Diagnostic value of gait speed and "Timed Up and Go" on Alzheimer's disease

Abstract

Objective It is commonly known that gait disturbance is related with Alzheimer's disease (AD) in its late stage. However, recent studies showed that gait disturbance may start in the early stage of AD or even mild cognitive impairment (MCI). This paper aims to explore the correlation of gait speed and Timed Up & Go (TUG) with AD and MCI.  Methods All subjects were examined by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Besides, they were designed to walk in two assigned conditions: single task (free gait) and dual task (walking and counting). The gait parameters of Four-Meter Walk Test (4mWT) and TUG were measured in the two conditions.  Results Forty-two patients with AD, 39 with MCI and 39 control subjects were enrolled in this study. Compared with control group, both single and dual gait speed of MCI and AD groups decreased (MCI single: t = -3.223, P = 0.002; MCI dual: t = -2.476, P = 0.016; AD single: t = -3.793, P = 0.003; AD dual: t = -12.708, P = 0.000). For TUG, compared with control group, both single and dual tasks of MCI and AD groups increased (MCI single: t = 2.831, P = 0.006; MCI dual: t = 4.060, P = 0.000; AD single: t = 3.420, P = 0.001; AD dual: t = 4.259, P = 0.000). As for the comparison between MCI and AD groups, dual gait speed of AD group decreased (t = -8.254, P = 0.000), but there was no significant increase of both single and dual TUG in AD group (single: t = 1.569, P = 0.121; dual: t = 1.904, P = 0.061). Compared with single task, no significant difference existed in dual gait speed of MCI group (t = -1.934, P = 0.057), while dual TUG of MCI group increased (t = 3.693, P = 0.000); dual gait speed of AD group decreased (t = -12.333, P = 0.000), while dual TUG increased significantly (t = 2.584, P = 0.012).  Conclusions Gait disturbance can be found even in early stage of dementia, so gait speed and TUG are reliable parameters for identification of AD, even MCI. Dual TUG increasing is meaningful for both AD and MCI, while dual gait speed shows its great significance in AD.

DOI: 10.3969/j.issn.1672-6731.2015.07.011