| Background:Along with the development of social population aging, the elderly related diseases or impairments have received more and more attention. Among them, Alzheimer’s disease (AD) and gait disorders(GD) have gradually become the focus of the society by their high prevalence and high disability rates. Alzheimer’s diseases, a kind of common nervous system degenerative disease in the elderly, with the pathological features of senile plaques, neurofibrillary tangles, granulovacuolar degeneration of hippocampal pyramidal cells and loss of neurons. Clinical features of insidious onset, progressive intelligence impairment, mostly accompanied by personality changes. Symptoms continue to progress, more courses are usually 5～10 years. Gait disorders, which is caused by motor disorders or sensory disorders. Its characteristic is associated with pathological changes, which is seen in many diseases of the nervous system or other system. The typical abnormal gait can prompt significance to the diagnosis of certain diseases.Recently, epidemiological research has found that among people older than 65 years of age, the prevalence of AD was 11% and increased further with aging, reaching 32% in subjects older than 85 years old. And another large, population-based epidemiological research also found that the prevalence of any gait disorder was 35% among people older than 70 years old and reached 46% in people older than 80 years old.A number of studies have revealed that the prevalence of gait disorders is higher in people with AD than those cognitively healthy elders and there is a strong positive correlation between cognition disorders and gait disorders. The gait disorders are expressed with slow gait velocity, high variability of stride time and so on. These changes can make people unsafe and they are associated with an increased risk for falls, which can cause the high disability rates, and reduce the quality of life, also increase the burden of families and the society.Objectives:At present, the most common used anti-dementia drugs, memantine and Acetyl-cholinesterase inhibitors, are both cognitive enhancers. Till now, a few studies have highlighted that these anti- dementia drugs can improve the gait performance in people with AD, while others are not. Then the statistical model was decided to go based on the value we got to evaluate the effect of anti-dementia drugs on the gait performance in patients with AD. This Meta analysis is aimed to exam the effect of the anti-dementia drugs, AChEIs and memantine, on the gait performance in AD patients.Materials and Methods:We will search studies in Pubmed, Embase, Cochrane library, with no time limit, and input these keywords:"dementia" OR "cognition" OR "Alzheimer’s disease" NOT "Parkinson" OR "anti-dementia drug" AND "gait". At the same time, we should enlarge the retrieval in above databases and read related reviews and references to get more information.According to inclusion and exclusion criteria, we screened these literatures, evaluated them using the measuring scale and extracted the useful data. Finally, we entered data into the Review Manager 5.2 system for meta-analysis to quantitatively synthesize anti-dementia drugs-related changes in GV and STV.Results:The meta-analysis assessing GV included 2 studies (both assessing AChEIs) and 62 patients. In single task, GV had no significant changes before and after drug use (-3.59cm/s,95%CI[-10.46,3.28], p=0.31). In dual task, the GV had no significant changes before-after drug use either(-1.27cm/s,95%CI[-9.16,6.62],p=0.75).The meta-analysis assessing STV included 5 studies and 208 patients (114 patients using AChEIs and 94 patients using memantine). In the AChEIs group, STV had no significant changes before-after(0.03%,95%CI[-0.47,0.53],p=0.91), while the memantine group had significant changes before-after(2.21%,95%CI[1.03,3.38], p=0.0002).Conclusions:Our results showed that AChEIs can’t improve gait performance, but memantine can improve the stability of gait. Despite the results we got in this meta-analysis, the limitation of the studies and patients makes the author realize that new large NCTs are still needed to provide more clear and definite evidence on the relationship between anti-dementia drugs and gait performance in patients with AD. |
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