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 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

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 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 Prediction of Life Satisfaction in People with Parkinson’s Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Stina B. Jonasson ◽  
Merja Rantakokko ◽  
Erika Franzén ◽  
Susanne Iwarsson ◽  
Maria H. Nilsson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Sex Education ◽  
Self Efficacy ◽  
Baseline Information ◽  
Independent Variable ◽  
General Self Efficacy

Introduction. People with Parkinson’s disease (PD) have lower life satisfaction (LS) than healthy peers. No study has yet identified predictors of LS in people with PD. Such information would be valuable for health care and future interventions that aim to maintain or increase LS. Aim. To examine how LS evolved in people with PD over a 3-year period, as well as to identify predictive factors of LS. Methods. We used data from baseline assessments and a 3-year follow-up of 163 people with PD (baseline, mean age 68 years; median PD duration 8 years, 35% women). LS was assessed with item 1 of the Life Satisfaction Questionnaire (LiSat-11). Dichotomized LS data from the 3-year follow-up were used as the dependent variable in multivariable logistic regression analyses. In the first step, independent variables included baseline information on sex, education, general self-efficacy, motor symptoms, perceived walking difficulties, fall-related activity avoidance, and difficulties with/need help in activities of daily living. At the second step, depressive symptoms were added as an independent variable. Results. The proportion of those who reported being satisfied with their lives reduced from 63.2% at baseline to 49.7% 3 years later (p=0.003). When depressive symptoms were not included in the analysis, general self-efficacy (odds ratio, OR = 1.081; 95% CI = 1.019–1.147) and perceived walking difficulties (OR = 0.962; 95% CI = 0.929–0.997) were significant (p<0.05) predictors of LS 3 years later. With depressive symptoms included, the influence of walking difficulties diminished, and depressive symptoms (OR = 0.730; 95% CI = 0.607–0.877) and general self-efficacy (OR = 1.074; 95% CI = 1.010–1.142) were the only significant predictors of LS 3 years later. Conclusions. LS is reduced over a 3-year period. The study suggests that perceived walking difficulties, general self-efficacy, and depressive symptoms are important predictors of LS in people with PD.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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