Clinical Research Directory

Groningen Meander Walking Test in Older Adults With Balance Problems

This observational cross-sectional psychometric study aims to examine the test-retest reliability and construct validity of the Groningen Meander Walking Test in older adults with self-reported balance problems and/or a history of falls. Participants aged 65 years or older will be recruited from the Orthopedics and Traumatology outpatient clinic of Ordu University Training and Research Hospital. The Groningen Meander Walking Test will be performed twice during the first session and repeated in a second session to assess within-day and between-day reliability. Construct validity will be evaluated using the Timed Up and Go Test, Figure-of-Eight Walking Test, Berg Balance Scale, and Falls Efficacy Scale-International. The study will also explore the ability of the Groningen Meander Walking Test to discriminate between participants with low and increased fall risk according to the Berg Balance Scale.

Unsteady Gait in Older People May be a Common and Treatable Neurological Disease Associated With Increased Mortality

We live in an aging population and a third of the older population has a gait disorder that may cause institutionalization, and increased mortality. Sixteen percent of them have a slow, unsteady, neurological gait disorder, called Higher-Level Gait Disorder (HLGD). A known cause of HLGD is Idiopathic Normal Pressure Hydrocephalus (INPH), which is a treatable neurological disease. More than half of individuals with HLGD meet the diagnostic criteria for INPH as they have wide brain ventricles on MRI images of the brain, but far from all of these are in contact with the healthcare system. Possibly, HLGD without wide brain ventricles and where no other known explanation for the symptom is found could be a variant of or a precursor to INPH. Gait disorder is common among older people and can lead to falls and reduced quality of life. Complications after falls contribute to both increased mortality and increased costs in society. Therefore, it is important to have a solid knowledge of different types of gait disorders and how they can be treated. Our research will contribute with information about how HLGD affects the individual and how affected individuals can be investigated and helped. The disease mechanisms behind INPH and often behind HLGD are unknown. It is also unknown how often older individuals are affected by HLGD and how high the mortality is for those affected. It is likely that the incidence of HLGD is high and that it is linked to an increased mortality. It is also likely that the disease mechanism behind the symptom is the same as that of INPH and that HLGD can be detected with the help of brain imaging. In this epidemiological cohort study, we want to answer the following overarching questions: What is the incidence and mortality of HLGD and INPH? Can HLGD be predicted using biomarkers and what disease mechanism causes HLGD?