Frail elderly patients with dementia go too fast

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 77; no. 7; pp. 874 - 876
• Main Authors: van Iersel, M B, Verbeek, A L M, Bloem, B R, Munneke, M, Esselink, R A J, Olde Rikkert, M G M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.07.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Accidental Falls; Activities of daily living; Aged; Biological and medical sciences; Biomechanical Phenomena; Cohort Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - complications; Female; Frail Elderly; Frailty; Gait Disorders, Neurologic - complications; Gait Disorders, Neurologic - epidemiology; Gait Disorders, Neurologic - etiology; Humans; Incidence; Male; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Regression analysis; Risk Factors; Short Report; Studies; Velocity; Walking; Human; Nervous system diseases; Elderly; Dementia
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.084418

The reason why patients with dementia fall more often and sustain more fractures than patients without dementia remains unclear. Therefore, the relationship between dementia and gait velocity as a marker for mobility and falls in a cohort of frail elderly (mean age of 77.3 years) inpatients was assessed. Patients with dementia were expected to walk slower than patients without dementia. A trend was indeed observed: absolute gait velocity of 0.59 m/s in patients with dementia (n = 63) versus 0.65 m/s in patients without dementia (n = 62; p = 0.19). After adjustment for parkinsonism and walking aids, however, patients with dementia walked 0.44 m/s faster than patients without dementia (p = 0.02). Probable explanations are frontal lobe disinhibition and lack of insight, causing patients with dementia to walk relatively too fast in the context of their frailty. Therefore, the high risk of falls in dementia may be partially explained by the loss of control of gait velocity.