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OBJECTIVE: To reveal the discriminative value of gait parameters between Alzheimer's disease (AD) and Parkinson's disease (PD) subjects. METHODS: We included all consecutive patients with newly diagnosed AD and those with a diagnosis of PD who applied to our polyclinic between March 2022 and June 2022. The demographic and clinical features were evaluated during interviews. The gait analyses were performed using a quantitative, smartphone-based gait analyses program. Using this program, the step time (ST), step length (SL), step number (SN), gait velocity (GV), and cadence were measured in all individuals. RESULTS: Overall, 31 patients with AD and 45 with PD were enrolled in the analyses. The mean age of the AD group was higher according to those with PD. As expected, the Mini-Mental State Examination (MMSE) values were lower in the AD group. The comparative analyses of the gait parameters between groups did not reveal differences in any of the measures. The correlation analyses to investigate the possible association between the disease severity and gait parameters revealed that the MDS-UPDRS showed low negative correlations with SL and GV. CONCLUSION: Our findings suggest that the evaluation of gait using the gait analyses program does not contribute to the discrimination between AD and PD in clinical practice.
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INTRODUCTION: Clinical studies remark that gait disturbance is common in patients with Alzheimer's disease (AD). However, the treatment response of gait disturbance in those patients may constitute a more interesting issue that is rarely addressed. METHODS: In this prospective, interventional study, we included 14 consecutive patients with a new diagnosis of AD. Basal gait analysis was performed using a 'Gait Analyzer' program that was uploaded to a mobile phone. The gait parameters including Step time (ST), step length (SL), step number (SN), gait velocity (GV), and cadence were measured. Afterward, donepezil 5 mg daily was initiated, and the re-assessments were re-performed 8 weeks after the treatment. RESULTS: The mean age was 71.78 ± 5.02 (F/M = 8/6). The evaluations after the donepezil treatment showed that there was a significant improvement in the SN (p = 0.021) and SL (p = 0.001) in comparison to the basal evaluations. The repeated analysis in the subgroup of early-stage AD subjects (n = 10) yielded that there were significant improvements in SN (p = 0.003), SL (p = 0.005), and cadence (p = 0.026) after treatment. CONCLUSIONS: Our results support the efficiency of cholinergic treatment in gait functions in AD subjects.
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BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease, and swallowing difficulties may occur as the disease progresses. Dysphagia has many consequences, such as aspiration and pneumonia. In particular, in the advanced stage, approximately 70% of the causes of death in AD involve aspiration pneumonia. Therefore, it is vital to assess the presence or absence of dysphagia in AD. OBJECTIVE: This study aims to describe swallowing difficulty across the stages of AD. METHODS: Thirty-five AD patients were evaluated. The Mini-Mental State Examination was conducted. A bedside water swallow test (BWST) and the Eating Assessment Tool (EAT-10) were administered. Finally, fiberoptic endoscopic evaluation of swallowing was used to evaluate residual, aspiration and penetration conditions. RESULTS: EAT-10 scores, BWST results, and penetration-aspiration status were statistically significantly different according to AD stage (p < 0.05). Among all patients, 74.3% had residue, 25.7% had penetration, and 2.9% had aspiration. CONCLUSIONS: This study has demonstrated that swallowing dysfunction begins at a mild stage and progressively worsens toward the advanced stage in patients with AD. At all stages of AD, residue was observed, and this poses a risk for the development of penetration-aspiration. Therefore, it is necessary to evaluate the early dysphagia of individuals.