PMID- 20204394
OWN - NLM
STAT- MEDLINE
DCOM- 20110324
LR  - 20181113
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 257
IP  - 8
DP  - 2010 Aug
TI  - Progressive nature of a higher level gait disorder: a 3-year prospective study.
PG  - 1279-86
LID - 10.1007/s00415-010-5507-6 [doi]
AB  - The objective of the study was to characterize the natural history of patients 
      with a higher level gait disorder (HLGD) of the cautious/disequilibrium type in a 
      3-year prospective study. Subjects were taken from an outpatient setting in a 
      movement disorders clinic. Twenty-two mobile, community-living patients with a 
      HLGD of the cautious/disequilibrium type and 26 age- and gender-matched healthy 
      controls were evaluated at baseline and approximately 3 years later. Detailed 
      medical history, a complete, structured geriatric and neurological examination, 
      mental and affective state, gait and balance assessment were obtained. At 
      follow-up, marked declines were observed in gait, mobility and functional 
      independence in the patients, but not in the controls. For example, 23% of the 
      patients could not complete the Timed Up and Go test, compared to only 4% of the 
      control group, and among those who could complete the test, time to completion 
      was almost three times longer (P < 0.0001) in the patients (23 s), compared to 
      the controls (8 s). At follow-up, 50% of the patients required a personal live-in 
      caregiver compared to only 4% of the controls (P < 0.0001). Although mild 
      extra-pyramidal, pyramidal, cognitive and affective alterations were observed at 
      baseline in the patients, those symptoms were stable over time. Unexpectedly, 
      there was no association between the presence of HLGD or its progression and 
      vascular risk factors. HLGD is a debilitating, rapidly progressive disease. The 
      profound deterioration in functional independence in a relatively short period of 
      time suggests that early multidisciplinary interventions may be the appropriate 
      clinical approach to the treatment of these patients who are at risk for a rapid 
      decline in functional abilities.
FAU - Huber-Mahlin, V
AU  - Huber-Mahlin V
AD  - Movement Disorders Unit and Parkinson Center, Department of Neurology, Tel-Aviv 
      Sourasky Medical Center, Tel-Aviv, Israel.
FAU - Giladi, N
AU  - Giladi N
FAU - Herman, T
AU  - Herman T
FAU - Perez, C
AU  - Perez C
FAU - Gurevich, T
AU  - Gurevich T
FAU - Hausdorff, J M
AU  - Hausdorff JM
LA  - eng
PT  - Journal Article
DEP - 20100304
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
SB  - IM
MH  - Activities of Daily Living/psychology
MH  - Aged
MH  - Aged, 80 and over
MH  - Aging/*physiology
MH  - Disease Progression
MH  - Early Diagnosis
MH  - Female
MH  - Gait Disorders, Neurologic/*diagnosis/*physiopathology
MH  - Humans
MH  - Independent Living/standards
MH  - Longitudinal Studies
MH  - Male
MH  - Mobility Limitation
MH  - Prospective Studies
MH  - Risk Factors
MH  - Time Factors
EDAT- 2010/03/06 06:00
MHDA- 2011/03/25 06:00
CRDT- 2010/03/06 06:00
PHST- 2009/06/10 00:00 [received]
PHST- 2010/02/10 00:00 [accepted]
PHST- 2010/02/08 00:00 [revised]
PHST- 2010/03/06 06:00 [entrez]
PHST- 2010/03/06 06:00 [pubmed]
PHST- 2011/03/25 06:00 [medline]
AID - 10.1007/s00415-010-5507-6 [doi]
PST - ppublish
SO  - J Neurol. 2010 Aug;257(8):1279-86. doi: 10.1007/s00415-010-5507-6. Epub 2010 Mar 
      4.