1 Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada. olivier.beauchet@mcgill.ca.
2 Faculty of Medicine, McGill University, Montreal, QC, Canada. olivier.beauchet@mcgill.ca.
3 Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, QC, Canada. olivier.beauchet@mcgill.ca.
4 Faculty of Kinesiology and Health Studies, Neuromechanical Research Centre, University of Regina, Regina, SK, Canada.
5 Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, BC, Canada.
6 Andrew and Marjorie McCain Human Performance Laboratory, Faculty of Kinesiology, Richard J. Currie Center, University of New Brunswick, Fredericton, NB, Canada.
7 Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
8 University Memory Clinic of Angers, Angers, France.
9 UPRES EA 4638, University of Angers, UNAM, Angers, France.
10 Department of Medical Biophysics, Center for Functional and Metabolic Mapping, Schulich School of Medicine and Dentistry, Robarts Research Institute, University of Western Ontario, London, ON, Canada.
11 Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
12 Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.
13 Institut universitaire de gériatrie de Sherbrooke (IUGS), Montréal, QC, Canada.
14 PERFORM Centre and Department of Psychology, Concordia University, Montreal, QC, Canada.
15 Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Anti-Dementia Drugs, Gait Performance and Mental Imagery of Gait: A Non-Randomized Open-Label Trial.

Drugs Aging. 2016 09;33(9):665-73

Authors: Beauchet O, Barden J, Liu-Ambrose T, Chester VL, Annweiler C, Szturm T, Grenier S, Léonard G, Bherer L, Allali G, Canadian Gait Consortium

Abstract

BACKGROUND: Few studies have examined the effect of anti-dementia drugs (i.e., acetylcholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists) on gait performance. Past studies have focused on the stride time (i.e., gait cycle duration) but not on the mental imagery of gait.

OBJECTIVES: To compare mental imagery of gait and spatiotemporal gait parameters in patients with dementia [i.e., Alzheimer's disease (AD) and non-AD] before and after the use of anti-dementia drugs (i.e., acetylcholinesterase inhibitors and memantine) and in controls (i.e., patients with dementia who did not take anti-dementia drugs).

METHODS: A total of 112 patients (mean age 82.5 ± 4.2 years, 68.8 % female) with mild-to-moderate AD and non-AD dementia were included in this non-randomized open-label trial (n = 56 in the Intervention group, and n = 56 in the Control group matched for age, sex, and stage and type of dementia) nested in a cohort study (mean follow-up 238.5 ± 79.8 days). Mental imagery of gait was assessed with the actual and imagined Timed Up and Go tests (aTUG and iTUG) and the difference between aTUG and iTUG (i.e., delta-TUG). Spatiotemporal gait parameters were measured with the GAITRite(®) system during normal walking.

RESULTS: Participants in the Intervention group had a longer iTUG time (p < 0.001) and a lower delta-TUG value (p = 0.001) at the follow-up compared with those in the Control group. There was a significant increase in iTUG (p = 0.001) and decrease in delta-TUG (p < 0.001) from baseline to the follow-up only in the Intervention group. Multiple linear regression showed that the use of anti-dementia drugs was associated with a longer iTUG time and a lower delta-TUG value (best performance, p < 0.002).

CONCLUSIONS: Our findings showed an improvement in mental imagery of gait with the use of anti-dementia drugs, but no changes in actual gait performance.

TRIAL REGISTRATION: NCT01315704.

PMID: 27568453 [PubMed - indexed for MEDLINE]