus , balance (ability) , vascular dementia , physical therapy , lewy body , disease , physical medicine and rehabilitation , pediatrics , environmental health
Background Balance and gait disorders (B&GDs) increase with ageing, but often they are not adequately evaluated and largely go underdiagnosed. We have therefore investigated the prevalence of B&GDs and the underlying diagnosis among patients with memory impairment. Method 410 consecutive patients enrolled between 2010 and 2014 from the Memory Disorders Clinic, Launceston, Tasmania. All patients had a detailed history of memory, balance and gait symptoms including features suggesting dementia. A full examination included the Mini‐Mental State Examination (MMSE) and balance/gait functions by observing the patients standing with their eyes closed, on their toes, and doing the tandem test. All patients had a brain CT scan. Result 218 women and 192 men participated in the study, the median age was 76.5 years (range 32.6‐94.8) and the mean MMSE score was 23.3 (SD 4.9). 214 (52%) had B&GDs of whom, 85 (40%) had mild cognitive impairment (MCI), 25 (12%) had Alzheimer’s disease (AD), 62(29%) had idiopathic normal pressure hydrocephalus (INPH), 11 (5%) had mixed dementia (MD), 10 (5%) had vascular dementia (VD), 9 (4%) had Parkinson’s disease dementia, 2(1%) had Lewy body disease (LBD). 196(48%) didn’t have B&GIs, of whom, 97 (50%) had MCI, 66 (34%) had AD, 13(7%) had MD, 6(3%) had Gertsmann’s syndrome, 4 (2%) had hypogonadism, and 4 (2%) had frontal lobe dementia (FLD). After excluding patients with MCI, patients with B&GDs (n=129); 60 (48%) had INPH, 25 (20%) had AD, 11 (9%) had MD, 10 (8%) had VD, 2 (2%) had LBD. Patients without B&GDs (n=100), 66% had AD, 13% had MD, 1% had VD and 4% had FLD. Conclusion The study shows that B&GDs are common among patients with memory impairment, and highlights the high prevalence of INPH, a condition that could be treated with shunt surgery resulting in improvement of cognitive, balance and gait functioning.