Impact of small vessel disease in the brain on gait and balance

Pinter, D. et al. (2017) Impact of small vessel disease in the brain on gait and balance. Scientific Reports, 7, 41637. (doi: 10.1038/srep41637) (PMID:28134332) (PMCID:PMC5278543)

Abstract

Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71–74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity – WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients’ performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.

• Item Type: Articles
• Additional Information: D.P. receives funding from the Austrian Science Fund: T690-B23. LBC1936 data collection and analysis are supported by the Disconnected Mind project funded by Age UK, the UK Medical Research Council (MRC), and the Scottish Chief Scientist Office. The study was performed at the Brain Research Imaging Centre (which is supported by the Scottish Funding Council as part of the SINAPSE Collaboration) and the Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (MR/K026992/1), both at the University of Edinburgh. Funding from the Biotechnology and Biological Sciences Research Council (BBSRC) is gratefully acknowledged.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Dickie, Dr David Alexander
• Authors: Pinter, D., Ritchie, S. J., Doubal, F., Gattringer, T., Morris, Z., Bastin, M. E., del C. Valdés Hernández, M., Royle, N. A., Corley, J., Muñoz Maniega, S., Pattie, A., Dickie, D. A., Staals, J., Gow, A. J., Starr, J. M., Deary, I. J., Enzinger, C., Fazekas, F., and Wardlaw, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Scientific Reports
• Publisher: Nature Research
• ISSN: 2045-2322
• ISSN (Online): 2045-2322
• Copyright Holders: Copyright © 2017 The Authors
• First Published: First published in Scientific Reports 7(1):41637
• Publisher Policy: Reproduced under a Creative Commons License