Jahn K, Heinze C, Selge C, Heßelbarth K, Schniepp R. Nervenarzt, Der 2015; 86(4): 431-439.
Vernacular Title
Gangstörungen beim geriatrischen Patienten : Klassifikation und Therapie.
Affiliation
Schön Klinik Bad Aibling, Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Kolbermoorer Str. 72, 83043, Bad Aibling, Deutschland, klaus.jahn@med.uni-muenchen.de.
BACKGROUND: Slow walking with reduced body dynamics is a characteristic feature of locomotion in the elderly. Impaired mobility and falls associated with gait disorders significantly contribute to a reduced quality of life in the elderly.
OBJECTIVES: A gait disorder is not an inevitable consequence of aging. This article shows that it is worth recognizing specific deficits and differentiating specific aspects in multifactorial disorders because many causes can be well treated. Also provided are the bases for clinical classification and therapeutic principles.
METHODS: Review of recent literature and clinical review based on own experience and own scientific results.
RESULTS: Common causes of disturbed gait in the elderly are neurological deficits, including sensory deficits (e.g. peripheral neuropathy and vestibulopathy), neurodegeneration (e.g. cerebellar ataxia and parkinsonian syndromes, cognitive impairment (e.g. degenerative dementia), degeneration of joints (e.g. coxarthrosis) and general loss of muscle mass (sarcopenia). Furthermore, a fear of falling also contributes to the gait disorder. Multimodal therapies are often necessary and the principles are presented.
CONCLUSION: Identification of deficits is a prerequisite for specific therapy. As physical activity protects against cognitive impairment, reduces the risk of falling and improves overall quality of life, a structured assessment of causes for gait impairment is crucial.