Do Alzheimer's and Lewy body disease have discrete pathological signatures of gait?

[adambeyoncelowe]

Thought this was relevant since @Jonathan Edwards has mentioned gait as a possible diagnostic tool in ME.

Objective
We aimed to refine the hypothesis that dementia has a unique signature of gait impairment reflective of underlying pathology by considering two dementia subtypes, Alzheimer's disease (AD) and Lewy body disease (LBD), and exploring the role of cognition in disease-specific gait impairments.

Background
Accurately differentiating AD and LBD is important for treatment and disease management.

Early evidence suggests gait could be a marker of dementia due to associations between discrete gait characteristics and cognitive domains.

Updated Hypothesis
We hypothesize that AD and LBD have unique signatures of gait, reflecting disease-specific cognitive profiles and underlying pathologies.

An exploratory study included individuals with mild cognitive impairment or dementia due to LBD (n = 45) and AD (n = 36) and 29 older adult controls.

An instrumented walkway quantified 16 gait characteristics reflecting five independent domains of locomotion (pace, rhythm, variability, asymmetry, and postural control).

The LBD group demonstrated greater impairments in asymmetry and variability compared with AD; both groups were more impaired in pace and variability domains than controls.

Executive dysfunction explained 11% of variance for gait variability in LBD, whereas global cognitive impairment explained 13.5% of variance in AD; therefore, gait impairments may reflect disease-specific cognitive profiles.

With a refined hypothesis that AD- and LBD-specific signatures of gait reflect discrete pathologies, future studies must examine the relationship between a validated model of gait with neural networks, using recognized biomarkers and postmortem follow-up.

Link: https://www.alzheimersanddementia.com/article/S1552-5260(19)35120-9/fulltext

 

[Amw66]

Thanks Andy this is interesting. My father in law has been diagnosed wih LBD which was explained as dementia with Parkinsonian traits.

Gait is one of the first obvious physical impacts. It is variable, notably shorter and " shuffle-y" and a stick is needed to steady , though stamina is good.

It would have been interesting if the walk test had included steps - these demand a huge co-ordination effort which is plainly evident - it looks similar to when my daughter has overdone it and says she feels like a baby looking at her limbs and having to really concentrate to place them in space where she wants them to go. It is as if depth of field perception doesn't work.