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

Drugs Aging. 2016 Sep;33(9):665-73. doi: 10.1007/s40266-016-0391-0.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / psychology
  • Cholinesterase Inhibitors / administration & dosage
  • Cholinesterase Inhibitors / adverse effects
  • Cholinesterase Inhibitors / therapeutic use*
  • Cohort Studies
  • Female
  • Gait / drug effects*
  • Geriatric Assessment
  • Humans
  • Imagination* / physiology
  • Male
  • Memantine / administration & dosage
  • Memantine / adverse effects
  • Memantine / therapeutic use*
  • Receptors, N-Methyl-D-Aspartate / antagonists & inhibitors*
  • Spatio-Temporal Analysis
  • Task Performance and Analysis
  • Walking* / physiology
  • Walking* / psychology

Substances

  • Cholinesterase Inhibitors
  • Receptors, N-Methyl-D-Aspartate
  • Memantine

Associated data

  • ClinicalTrials.gov/NCT01315704