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

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.

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

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.

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

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.

scholarly journals Better quality of life and less caregiver strain in young-onset Parkinson’s disease: a multicentre retrospective cohort study

2020 ◽  
Author(s):  
Maarten Te Groen ◽  
◽  
Bastiaan R. Bloem ◽  
Samuel S. Wu ◽  
Bart Post
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Functioning ◽  
Age At Onset ◽  
Caregiver Strain ◽  
Young Onset ◽  
Over Time

Abstract Background Parkinson’s disease (PD) is typically considered as a disease of the elderly. However, there is a sizeable subgroup of patients where PD starts at a younger age, known as young-onset PD (YOPD). We evaluated the differences in quality of life and caregiver strain between YOPD and later onset PD (LOPD) patients in a large cohort. Methods In collaboration with the Parkinson Foundation Quality Improvement Initiative (PF-QII), we conducted a retrospective three-year analysis on 962 PD patients of the QII database (starting date May 2016). Of these, 272 patients had YOPD, and 690 had LOPD. The Parkinson’s Disease Questionnaire-39 (PDQ-39) total score served as primary outcome measure. Furthermore, we analysed group differences in modified caregiver strain index (MCSI) total score, three cognition functions, and number of falls. A regression analysis adjusting for covariates was used to assess the association of age at onset with PDQ-39 and MCSI. Results PDQ scores were better in YOPD patients, MCSI scores on social constraint were lower in YOPD patients, but scores on financial constraint were higher in this group. After adjusting for covariates, YOPD patients had better quality of life and less caregiver strain at all follow-up moments, but not at baseline. Decline over time for all outcomes was lower in the YOPD group compared to the LOPD group. Cognitive functioning and number of falls progressed slower in the YOPD group compared to the LOPD group. Conclusion Compared to LOPD patients, YOPD patients had a better quality of life, less caregiver strain, fewer falls and better cognitive functioning after their first follow-up visit, and also a slower decline over time.

scholarly journals Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

2019 ◽  
Vol 267 (1) ◽  
pp. 259-266
Author(s):  
Aleksander H. Erga ◽  
Guido Alves ◽  
Ole Bjørn Tysnes ◽  
Kenn Freddy Pedersen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Short Form ◽  
Population Based ◽  
Self Report ◽  
Cognitive Changes ◽  
Compulsive Behaviors ◽  
Changes Over Time ◽  
Over Time

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

scholarly journals Dynamic interplay of cognitive functioning and depressive symptoms in patients with Parkinson’s Disease

2021 ◽  
Author(s):  
Ulrich Schroeders ◽  
Johannes Zimmermann ◽  
Tamara Wicke ◽  
Martina Schaumburg ◽  
Elisabeth Lang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Symptoms ◽  
Cognitive Functioning ◽  
Cognitive Abilities ◽  
Large Variability ◽  
Random Intercept ◽  
Behavioral Enrichment ◽  
Dynamic Interplay

Objective: We examine the trajectories of and the dynamic interplay between cognitive functioning and depressive symptoms in patients with Parkinson's disease (PD) in comparison to healthy controls (HC) from an intraindividual perspective.Method: The DeNoPa study is a single-center, observational, longitudinal study with biennial follow-ups over 8 years. The present analyses are based on 123 PD (79 male) and 107 HC (64 male) with a mean age of 64.1. PD and HC completed a comprehensive battery of neurological tests and scales assessing depressive symptoms. To study their trajectories and the dynamic interplay we used a random-intercept cross-lagged panel model.Results: Cognitive abilities of PD were on average d = -0.56 worse at baseline and d = -0.93 at 8-years follow-up in comparison to HC. Depressive symptoms in PD showed a large variability and followed a U-shaped trajectory. From an intraindividual perspective, stronger impairments in cognitive abilities were subsequently associated with increased depressive symptoms (b = -0.52, p = .01), whereas the effect in the opposite direction was not significant.Conclusions: We found no indication that depressive symptoms can be seen as precursors of dementia. On the contrary, to counter cognitive losses and the subsequent mood deterioration, patient education and early cognitive (and behavioral) enrichment seem promising candidates for treatment.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Magnus Lindh-Rengifo ◽  
Stina B. Jonasson ◽  
Niklas Mattsson ◽  
Susann Ullén ◽  
Maria H. Nilsson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Predictive Factors ◽  
Fear Of Falling ◽  
Daily Activities ◽  
Negative Consequences ◽  
Dual Tasking ◽  
Future Studies ◽  
Female Sex ◽  
The Mean

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.

Changes in Self- and Informant-Reported Frontal Behaviors in Parkinson’s Disease: A Longitudinal Study

2020 ◽  
pp. 089198872096425
Author(s):  
Celina F. Pluim ◽  
Marina Z. Nakhla ◽  
Molly Split ◽  
J. Vincent Filoteo ◽  
Irene Litvan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Caregiver Burden ◽  
Executive Dysfunction ◽  
Behavior Ratings ◽  
Patient Reported ◽  
Frontal Systems ◽  
Behavior Scale ◽  
Over Time

Objective: Frontal behaviors (i.e., executive dysfunction, disinhibition, apathy) are common in Parkinson’s disease (PD). However, it is unclear if patient and informant reports of patient frontal behaviors are in agreement over time. Method: Sixty-two PD patients without dementia and their informants (87% spouses/partners) completed the self- and informant-versions of the Frontal Systems Behavior Scale at baseline and 2-year follow-up. Dyad ratings were compared and predictors of behavior ratings were examined. Results: Patient and informant reports at baseline and follow-up were in agreement, with significant increases in overall frontal behaviors, executive dysfunction, and apathy. Higher levels of baseline patient depression and caregiver burden predicted decrements in patient-reported executive function; worse patient cognition at baseline predicted worsening apathy as rated by informants. Conclusions: PD patients and their informants are concordant in their ratings of worsening frontal behaviors over time. Targeting patient depression, cognition, and caregiver burden may improve decrements in frontal behaviors (executive dysfunction and apathy) in PD.

Parkinson’s Disease Motor Subtypes Change with the Progression of the Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up

2021 ◽  
pp. 1-21
Author(s):  
Diego Santos García ◽  
Hector Canfield ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores Bartolomé ◽  
Lucía Naya Ríos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living ◽  
Cognitive Status ◽  
Postural Instability ◽  
Change Over Time ◽  
Factors Associated ◽  
Baseline Visit ◽  
Over Time

Background: Motor phenotype (MP) can be associated with a different prognosis in Parkinson’s disease (PD), but it is not fixed and can change over time. Objective: Our aim was to analyze how the MP changed over time and to identify factors associated with the changes in PD patients from a multicenter Spanish PD cohort. Methods: PD patients who were recruited from January-2016 to November-2017 (baseline visit; V0) and evaluated again at a 2-year±30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort, were included in this study.MP was calculated at both visits based on Jankovic classification in TD (tremor dominant), IND (indeterminate), or PIGD (postural instability and gait difficulty). Sociodemographic and clinical data were collected, including serum biomarkers. Results: Five hundred eleven patients (62.57±8.59 years old; 59.2%males) were included in the study. At V0, MP was: 47.4%(242/511) TD; 36.6%(187/511) PIGD; 16%(82/511) IND. Up to 38%(194/511) of the patients changed their phenotype from V0 to V2, being the most frequent from TD to IND (8.4%) and from TD to PIGD (6.7%). A worse cognitive status (OR = 0.966) and less autonomy for activities of daily living (OR  =  0.937) at V0 and a greater increase in the globalNMS burden (OR  =  1.011) from V0 to V2 were associated with changing from TD to another phenotype after 2-year follow-up. Conclusion: The MP in PD can change over time. With disease progression, the percentage of cases with non-tremoric MP increases. PD patients who changed from TD to postural instability and gait difficulty increased NMS burden significantly.

scholarly journals Coping Styles among People with Parkinson’s Disease: A Three-Year Follow-Up Study

2020 ◽  
Vol 10 (12) ◽  
pp. 190
Author(s):  
Maria H. Nilsson ◽  
Frank Oswald ◽  
Sebastian Palmqvist ◽  
Björn Slaug
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Factor Analysis ◽  
Coping Style ◽  
Daily Life ◽  
Coping Styles ◽  
Gradual Loss ◽  
The Stability ◽  
Over Time

People with Parkinson’s disease (PD) experience a gradual loss of functional abilities that affects all facets of their daily life. There is a lack of longitudinal studies on coping styles in relation to the disease progression among people with PD. The aim of this study was to explore how coping styles in PD evolve over a 3-year period. Data from the longitudinal project “Home and Health in People Ageing with PD” was utilized (N = 158), including baseline and 3-year follow-up assessments. Coping was captured by ratings of 13 different coping styles. A factor analysis was conducted to analyse patterns of coping styles. Stability and change were analysed for each of the 13 styles with respect to the course of the disease. The factor analysis revealed four coping patterns: pessimistic, optimistic, persistent and support-seeking. The stability of each coping style over time ranged from 75.3% to 90.5%. Those who experienced a worsening of the disease were most inclined to change their coping style (p = 0.006). The results suggest that even when facing severe challenges due to PD in daily life, coping styles remain relatively stable over time. However, a worsening in PD severity appeared to trigger a certain re-evaluation of coping styles.

scholarly journals Diagnostic accuracy of glabellar tap sign for Parkinson’s disease

2021 ◽  
Author(s):  
Simo Nuuttila ◽  
Mikael Eklund ◽  
Juho Joutsa ◽  
Elina Jaakkola ◽  
Elina Mäkinen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Diagnostic Value ◽  
Clinical Test ◽  
Diagnostic Validity ◽  
Healthy Controls ◽  
Validity And Reliability ◽  
Dopaminergic Activity ◽  
Over Time

AbstractGlabellar tap or reflex (GR) is an old bedside clinical test used in the diagnostics of Parkinson’s disease (PD), but its diagnostic value is unclear. This study examines the diagnostic validity and reliability of GR in PD in relation to brain dopaminergic activity. GR was performed on 161 patients with PD, 47 patients with essential tremor (ET) and 40 healthy controls immediately prior to dopamine transporter (DAT) [123I]FP-CIT SPECT scanning. The binding ratios were investigated with consideration of the GR result (normal/abnormal). In addition, the consistency of the GR was investigated with 89 patients after a mean follow-up of 2.2 years. PD and ET patients had higher GR scores than healthy controls (p < 0.001), but there was no difference in GR between PD and ET patients (p = 0.09). There were no differences in the ratio of abnormal to normal GRs between the PD and ET groups (73% vs. 64% abnormal, respectively, p = 0.13) or in DAT binding between PD patients with abnormal and normal GRs (p > 0.36). Over follow-up, the GR changed from abnormal to normal in 20% of PD patients despite the presence of clinically typical disease. The sensitivity and specificity of GR for differentiating PD from ET were 78.3% and 36.2%, respectively. Although GR has been used by clinicians in the diagnostics of PD, it does not separate PD from ET. It also shows considerable inconsistency over time, and abnormal GR has no relationship with dopamine loss. Its usefulness should be tested for other clinical diagnostic purposes.

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