Abstract
Objectives
This study aimed to investigate the effect of white matter hyperintensity (WMH), a
common cerebral small vessel disease (CSVD) imaging marker, and age on gait parameters
in middle-aged and geriatric populations.
Design
Cross-sectional study.
Setting and Participants
A total of 1076 participants (62.9% female; age 61.0 ± 9.3 years), who visited the
neurology clinic or obtained a physical check-up from the Affiliated Hospital of Guizhou
Medical University. In total, 883 patients with WMH and 193 healthy controls were
included in this study.
Methods
The Fazekas scores of patients with CSVD were used to assess the burden of WMH. Based
on the Fazekas scores, all participants were divided into 4 groups: 553 patients with
Fazekas I, 257 patients with Fazekas II, 73 patients with Fazekas III, and 193 controls.
Gait parameters, including step speed, frequency, length, width, stance time, and
swing time, were quantitatively assessed using a vision-based artificial intelligence
gait analyzer (SAIL system). The relationships among the Fazekas scores, age, and
gait parameters were analyzed.
Results
Step speed, step length, step width, stance time, and swing time were significantly
different among the 4 groups. Furthermore, Fazekas scores and age were both associated
with gait parameters, including step speed, step length, stance time, and swing time.
The Fazekas scores were associated with step width, whereas age was not. Age was associated
with step frequency, whereas Fazekas scores were not.
Conclusions and Implications
Fazekas score and age are useful for evaluating gait parameters in patients with CSVD.
Emerging WMH (such as Fazekas Ⅰ) could be a clinical warning sign of gait disturbance
in a geriatric population.
Keywords
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References
- Cerebral small vessel disease: a review.Adv Clin Exp Med. 2021; 30: 349-356
- Emerging evidence for pathogenesis of sporadic cerebral small vessel disease.Stroke. 2016; 47: 554-560
- The convergence of stroke and dementia.Arq Neuropsiquiatr. 2018; 76: 849-852
- WMH and long-term outcomes in ischemic stroke: a systematic review and meta-analysis.Neurology. 2019; 92: e1298-e1308
- Deterioration of gait and balance over time: the effects of age-related white matter change--the LADIS study.Cerebrovasc Dis. 2013; 35: 544-553
- Association of gait and balance disorders with age-related white matter changes: the LADIS study.Neurology. 2008; 70: 935-942
- Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.J Nutr Health Aging. 2009; 13: 881-889
- Gait analysis in neurological populations: Progression in the use of wearables.Med Eng Phys. 2021; 87: 9-29
- Association of cerebral small vessel disease with gait and balance disorders.Front Aging Neurosci. 2022 8; 14: 834496
- Spatiotemporal gait characteristics and risk of mortality in community-dwelling older adults.Maturitas. 2021; 151: 31-35
- White matter lesion progression in LADIS: frequency, clinical effects, and sample size calculations.Stroke. 2012; 43: 2643-2647
- Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention.J Am Geriatr Soc. 2001; 49: 664-672
- Neuroimaging standards for research into small vessel disease and its contribution to aging and neurodegeneration.Lancet Neurol. 2013; 12: 822-838
- MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging.AJR Am J Roentgenol. 1987; 149: 351-356
- Diagnostic value of a vision-based intelligent gait analyzer in screening for gait abnormalities.Gait Posture. 2022; 91: 205-211
- Normative spatiotemporal gait parameters in older adults.Gait Posture. 2011; 34: 111-118
- The neural correlates of discrete gait characteristics in ageing: a structured review.Neurosci Biobehav Rev. 2019; 100: 344-369
- Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges.Lancet Neurol. 2010; 9: 689-701
- Diffusion tensor imaging of freezing of gait in patients with white matter changes.Mov Disord. 2012; 27: 760-764
- Cerebral small vessel disease: from a focal to a global perspective.Nat Rev Neurol. 2018; 14: 387-398
- Age-related differences in white matter microstructure: region-specific patterns of diffusivity.Neuroimage. 2010; 49: 2104-2112
- High-cost, high-capacity backbone for global brain communication.Proc Natl Acad Sci U S A. 2012; 109: 11372-11377
- Disruption of rich club organisation in cerebral small vessel disease.Hum Brain Mapp. 2017; 38: 1751-1766
- Gait and cognition: a complementary approach to understanding brain function and the risk of falling.J Am Geriatr Soc. 2012; 60: 2127-2136
- Guidelines for assessment of gait and reference values for spatiotemporal gait parameters in older adults: the biomathics and canadian gait consortiums initiative.Front Hum Neurosci. 2017; 11: 353
- Slowing: A Vascular Geriatric Syndrome?.J Am Med Dir Assoc. 2022; 23: 47-53.e2
- Should slowing be considered a distinct geriatric syndrome?.J Am Med Dir Assoc. 2022; 23: 20-22
- The spatial parameters of gait and their association with falls, functional decline and death in older adults: a prospective study.Sci Rep. 2019; 9: 8813
- Impact of regional white matter hyperintensities on specific gait function in Alzheimer's disease and mild cognitive impairment.J Cachexia Sarcopenia Muscle. 2021; 12: 2045-2055
Article info
Publication history
Published online: December 30, 2022
Publication stage
In Press Corrected ProofFootnotes
This work was supported by the National Key R&D Program of China (Issue numbers: 2018YFC1312901). Research reported in this publication received support from the Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China; the National Key R&D Program of China (Issue numbers: 2018YFC1312901). Reprints are not available from the authors.
S.W. performs contract research for Combinostics; all funding is paid to her institution. The other authors declare no conflicts of interest.
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