보행과 인지장애의 연관성

Abstract

Background: The incidence and prevalence of gait disturbance increases as age increases. The importance of cognitive aspects of gait disturbances has been studied in various types of dementia and MCI. This study was performed to identify relationship between cognitive impairment and change in gait, and investigate specific domains of cognitive function that may have affects in gait disturbance. Methods: Three hundred eighty three participants over 60 years old volunteered for the study. Three stages evaluation were performed, dementia screening and timed up and go test (TUG), work up for cognitive impairment and dementia, and classifying cognitive impairment and dementia into subcategories by evaluating cause of the disease. To evaluate cognitive impairment, MMSE-KC (MMSE in the Korean version of the CERAD assessment packet) and Korean version of Consortium to Establish a Registry of Alzheimer’s Disease (CERAD-K) assessment were used. One hundred forty one people were excluded from study and 242 people were analyzed. Timed Up and Go test (TUG) was performed for evaluation of gait disturbance. Relationship in every subcategory of CERAD-K and TUG was studied by correlation and multiple logistic analysis. Results: Of the 242 participants, 122 were without cognitive impairment, 51 had mild cognitive impairment, 56 had Alzheimer’s disease and 13 had vascular dementia. These four groups showed different results in TUG. Normal group had the lowest values in TUG compare to other groups significantly. MMSE score also correlated with the value of TUG (r=-0.528, p<0.001). Every subcategory of CERAD-K score had significant correlation with the value of TUG. But there were no specific subcategory that had predominant effect in TUG. Only age was an independently significant factor influencing TUG (p<0.05). Conclusions: This study shows that increase in age and impairment in cognitive function has an association with gait disturbance. Therefore clinician should be concerned about cognitive factors for evaluation of a patient who has gait disturbance.