Research article

Gait unsteadiness and fall risk in two affective disorders: a preliminary study

Jeffrey M Hausdorff^1,2 , Chung-Kang Peng³ , Ary L Goldberger³ and Andrew L Stoll⁴

¹  Division on Aging, Harvard Medical School, Boston, MA USA

²  Laboratory for Gait & Neurodynamics, Tel-Aviv Sourasky Medical Center; Dept. of Physical Therapy, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv Israel

³  Margret and H.A. Rey Institute for Nonlinear Dynamics in Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA

⁴  Psychopharmacology Research Laboratory, McLean Hospital, Harvard Medical School, Belmont MA USA

author email corresponding author email

BMC Psychiatry 2004, 4:39doi:10.1186/1471-244X-4-39

Published:	24 November 2004

Abstract

Background

In older adults, depression has been associated with increased fall risk, but the reasons for this link are not fully clear. Given parallels between major depression and Parkinson's disease, we hypothesized that major depression and related affective disorders would be associated with impairment in the ability to regulate the stride-to-stride fluctuations in gait cycle timing.

Methods

We measured stride-to-stride fluctuations of patients with two forms of mood disorders, unipolar major depressive disorder (MDD) and bipolar disorder, and compared their gait to that of a healthy control group. The primary outcomes were two measures of gait unsteadiness that have been associated with fall risk: stride time variability and swing time variability.

Results

Compared to the control group, the two patient groups tended to walk more slowly and with decreased swing time and increased stride time. However, none of these differences was statistically significant. Compared to the control group, swing time variability was significantly larger in the subjects with bipolar disorder (p < 0.0001) and in the subjects with MDD (p < 0.0004).

Conclusions

Patients with MDD and patients with bipolar disorder display gait unsteadiness. This perturbation in gait may provide a mechanistic link connecting depression and falls. The present findings also suggest the possibility that measurement of variability of gait may provide a readily quantifiable objective approach to monitoring depression and related affective disorders.