Idiopathic senile gait disorders are signs of subclinical disease

OBJECTIVES: To evaluate survival and causes of death in subjects with idiop athic senile gait disorders. DESIGN: A population-based longitudinal study. SETTING: Survival analysis of the oldest old within the Leiden 85-plus Stud y. PARTICIPANTS: We distinguished three different groups according to their ga it: subjects with a normal gait (n = 25), subjects with senile gait disorde rs (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 d iffered among the three groups (P log-rank = .01). All cause mortality risk was increased in subjects with senile gait disorders compared with subject s 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 amon g the three groups (P log-rank = .03). The risk of cardiovascular death in subjects with senile gait disorders was twofold greater than in subjects wi th a normal gait (RR = 2.1; 95% CI, 0.4-10.3). CONCLUSIONS: Senile gait disorders are related to subclinical, perhaps card iovascular, disease. Senile gait disorders should not be accepted as an ine vitable, benign concomitant of the normal aging process.