A slow or uneven gait in older patients may be more than the effect of age, according to three studies that found walking disorders in older people also may be an early sign of Alzheimer's disease.
The studies sampled a combined 4,000 people, finding that pace, rhythm and the size of steps changed with neurological illness, according to information presented on Sunday at the Alzheimer's Association International Conference in Vancouver.
Watching an older patient walk into an exam room may offer a first clue that psychological evaluation needs to be done, said William Thies, chief medical and scientific officer for the Chicago-based Alzheimer's Association. Since people with Alzheimer's are more likely to suffer a debilitating fall than healthy peers, this simple observation may help patients get the right care and prevent injury and disability.
One study of more 1,100 people with an average age of 77 found that people with Alzheimer's disease walked more slowly and with a more irregular pattern of steps as their minds declined. Another study of more than 1,200 people over age 49 found that the rhythm of a person's stride was associated with information-processing speed.
A third study evaluated patients over multiple visits. It found that those who had slower steps and smaller strides had larger declines in thinking, memory and ability to control behavior, according to the study led by Rodolfo Savica of the Mayo Clinic in Rochester.
"Motor and cognitive function may be part of the same spectrum of the disease," Savica said. "These motor changes happen before the memory changes."
Most older adults walk more slowly as they age, the doctors said. It's important to know whether patients are walking more slowly because they have an arthritic knee or a bone disease, Savica said.