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Gait predicts decline in attention over three years in an incident cohort of Parkinson’s disease

Morris, R., Bunce, J., Lord, S., Galna, B.ORCID: 0000-0002-5890-1894, Burn, D. and Rochester, L. (2015) Gait predicts decline in attention over three years in an incident cohort of Parkinson’s disease. In: 19th International Congress of Parkinson's Disease and Movement Disorders, 14-18 June 2015, San Diego, CA, USA.

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Objective: To examine whether gait impairment measured within 4 months of being diagnosed with Parkinson’s disease (PD) can predict decline in attention over the subsequent 3 years.

Background: Impaired cognitive function is associated with gait impairment in incident PD in cross sectional studies1. Our preliminary work suggests walking speed can predict decline in attention in incident PD2. We sought to replicate our preliminary work in a subset of the same cohort once disease advanced a further 18 months. If gait can predict attentional decline, it may provide further evidence for gait as a non-invasive surrogate marker to identify those at risk of cognitive impairment and PD dementia.

Methods: 51 idiopathic PD and 49 age-matched controls completed assessments for gait and attention at baseline and 3 years later. Participants walked continuously for two minutes at their normal pace during which step velocity and step length were collected using a 7m GaitRite™ instrumented walkway. Attention was assessed using the cognitive drug research (CDR) computerized battery. Scatterplots and linear multiple regression analysis were used to assess the predictive value of baseline gait in relation to change in attention over 36 months controlling for age.

Results: In PD but not control participants a decline in fluctuating attention over 3 years was associated with slower velocity (p.013) and a shorter step length (p<.01) at diagnosis. Both step velocity and step length were entered into a regression model controlling for age. Step velocity was found to be an independent predictor of change in fluctuating attention (F(2,50) = 5.513, p<0.05, adjusted r2=.153, β=-.311) step length was a stronger independent predictor (F (2,50)=6.323, p<0.01, adjusted r2=.209, β=-.354). Conversely, fluctuating attention at baseline was unable to predict change in fluctuating attention or change in step length over 3 years.

Conclusions: Baseline step velocity and step length but not baseline fluctuating attention were significantly associated with change in fluctuating attention over 36 months in an incident PD cohort. This confirms earlier findings and suggests that gait may be a useful surrogate marker of change in cognitive function in PD that is not due to the normal ageing process.

1Lord, S et al. Front. Aging Neurosci,6: 249.
2Lord, S. et al. Mov Disord 2013;28 Sup 1: 361

Item Type: Conference Item
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Other Information: Part of: Movement Disorders (2015), Volume: 30, Issue: Suppl 1, S345, ISSN: 1531-8257.
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