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.

Key words: Walking, Alzheimer disease, Cognition disorders

摘要：

目的 初步探讨步速和起立-步行时间在阿尔茨海默病诊断中的价值。方法 采用简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA）评价39 例轻度认知损害（MCI）和42 例阿尔茨海默病（AD）患者认知功能，4 m 步行测验和起立-步行测验分别测定单项任务和负荷任务状态下步速和起立-步行时间。结果 与正常对照组相比，MCI 组和AD 组患者单项任务和负荷任务步速均减慢（MCI单项任务：t = -3.223，P = 0.002；MCI负荷任务：t = -2.476，P = 0.016；AD 单项任务：t = -3.793，P = 0.003；AD 负荷任务：t = -12.708，P = 0.000）；起立-步行时间均延长（MCI 单项任务：t = 2.831，P = 0.006；MCI 负荷任务：t = 4.060，P = 0.000；AD 单项任务：t = 3.420，P = 0.001；AD 负荷任务：t = 4.259，P = 0.000）。其中AD 组仅负荷任务步速低于MCI组（t = -8.254，P = 0.000）。与单项任务相比，MCI 组患者负荷任务起立-步行时间延长（t = 3.693，P = 0.000）；AD 组患者负荷任务步速减慢（t = -12.333，P = 0.000）、起立-步行时间延长（t = 2.584，P = 0.012）。结论 负荷任务状态下起立-步行时间对轻度认知损害和阿尔茨海默病诊断具有重要价值，负荷任务状态下步速对阿尔茨海默病诊断意义重大。

关键词: 步行, 阿尔茨海默病, 认知障碍