1. Gras, Laura Z. PT, DPT, DSc, GCS
  2. Kanaan, Saddam F. PT, PhD
  3. McDowd, Joan M. PhD
  4. Colgrove, Yvonne M. PT, PhD
  5. Burns, Jeffrey MD
  6. Pohl, Patricia S. PT, PhD


Background and Purpose: Studies have shown that adults with Alzheimer disease (AD) have gait and balance deficits; however, the focus has been on those with mild to severe disease. The purpose of this study was to determine whether balance and gait deficits are present in those with very mild AD.


Methods: Thirteen adults (72.9 +/- 4.7 years old) with very mild AD and 13 age-matched (72.6 +/- 4.6 years old) and sex-matched (10 males and 3 females) participants in a control group without AD performed balance and gait tests. All participants were living in the community and independent in community ambulation.


Results: Participants with very mild AD had shorter times in tandem stance with eyes open (P < 0.001) and with eyes closed (P = 0.007) compared with participants in the control group. Those with AD also took longer to complete the Timed "Up & Go" Test (P < 0.001). Gait deficits were found for those with AD as demonstrated by slower velocities in the 10-m walk at a comfortable pace (P = 0.029) and on an instrumented walkway (P < 0.001). Stance times were longer for those with AD (P < 0.001) and step length was shorter (P = 0.001). There were no group differences in the 10-m walk at a fast pace. The gait velocity of participants in the control group was faster on the instrumented walkway than in the 10-m walk at a comfortable pace (P = 0.031). In contrast, the gait velocity of those with AD was significantly slower on the instrumented walkway than in the 10-m walk at a comfortable pace (P = 0.024).


Discussion: Balance and gait deficits may be present in those in the very early stages of AD. Novel surfaces may affect gait speed in those with very mild AD. Identifying mobility deficits early in the progression of AD may provide an opportunity for early physical therapy intervention, thus promoting continued functional independence.


Conclusions: Adults in the very early stages of AD may show signs of balance and gait deficits. Recognition of these problems early with subsequent physical therapy may slow the progression of further balance and gait dysfunction.