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Gait in Vascular Cognitive Impairment

  • Yeo Jin Kim
Chapter
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Part of the Stroke Revisited book series (STROREV)

Abstract

Gait is a fundamental function that is required for maintenance of activities of daily living and cognitive function in elders or those with cognitive impairment. Gait disturbances in the vascular cognitive impairment (VCI) patient show a high degree of variability depending on the degree and location of vascular insults in the brain. Gait disturbances can be caused by cognitive impairment, which might be a sentinel symptom of dementia. In particular, executive dysfunction has been associated with gait disturbance, and gait disturbance further aggravates cognitive impairment. The related anatomical structures that cause gait impairment in patients with VCI are the hippocampus, prefrontal cortex, periventricular white matter, corpus callosum, cerebellar peduncle, and cingulum. Small vessel disease markers, white matter hyperintensities (WMH), lacunes, and cerebral microbleeds (CMB), are independently related to gait. WMH is related to stride and step length, lacunes are related to stride length, step frequency, and cadence, and CMB is related to stride length and double support time. In patients with vascular cognitive impairment no dementia (VCIND), cadence is reduced, single support phase is reduced, and variability of single and double support times is decreased. When patients progress to subcortical vascular dementia, they show a frontal gait characterized by slow, wide-based shuffling, and apractic-atactic gait. Patients with VCI frequently fall because of both cognitive and gait impairments. However, since there is no meaningful treatment to improve the gait function of VCI patients, more research is needed in the future.

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Copyright information

© Springer Science+Business Media Singapore 2020

Authors and Affiliations

  • Yeo Jin Kim
    • 1
  1. 1.Department of Neurology, Chuncheon Sacred Heart HospitalHallym University College of MedicineChuncheon-siSouth Korea

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