Factors Associated with Gait Impairment in Parkinson Disease (P06.050)

Objective: To determine non-motor and motor factors associated with gait impairment in Parkinson disease (PD). Background Gait impairment is a disabling problem in PD. A better understanding of factors associated with gait impairment could lead to improved treatments and preventive strategies. Design/Methods: Subjects with idiopathic PD (based on UK Brain Bank Criteria) were prospectively enrolled in the Johns Hopkins Morris K. Udall Parkinson9s Disease Research Center Clinical Core Longitudinal Study. They underwent biannual standardized motor (UPDRS III), cognitive, and behavioral assessments. Patients were grouped according to their level of gait impairment at baseline: none/mild (score 0 or 1 on UPDRS gait item) versus moderate/severe (scores 2 or above). Two sample t-tests and logistic regression were used to examine factors associated with impaired gait at baseline. Results: A total of 152 PD patients completed a baseline assessment: 101 with none/mild gait impairment and 51 with moderate/severe gait impairment. In the multivariate analysis, bradykinesia [Odds Ratio: 1.31; 95% CI: 1.10-1.43)] and age [Odds Ratio: 1.08 ; 95% CI: 1.02-1.13)] were the strongest independent predictors of gait impairment. Depression, duration of symptoms, and visuomotor integration (Berry VMI) were also independently associated with moderate/severe gait if bradykinesia was excluded from the model. Dementia, attention, executive dysfunction, and psychomotor speed were not associated with gait impairment in the multivariate models. Conclusions: In this cohort of subjects with idiopathic PD, most patients had no or mild gait impairment. Unsurprisingly, bradykinesia and older age was associated gait impairment. However, neither measures of attention, executive function, and psychomotor speed nor a clinical dementia diagnosis were independently associated with gait impairment. Our data support the assumption that poor motor functions and depression contribute to gait impairment, both of which being potentially treatable. Therefore, maximizing motor and depression treatment could help reduce significant gait impairment in Parkinson disease. Supported by: National Institutes of Health. Disclosure: Dr. Mari has received personal compensation for activities with Teva, Merz, and Ipsen. Dr. Mari has received research support from Merz, Allergan, and PharmaNet. Dr. Williams has received personal compensation for activities with Biogen Idec and Johns Hopkins University as an employee. Dr. Pontone has received research support from PharmaNet. Dr. Bassett has nothing to disclose.