Idiopathic Senile Gait Disorders Are Signs of Subclinical Disease

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Abstract
OBJECTIVES: To evaluate survival and causes of death in subjects with idiopathic senile gait disorders. DESIGN: A population‐based longitudinal study. SETTING: Survival analysis of the oldest old within the Leiden 85‐plus Study. PARTICIPANTS: We distinguished three different groups according to their gait: subjects with a normal gait (n = 25), subjects with senile gait disorders (n = 14), and subjects with gait disorders due to known disease (n = 87). The mean age was 90 years in all groups (range 87 to 97 years). MEASUREMENTS: The risk of all cause mortality and cardiovascular mortality was estimated over 5 years of follow‐up in a Cox‐proportional hazards model, adjusted for age and sex. RESULTS: Eighty‐nine of 126 subjects died during follow‐up. Mean survival differed among the three groups (P log‐rank = .01). All cause mortality risk was increased in subjects with senile gait disorders compared with subjects with a normal gait (RR = 2.8; 95% CI, 1.1–7.3, P = .03) and was similar to subjects with gait disorders caused by known disease (RR = 1.2; 95% CI: .6–2.5, P = .6). Mortality caused by cardiovascular disease also differed among the three groups (P log‐rank = .03). The risk of cardiovascular death in subjects with senile gait disorders was twofold greater than in subjects with a normal gait (RR = 2.1; 95% CI, 0.4–10.3). CONCLUSIONS: Senile gait disorders are related to subclinical, perhaps cardiovascular, disease. Senile gait disorders should not be accepted as an inevitable, benign concomitant of the normal aging process.