A comparison of community-residing older adults with frontal and parkinsonian gaits

Frontal gaits (FG) and parkinsonian gaits (PG) are common neurological gait abnormalities in older adults. It may be difficult to distinguish these gaits as they share common clinical characteristics such as unsteadiness, slowing, and shuffling. Of 488 community-residing subjects in an aging study, 11 were diagnosed with FG and 9 with PG at baseline clinical evaluations. Subjects with FG were older than subjects with PG (84.5 vs. 77.7 years, p<0.001). As expected, parkinsonian signs such as tremor and rigidity were associated with PG and frontal release signs with FG. Subjects with PG had more falls (67% vs. 18%, p=0.02). They performed worse on a panel of executive function tests, although the scores were significantly different only on the verbal fluency test (17.0 vs. 28.3, p=0.009). Advancing age was associated with FG (OR=1.3, 95% CI=1.1-1.4) but not PG (OR=1, 95% CI=0.9-1.1). Medical illnesses were not significantly associated with FG. Diabetes (OR=4.1, 95% CI=1.1-15.5), strokes (OR=4.3, 95% CI=1.1-17.3), and depression (OR=5.1, 95% CI=1.2-20.8) were associated with PG. Despite similar gait characteristics, FG may be distinguished from PG by associated clinical signs, frequency of falls, and the neuropsychological profile. Vascular risk factors and depression were strongly associated with PG, and should be explored further.