Predictive Factors of Concerns about Falling in People with Parkinson’s Disease: A 3-Year Longitudinal Study

Introduction. Fear of falling (FOF) is more common in people with Parkinson’s disease (PD) than in healthy controls. It can lead to several negative consequences such as restrictions in everyday life. Moreover, FOF is a risk factor for future falls. Aim. This study aimed to identify predictive factors of FOF (conceptualized as concerns about falling) after three years, with and without adjusting for concerns about falling at baseline, in people with PD. Methods. This study included 151 participants (35% women) with PD. At baseline, their mean (SD) age and PD duration were 68 (±9.0) and 9 (±6.1) years, respectively. The Falls Efficacy Scale-International (FES-I) was used as the dependent variable in multivariable linear regression analyses. Results. The mean (SD) FES-I score increased from 28.1 (11.9) to 33.1 (14.0) three years later (p<0.001). The strongest (according to the standardized regression coefficient, β) predictor of concerns about falling was walking difficulties (β = 0.378), followed by age (0.227), problems maintaining balance while dual tasking (0.172), and needing help in daily activities (0.171). When adjusting for baseline FES-I scores, the strongest predictive factor was problems maintaining balance while dual tasking (β = 0.161), which was followed by age (0.131) and female sex (0.105). Conclusions. This study pinpoints several predictive factors of concerns about falling that are modifiable and which could be addressed in rehabilitation: perceived walking difficulties, having problems maintaining balance while dual tasking, and dependence on others in daily activities. The importance of dual tasking is a novel finding, which future studies need to confirm or refute. One should be aware of the fact that an increased age predicts concerns about falling with and without adjusting for baseline FES-I scores, whereas female sex predicts concerns about falling only when adjusting for baseline FES-I scores.

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The Association Between Balance, Fear of Falling and Daily Activities in Drug Phases and Different Levels of Disease Severity in Patients With Parkinson's Disease

Basic and Clinical Neuroscience Journal ◽

10.32598/bcn.9.10.295 ◽

2018 ◽

Cited By ~ 1

Author(s):

Maryam Mehdizadeh ◽

Pablo Martinez-Martin ◽

Seyed Amirhasan Habibi ◽

Negar Nikbakht ◽

Faeze Alvandi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Fear Of Falling ◽

Daily Activities ◽

Different Levels

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Perceived walking difficulties in Parkinson’s disease – predictors and changes over time

10.21203/rs.3.rs-60246/v2 ◽

2021 ◽

Author(s):

Magnus Lindh-Rengifo ◽

Stina B. Jonasson ◽

Susann Ullén ◽

Niklas Mattsson-Carlgren ◽

Maria H. Nilsson

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Functioning ◽

Predictive Factors ◽

Intervention Studies ◽

Personal Factors ◽

Dual Tasking ◽

Balance Problems ◽

Over Time

Abstract Background: People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties.Methods: 148 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results: Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p <0.001. Concerns about falling was the strongest predictor (β=0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β=0.268) and pain (β=0.153). Perceived balance problems while dual tasking was the strongest predictor (β=0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β=-0.107). Conclusions: Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.

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Perceived walking difficulties in Parkinson’s disease – predictors and changes over time

BMC Geriatrics ◽

10.1186/s12877-021-02113-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Magnus Lindh-Rengifo ◽

Stina B. Jonasson ◽

Susann Ullén ◽

Niklas Mattsson-Carlgren ◽

Maria H. Nilsson

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Functioning ◽

Predictive Factors ◽

Intervention Studies ◽

Personal Factors ◽

Dual Tasking ◽

Balance Problems ◽

Over Time

Abstract Background People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. Methods One hundred forty-eight people with PD (mean age 67.9 years) completed the Generic Walk-12 (Walk-12G) questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p < 0.001. Concerns about falling was the strongest predictor (β = 0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β = 0.268) and pain (β = 0.153). Perceived balance problems while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β = − 0.107). Conclusions Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.

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Change in fear of falling in Parkinson's disease: a two-year prospective cohort study

International Psychogeriatrics ◽

10.1017/s1041610217002514 ◽

2017 ◽

Vol 31 (1) ◽

pp. 13-20 ◽

Cited By ~ 3

Author(s):

Tatjana Gazibara ◽

Darija Kisic Tepavcevic ◽

Marina Svetel ◽

Aleksandra Tomic ◽

Iva Stankovic ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Fall Prevention ◽

Rating Scale ◽

Fear Of Falling ◽

Daily Activities ◽

First Year ◽

Factors Associated ◽

Disease Rating

ABSTRACTBackground:Fear of falling in Parkinson's disease (PD) has been suggested as predictor of future falling. The purpose of this study was to compare fear of falling score after two years of follow-up with those observed at baseline and to assess factors associated with change in fear of falling over time.Methods:A total of 120 consecutive persons with PD were recruited and followed for two years. Fear of falling was assessed by using the 10-item Falls Efficacy Scale (FES). Occurrence of falling was registered during the first year of follow-up.Results:After two years, the average FES score statistically significantly changed (p = 0.003) from 30.5 to 37.5 out of 100 (increase of 22.9%). We observed that median scores of all FES items, except for “Preparing a meal, not requiring carrying of heavy or hot objects” and “Personal grooming,” significantly increased after two-year follow-up. After accounting for age, gender, PD duration, levodopa dosage, Hoehn and Yayhr stage, Unified Parkinson's Disease Rating Scale score three, depression, anxiety, and falling, we observed that sustaining greater number of falls in the first year of follow-up was associated with higher increase in FES score after two years (odds ratio 3.08, 95% confidence interval 1.30–4.87).Conclusion:After two years of follow-up, we observed a decrease in confidence at performing nearly all basic daily activities. Fall prevention programs should be prioritized in management of PD.

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Perceived walking difficulties in Parkinson’s disease – predictors and changes over time

10.21203/rs.3.rs-60246/v1 ◽

2020 ◽

Author(s):

Magnus Lindh-Rengifo ◽

Stina B. Jonasson ◽

Susann Ullén ◽

Niklas Mattsson-Carlgren ◽

Maria H. Nilsson

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Predictive Factors ◽

Intervention Studies ◽

Postural Instability ◽

Dual Tasking ◽

Paired Samples ◽

Changes Over Time ◽

Over Time

Abstract Background People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. Methods 149 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.7 versus 18.6, p < 0.001. Concerns about falling was the strongest predictor (β = 0.467) of perceived walking difficulties, followed by problems maintaining balance while dual tasking (β = 0.265), pain (β = 0.137) and postural instability (β = 0.116). Problems maintaining balance while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed postural instability (β = 0.098). Conclusions Perceived walking difficulties increase over time in people with PD. The predictive factors identified in this study (concerns about falling, problems maintaining balance while dual tasking, pain, postural instability) are modifiable. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.

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Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2020/4260501 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Bendix Labeit ◽

Inga Claus ◽

Paul Muhle ◽

Sonja Suntrup-Krueger ◽

Rainer Dziewas ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Common Symptom ◽

Yahr Stage ◽

Future Studies ◽

Pharyngeal Dysphagia ◽

Before And After ◽

The Mean ◽

Larger Sample

Background. Pharyngeal dysphagia is a common symptom of Parkinson’s disease (PD) leading to severe complications. PD-related pharyngeal dysphagia (PDrPD) may significantly improve in up to half of patients following acute oral levodopa challenge. Objective. The aim of this study was to investigate the effects of levodopa-carbidopa intestinal gel (LCIG) on PDrPD. Methods. Forty-five PD patients under LCIG treatment were available for retrospective analysis. In all patients with PDrPD who underwent flexible endoscopic evaluation of swallowing (FEES) in the clinical “on-state” both before and after implementation of LCIG treatment, FEES videos were systematically reassessed. PDrPD was characterized using a PD-specific FEES score evaluating premature bolus spillage, penetration/aspiration, and pharyngeal residue. Further, the duration of white-out was assessed, as a parameter for pharyngeal bradykinesia. Results. Eleven patients with PDrPD (mean age 74.6 ± 4.4 years; mean Hoehn and Yahr stage 3.8 ± 0.6) received FEES both before and after the onset of LCIG treatment. The mean swallowing score improved from 14.9 ± 7.3 to 13.0 ± 6.9 after implementation of LCIG; however, this difference was not significant (p=0.312). Premature bolus spillage decreased significantly (p=0.002) from 5.4 ± 1.1 to 3.6 ± 1.0, and white-out duration decreased significantly (p=0.002) from 984 ± 228 ms to 699 ± 131 ms after implementation of LCIG. Conclusions. LCIG may affect PDrPD and reduce premature bolus spillage and pharyngeal bradykinesia. Future studies with larger sample sizes are required to follow-up on these pilot results and identify which factors predict a good response of PDrPD to LCIG treatment.

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The mean velocity of posterior cerebral artery and basilar artery in Parkinson's disease with sleep disorders

Medicina Clínica Práctica ◽

10.1016/j.mcpsp.2021.100207 ◽

2021 ◽

Vol 4 ◽

pp. 100207

Author(s):

Muhammad Iqbal Basri ◽

Ida Farida ◽

Yudy Goysal ◽

Jumraini Tammasse ◽

Muhammad Akbar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disorders ◽

Cerebral Artery ◽

Basilar Artery ◽

Posterior Cerebral Artery ◽

Mean Velocity ◽

The Mean

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Intrinsic motivation in patients with Parkinson’s disease: a neuropsychological investigation of curiosity using dopamine transporter imaging

Neurological Sciences ◽

10.1007/s10072-020-04968-4 ◽

2021 ◽

Author(s):

Yayoi Shigemune ◽

Iori Kawasaki ◽

Akira Midorikawa ◽

Toru Baba ◽

Atsushi Takeda ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Intrinsic Motivation ◽

Extrinsic Motivation ◽

Brain Regions ◽

Word Recall ◽

Negative Consequences ◽

Dopamine Transporters ◽

Trail Making ◽

Neuropsychological Investigation

AbstractBoth intrinsic and extrinsic motivation are believed to involve brain regions that are innervated by the dopaminergic pathway. Although dopaminergic neurons in the midbrain deteriorate in Parkinson’s disease (PD), it remains unclear whether intrinsic motivation is impaired in PD patients. To address this issue, we investigated intrinsic motivation in PD patients using a task designed to assess the “Pandora effect,” which constitutes a curiosity for resolving uncertainty, even if this curiosity is likely to result in negative consequences. Twenty-seven PD patients and 27 age-matched healthy controls (HCs) completed a curiosity task in which they were required to decide either to view or skip negative pictures (e.g., snakes, spiders) and an examination battery that included the Mini-Mental State Examination, a verbal fluency test, the Trail Making Test, 10-word recall tests, and questionnaires for behavioral inhibition/activation and depression. DaTSCAN images to assess the distribution of dopamine transporters in the striatum were acquired only from PD patients. The results revealed that PD patients, relative to the HCs, viewed the pictures less frequently under both the certain and uncertain conditions. However, both the PD patients and HCs viewed the pictures at a higher frequency under the uncertain condition than under the certain condition. In the PD patients, the proportion of pictures viewed under the certain condition was positively correlated with the distribution of dopamine transporters in the striatum. These results suggest that despite the overall decreasing level of interest in viewing negative pictures, the motivation to resolve uncertainty is relatively intact in PD patients.

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