Gait Disturbances are Associated with Increased Cognitive Impairment and Cerebrospinal Fluid Tau Levels in a Memory Clinic Cohort.
Gait Disturbances are Associated with Increased Cognitive Impairment and Cerebrospinal Fluid Tau Levels in a Memory Clinic Cohort.
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DOI：
10.3233/jad-200225
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
de Boer C
中科院分区：
文献类型：
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作者：
Muurling M;Rhodius-Meester HFM;Pärkkä J;van Gils M;Frederiksen KS;Bruun M;Hasselbalch SG;Soininen H;Herukka SK;Hallikainen M;Teunissen CE;Visser PJ;Scheltens P;van der Flier WM;Mattila J;Lötjönen J;de Boer C
使用加速度计的步态分析是一种相对便宜且易于使用的方法，可能支持阿尔茨海默病和其他痴呆症的临床诊断。然而，目前尚不清楚哪些步态特征最具信息性，以及这些措施与阿尔茨海默病病理学的关系。在这项研究中，我们测试了步态的计算特征是否1）在认知正常受试者（CN），轻度认知障碍（MCI）患者和痴呆患者之间存在差异，2）与阿尔茨海默病相关的脑脊液（CSF）生物标志物相关，以及3）预测认知下降。步态测量使用三轴加速度计连接到第五腰椎（L5）在58 CN，58 MCI，和26痴呆参与者，同时执行步行和双重任务。从垂直L5加速度计算10个步态特征，主成分分析聚类在四个领域，即步伐，节奏，时间变异性和长度变异性。使用MMSE测量随时间的认知下降，并且在亚组中可获得CSF生物标志物。线性混合模型显示，痴呆患者的步速评分低于MCI患者和CN受试者（p <0.05）。 此外，我们发现节奏域和CSF-tau之间的关联，特别是在双重任务。步态与CSF Aβ42水平和MMSE测量的随时间推移的认知下降无关。这些发现表明，步态-特别是与步伐和节奏相关的措施-在痴呆症中发生改变，并与神经退行性变的措施有直接联系。
Gait analysis with accelerometers is a relatively inexpensive and easy to use method to potentially support clinical diagnoses of Alzheimer’s disease and other dementias. It is not clear, however, which gait features are most informative and how these measures relate to Alzheimer’s disease pathology. In this study, we tested if calculated features of gait 1) differ between cognitively normal subjects (CN), mild cognitive impairment (MCI) patients, and dementia patients, 2) are correlated with cerebrospinal fluid (CSF) biomarkers related to Alzheimer’s disease, and 3) predict cognitive decline. Gait was measured using tri-axial accelerometers attached to the fifth lumbar vertebra (L5) in 58 CN, 58 MCI, and 26 dementia participants, while performing a walk and dual task. Ten gait features were calculated from the vertical L5 accelerations, following principal component analysis clustered in four domains, namely pace, rhythm, time variability, and length variability. Cognitive decline over time was measured using MMSE, and CSF biomarkers were available in a sub-group. Linear mixed models showed that dementia patients had lower pace scores than MCI patients and CN subjects (p < 0.05). In addition, we found associations between the rhythm domain and CSF-tau, especially in the dual task. Gait was not associated with CSF Aβ42 levels and cognitive decline over time as measured with the MMSE. These findings suggest that gait — particularly measures related to pace and rhythm — are altered in dementia and have a direct link with measures of neurodegeneration.