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Gait Impairment Is Found to Be Predictor of Dementia, New England Journal of Medicine Reports

November 27, 2002 -- (BRONX, NY)-- Being "out of step" takes on new significance for the elderly according to new findings about gait disorders reported by researchers at the Albert Einstein College of Medicine of Yeshiva University in the November 28 issue of the New England Journal of Medicine. Through the study, which followed participants for up to 20 years, the researchers found that abnormal walking proved to be a predictor of non-Alzheimer's dementia in their (75+ years old) subjects.

"The frequency of gait disorders and the prevalence of dementia both increase with age. We were surprised to find that abnormal gaits predicted the development of dementia over 10 years of follow-up," says Dr. Joe Verghese, assistant professor of neurology at Einstein and lead investigator of the study.

While Alzheimer's disease is the most common type of dementia in the elderly, vascular dementia is the second most common cause, accounting for about 30 percent of all dementia cases. The study, a part of the larger, long-term NIH-sponsored Einstein Aging Study, looked at 422 individuals age 75 to 85, and evaluated their gait and their performance on neuropsychological tests. At enrollment, none of the participants had dementia. However, over the course of the study, 125 individuals developed dementia. Of these individuals, nearly half had abnormal gaits at enrollment while only one-fourth of individuals with normal gaits at enrollment were found to develop dementia.

"We found that the participants with neurologic gait abnormalities were at increased risk -- nearly two to one -- for developing dementia and that the presence of the gait abnormalities strongly predicted their risk for developing vascular dementia, but not Alzheimer's disease," says Dr. Richard Lipton, the Lotti and Bernard Benson Faculty Scholar in Alzheimer's Disease at Einstein, who is co-author on the paper and lead investigator for the Einstein Aging Study. "Now, just as we have good ways of identifying people at high risk for Alzheimer's, we also have a new approach for detecting individuals at risk for vascular dementia."

He further points out that the risk for non-Alzheimer's dementia remained strong following adjustment for demographic, medical, and baseline cognitive variables.

"Our research offers a clinical profile for elderly individuals at high risk for non-Alzheimer's dementia, particularly vascular dementia," says Dr. Verghese. "It is our hope these findings will not only provide a useful strategy for identifying those people at very high risk for vascular dementia, but can help to facilitate the development of interventions designed to reduce its onset."

Dr. Verghese, who first took part in the Einstein Aging Study as a Fellow in Einstein's Clinical Research Training Program, has since been appointed to the faculty at Einstein. In addition to Dr. Lipton, his colleagues on the study include Dr. Charles Hall, Dr. Gail Kuslansky, Mindy Katz and Dr. Herman Buschke. For 21 years, The Einstein Aging Study has conducted detailed clinical evaluations, studying various potential risk factors among community-based participants, to help identify the risk of Alzheimer's disease as compared with non-Alzheimer's dementia.

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