Gait disorders of unknown cause in the elderly: Clinical and MRI findings

BACKGROUND Disequilibrium of unknown cause in older people has been associated with white matter lesions on neuroimaging studies. OBJECTIVE To investigate the relationship between gait and balance problems in the elderly, white matter hyperintensities, and vascular risk factors. METHODS We studied clinical and neuroimaging features in 30 people older than 65 years of age with gait disorders of unknown cause and 30 age- and sex-matched controls. Patients and controls underwent the same extensive quantitative test battery. White matter lesions on MRI scans were graded in different brain regions. RESULTS History of hypertension was more common among patients than controls (60% vs. 27%, p=0.012). On all scales, patients with gait disorders scored worse than controls. The frequency of white matter lesions was significantly higher in patients than in controls (p<0.001). In a multivariate logistic regression analysis in which diagnosis (patient vs. control) was the dependent variable, there was an association between diagnosis and white matter signal hyperintensity score (p<0.001) and history of hypertension (p=0.039). CONCLUSIONS Gait disorders of unknown cause in older people are associated both with white matter lesions on MRI scans and with history of hypertension.