Changes in Gait Variability with Anti-dementia Drugs: A Systematic Review and Meta-analysis

Studies have examined the effects of anti-dementia drugs on gait performance. No structured critical evaluation of these studies has been done so far. The objectives of this study were (1) to perform a qualitative analysis of all published studies on changes in stride time variability (STV) with anti-dementia drugs among patients with Alzheimer disease through a systematic review, and (2) to quantitatively synthesize anti-dementia drug-related changes in STV. An English and French MEDLINE search was conducted on November 2013, with no limit of date, using the Medical Subject Headings term "pharmaceutical preparations" combined with "delirium", "dementia", "amnestic", "cognitive disorders" AND "gait" OR "gait disorders, neurologic" OR "gait apraxia". Fixed-effects meta-analyses were performed to compare STV before and after the use of anti-dementia drugs, and to compare the final STV among participants in intervention and control groups. Of the 110 originally identified abstracts, four studies (i.e., one assessing galantamine, one donepezil, one memantine, and one memantine and acetylcholinesterase inhibitors) were included in the qualitative review, and three studies in the quantitative synthesis. Results were mixed, as two studies showed significant between-visit improvements (i.e., decrease in mean value) in STV, while one study did not, and the last one reported mixed results. In the meta-analysis, there was no difference between intervention and control groups (summary mean difference of final STV = -0.38 % [95 % confidence interval -1.14 to 0.37]) and no before-after difference in the intervention group (summary mean difference of STV = 0.66 [95 % confidence interval -0.17 to 1.49]). Our findings showed inconclusive effects of anti-dementia drugs on STV.