Objective: To examine the relationship of gait impairment of Parkinson’s disease (PD) patients with different clinical factors including motor function, non-motor function and cognitive function.

Background: The pathophysiology of gait impairment in PD remains unclear. It has been suggested that multifactorial etiology including motor and cognitive dysfunction may contribute to gait disorders in these patients.

Methods: We conducted a cross-sectional study in the multidisciplinary PD clinic in a tertiary hospital in Hong Kong. All ambulatory Asian PD patients, who were followed in the multidisciplinary clinic, were recruited. Their demographic information were documented. The motor function including gait was evaluated with Hoehn and Yahn (H&Y) stage, Unified Parkinson’s disease Rating Scale motor score (UPDRS III), Postural Instability and Gait Impairment (PIGD) score (using the UPDRS items 27, 28, 29, 30 and 31) and Timed Up and Go test (TUG). The non-motor function was assessed by Non Motor Symptoms Scale (NMSS). Cognitive function was assessed by Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The correlation between different clinical variables and TUG was evaluated with Spearman’s rank correlation coefficient.

Results: 145 PD patients were recruited between 2014 and 2015. Their mean age was 64.87 ± 9.44. Their mean disease duration was 7.97 ± 5.36 years. The patients were classified into four subtypes: Tremor dominant 54.2%; Akinetic rigid 31.7%; PIGD 2.0%; Mixed 12.0%. TUG test, the tool for gait assessment in our cohort, was found to be correlated with motor function (H&Y stage: rs 0.483; UPDRS III: rs 0.435; PIGD score: rs 0.517). It was also reported to weakly correlated with non-motor function (NMSS: rs 0.190). Besides, both MMSE and MoCA were found to be negatively correlated with TUG (MMSE: rs -0.440; MoCA: rs -0.443). When looking at the cognitive domains of MoCA in details, visuospatial and executive dysfunction (rs -0.357) was found to have the strongest association with TUG.

Conclusions: This study showed that apart from motor dysfunction, cognitive disorders, especially visuospatial and executive dysfunction, can contribute to gait disorder in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gait-impairment-is-more-than-a-motor-symptom-in-parkinsons-disease/