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.