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J Neurol Neurosurg Psychiatry 2004;75:196-201 doi:10.1136/jnnp.2002.008805
  • Paper

Walking difficulties in patients with Alzheimer’s disease might originate from gait apraxia

  1. S Della Sala1,*,
  2. H Spinnler2,
  3. A Venneri1
  1. 1Neuropsychology Research Group, School of Psychology, University of Aberdeen, Aberdeen, UK
  2. 2Third Neurology Ward, Department of Medicine, Surgery and Dentistry, University of Milan, S Paolo Hospital, Milan, Italy
  1. Correspondence to:
 Dr Sergio Della Sala
 Psychology Department, University of Aberdeen, Aberdeen AB24 2UB, UK; sergioabdn.ac.uk
  • Received 10 December 2002
  • Accepted 21 June 2003
  • Revised 20 June 2003

Abstract

Objectives: To investigate whether gait apraxia is a possible cause for some of the walking abnormalities shown by patients with Alzheimer’s disease.

Methods: 60 patients with Alzheimer’s disease, selected as being free from overt extrapyramidal impairment or other potential causes of walking deficits, were assessed with a new test evaluating aspects of walking and related movements. Norms for this test were collected from a sample of 182 healthy volunteers.

Results: 40% of the Alzheimer group performed below the cut off score on this test, and half performed poorly. Performance of the Alzheimer group in the walking skills test correlated highly with scores in a test assessing limb apraxia and with dementia severity.

Conclusions: Gait apraxia may be the cause of walking disorders found in a subgroup of patients with Alzheimer’s disease. Its detection is made easier by the use of a standardised test, but still relies heavily on the exclusion of other causes of walking deficits. It is a recognisable and independent form of apraxia.

Footnotes

  • * The authors’ names are listed in alphabetical order

  • Competing interests: none declared

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