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Gait Progression Over 6 Years in Parkinson’s Disease: Effects of Age, Medication, and Pathology

Lookup NU author(s): Joanna Wilson, Dr Lisa Alcock, Dr Alison Yarnall, Dr Susan Lord, Dr Rachael Lawson, Professor John-Paul Taylor, Professor David Burn, Professor Lynn Rochester, Dr Brook Galna

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background: Gait disturbance is an early, cardinal feature of Parkinson’s disease (PD) associated with falls and reduced physical activity. Progression of gait impairment in Parkinson’s disease is not well characterized and a better understanding is imperative to mitigate impairment. Subtle gait impairments progress in early disease despite optimal dopaminergic medication. Evaluating gait disturbances over longer periods, accounting for typical aging and dopaminergic medication changes, will enable a better understanding of gait changes and inform targeted therapies for early disease. This studyaimed to describe gait progression over the first 6 years of PD by delineating changes associated with aging, medication, and pathology.Methods: One-hundred and nine newly diagnosed PD participants and 130 controls completed at least two gait assessments. Gait was assessed at 18-month intervals for up to 6 years using an instrumented walkway to measure sixteen spatiotemporal gait characteristics. Linear mixed-effects models assessed progression.Results: Ten gait characteristics significantly progressed in PD, with changes in four of these characteristics attributable to disease progression. Age-related changes also contributed to gait progression; changes in another two characteristics reflected both aging and disease progression. Gait impairment progressed irrespective of dopaminergic medication change for all characteristics except step width variability.Conclusions: Discrete gait impairments continue to progress in PD over 6 years, reflecting a combination of, and potential interaction between, disease-specific progression and age-related change. Gait changes were mostly unrelated todopaminergic medication adjustments, highlighting limitations of current dopaminergic therapy and the need to improve interventions targeting gait decline.


Publication metadata

Author(s): Wilson J, Alcock L, Yarnall AJ, Lord S, Lawson RA, Morris R, Taylor J-P, Burn DJ, Rochester L, Galna B

Publication type: Article

Publication status: Published

Journal: Frontiers in Aging Neuroscience

Year: 2020

Volume: 12

Online publication date: 15/10/2020

Acceptance date: 09/09/2020

Date deposited: 27/10/2020

ISSN (electronic): 1663-4365

Publisher: Frontiers

URL: https://doi.org/10.3389/fnagi.2020.577435

DOI: 10.3389/fnagi.2020.577435

PubMed id: 30906393


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