scholarly journals Golf as a Physical Activity to Potentially Reduce the Risk of Falls in Older Adults with Parkinson’s Disease

Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 72
Author(s):  
Rebecca R. Bliss ◽  
Frank C. Church
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Advanced Age ◽  
Golf Club ◽  
Increased Risk ◽  
Risk Of Falls

Advanced age is associated with an increased risk for falls in aging adults. Older adults are also more likely to be diagnosed with Parkinson’s disease (PD), with advanced age as the most significant risk factor. PD is a neurodegenerative disorder with four Cardinal motor symptoms: rigidity, bradykinesia, postural instability, and tremor. Thus, people (person)-with-Parkinson’s disease (PwP) have an even greater risk of falling than non-disorder age-matched peers. Exercise is an activity requiring physical effort, typically carried out to sustain or improve overall health and fitness, and it lowers the risk of falls in the general population. The sport of golf provides a low-impact all-around workout promoting a range of motion, activation of muscles in the upper and lower body, flexibility, and balance. Swinging a golf club offers a unique combination of high amplitude axial rotation, strengthening postural musculature, coordination, and stabilization, demonstrating the potential to impact PD symptoms positively. Golf may be a novel exercise treatment regimen for PD to use in conjunction with traditional medical therapy. We completed a literature review to determine the relationship between the game of golf, PD, and the risk of falls. We concluded that regularly playing golf can lower the risk for falls in community ambulating older adults with PD and demonstrates the potential to improve quality of life for PwP.

scholarly journals Television Viewing and Cognitive Dysfunction of Korean Older Adults

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 547
Author(s):  
Mi Sook Jung ◽  
Eunyoung Chung
Keyword(s):  
Older Adults ◽  
Cognitive Dysfunction ◽  
Cognitive Aging ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Later Life ◽  
Significant Risk Factor ◽  
Tv Viewing ◽  
Increased Risk ◽  
The Impact

This study examined the association between television (TV) viewing and cognitive dysfunction in elderly Koreans. Among participants of the 2014 National Survey of Older Koreans, 9644 were considered in this study. To better identify the association between two factors, propensity score (PS) matching with exact method was used. Finally, 168 viewers and non-viewers each were selected based on estimated PS on key variables and eliminating double matches. Multivariate logistic regression analysis was performed when controlling for possible covariates. Viewers were more likely to have cognitive dysfunction than non-viewers, with significant differences in most covariates. After correcting confounding effects of these covariates with PS matching, TV viewing was found to be a significant risk factor of cognitive dysfunction, along with absence of diagnosed hypertension and non-participation in physical leisure activities. TV viewing might be associated with increased risk of cognitive dysfunction in later life. Appropriate education and strategies to minimize TV viewing among older adults should be established to contribute to attenuating cognitive aging. More interventional studies can help older adults, caregivers, and healthcare professionals explore the cognitively beneficial alternatives to TV use considering the impact of socioeconomic factors of selecting TV viewing as a preferred leisure activity.

scholarly journals Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly

2019 ◽  
Vol 12 ◽  
pp. 117954411988493 ◽  
Author(s):  
Anneli Teder-Braschinsky ◽  
Aare Märtson ◽  
Marika Rosenthal ◽  
Pille Taba
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Knee Osteoarthritis ◽  
The Elderly ◽  
Control Group ◽  
Increased Risk ◽  
Symptomatic Knee ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.

Parkinson's disease and psychosis: Report of a case

2017 ◽  
Vol 41 (S1) ◽  
pp. s843-s844
Author(s):  
M. Valverde Barea ◽  
A. España Osuna ◽  
F. Cartas Moreno
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Family Background ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Behavioral Disorder ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Good Tolerance ◽  
Competing Interest

IntroductionJealous delusional ideation appears in 7-14% of cases of Parkinson's disease. Treatment with dopaminomimetics drugs is a significant risk factor for psychosis. However, the most likely etiology of psychosis in these patients is a loss of central cholinergic function associated with age since described psychosis even before the introduction of the L-Dopamine. Cognitive impairment and sleep disorders are predictors of development of psychosis.ObjectivePresent a clinical case of psychosis in Parkinson's disease and its treatment.MethodReason for consultation. Patient diagnosed with Parkinson's disease with behavioral disorder and delusional.Current illnessThe patient after antiparkinsonian medication has increased suspicion, self-referentiality, delusional jealousy ideation to her husband, delusional interpretations regarding somatic symptoms, insomnia and behavioral disorders with aggression.Family backgroundMother with Alzheimer's.Personal historyNo contact with mental health.Psychopathological examinationConscious, repetitive language, dysphoric mood with delusions of prejudice and jealousy.Mixed insomnia.DiagnosisPsychosis in Parkinson's disease.TreatmentQuetiapine 300 mg/day. Carbidopa 25 mg/L-dopa 100 mg: 1-0-1. On subsequent visits quetiapine was suspended and replaced by clozapine 200 mg/day.ResultsThe treatment of psychosis was effective with the use of quetiapine and subsequently clozapine with good tolerance and effectiveness. He also said lower antiparkinsonian medication.ConclusionsPsychotic symptoms are the most common psychiatric clinic in Parkinson's disease. Often not enough antiparkinsonian dopaminomimetics reduced to control psychotic symptoms and use of antipsychotics is required. The use of antipsychotics in Parkinson's disease should be careful for the likely increase in motor clinical and increased mortality. The most useful, are especially quetiapine and clozapine atypical antipsychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of mental practice strategies associated to physiotherapy on gait and risk of falls in Parkinson’s disease: a pilot study of a randomized clinical trial

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
T Silva ◽  
L Silva ◽  
K Silva ◽  
S Silva ◽  
D Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Gait Speed ◽  
Mental Practice ◽  
Control Group ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Degenerative Disorder

Abstract Introduction Parkinson’s Disease (PD) is a degenerative disorder that interferes with the voluntary movements due to dysfunction of the basal ganglia and presenting with motor signals, such as the reduction of gait speed. This contributes to an increased risk of falls. In rehabilitation, mental practice (MP) has been shown to promote plastic modulation of neural circuits and improve motor learning, but the results of research with MP in PD are still ambiguous due to the diversity of intervention strategies. Objectives To compare the effects of MP strategies associated to physiotherapy in gait and risk of falls in PD patients. Methodology We performed a pilot study of a clinical randomized, single blind, trial, conducted in accordance with the consort checklist. Patients with idiopathic PD were included and allocated to four groups: Control group (CG); Group with mental practice guided by images (MPI); Group with mental practice guided by audio (MPA); group with mental practice without a guide (MPWG). The subjects of the experimental groups were submitted to 15 sessions of physiotherapy and mental practice, while the CG received only physiotherapy. The sessions were held 2 times per week, 40 minutes for physiotherapy and approximately 5-10 minutes for the corresponding mental practice protocol. Spatial-temporal parameters of gait were assessed with the 10 meters Walking Test (TC10m), and the risk of falls was evaluated with the Timed Up and Go (TUG) test. Results The MPI group showed significant results for the parameters time (p = 0.027) and speed (p = 0.025) when compared with the results of the CG. No main effects for the group were observed concerning cadence and risk of falls had. Groups MPWG and MPA showed no significant results for the TC10m and TUG when compared with the CG. Conclusion The results of this pilot study suggest that MP guided by images associated to physical therapy was more effective to increase the gait speed than the alternative strategies.

scholarly journals A Cross-Sectional Study of Set Shifting Impairments and Falling in Individuals with and without Parkinson’s Disease

2017 ◽  
Author(s):  
J. Lucas McKay ◽  
Kimberly C. Lang ◽  
Lena H. Ting ◽  
Madeleine E. Hackney
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Freezing Of Gait ◽  
Cross Sectional Study ◽  
Set Shifting ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk

AbstractINTRODUCTION. Individuals with Parkinson’s disease (PD) are at increased risk for falls, and exhibit deficits in executive function, including Set Shifting, which can be measured as the difference between parts B and A of the Trailmaking Test. METHODS. We conducted a cross-sectional study using baseline data of PD patients with and without freezing of gait (FOG) (n=69) and community-dwelling neurologically-normal older adults (NON-PD) (n=84) who had volunteered to participate in clinical rehabilitation research. Multivariate logistic regression analyses were performed to determine associations between Set Shifting, PD, and faller status, as determined by ≥1 self-reported falls in the previous 6 months, after adjusting for demographic and cognitive factors and clinical disease characteristics. RESULTS. Impaired Set Shifting was associated with previous falls after controlling for age, sex, overall cognitive function, PD, FOG, and PD disease duration (OR=1.29 [1.03-1.60]; P=0.02). In models controlling for age, sex, and overall cognitive function, PD was associated with increased fall prevalence among the study sample (OR=4.15 [95% CI 1.65-10.44], P<0.01) and FOG was associated with increased fall prevalence among the PD sample (OR=3.63 [1.22-10.80], P=0.02). Although the strongest associations between Set Shifting and falling were observed among PD without FOG (OR=2.11) compared to HOA (OR=1.14) and PD with FOG (OR=1.46) in a multivariate model that allowed for interaction between set shifting and PD status, there was insufficient evidence to reject the null hypothesis of no interaction. CONCLUSIONS. Set Shifting is associated with previous falls in non-demented older adults with and without PD.HighlightsIndividuals with PD are at increased risk for falls, although causes are unclear.Impaired Set Shifting was associated with falls in older adults with and without PD.Associations were strongest among those with PD but without freezing of gait.

scholarly journals Frequency and predictors of potential drug: Drug interactions in hospitalized patients with Parkinson's diseases

2021 ◽  
Vol 8 (3) ◽  
pp. 1099-1108
Author(s):  
Dejan Aleksić ◽  
Srđan Stefanović ◽  
Miloš Milosavljević ◽  
Jovana Milosavljević ◽  
Slobodan Janković
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Interactions ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hospitalized Patients ◽  
Elderly Persons ◽  
Potential Drug ◽  
Cross Sectional ◽  
Parkinson’S Diseases

Introduction: Patients with Parkinson's disease are exposed to higher number of drugs on average than other elderly persons. Levodopa, of the mainstay of Parkinson's disease therapy, is frequently interacting with numerous drugs. Aim: The aim of this study was to identify predictors of potential drug-drug interactions (pDDIs) in hospitalized patients suffering from Parkinson's disease (PD). Material and Methods: This was a academic retrospective cross-sectional study in PD patients hospitalized at the Clinic of Neurology, Clinical Center Kragujevac. Medical records of hospitalized patients during the period 1.1.2017 - 31.12.2019 were analysed. The pDDIs were identified by means of Micromedex andLexi-Interact online softwares, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient. Results: Micromedex detected 160 different pDDIs in 77.8% of 72 patients with PD. The most frequent pDDIs were those that involved aspirin (with bisoprolol, sertraline and perindopril). Predictors of pDDIs in general was total number of drugs, while use of antidepressants presented a significant risk factor for major pDDIs. Lexi-Interact revealed 310 pDDIs in 98.6% of patients. The three most common pDDIs were with levodopa (bisoprolol, clonazepam, perindopril). Total number of drugs, number of co-morbidities, hospitalization at the neurodegenerative ward, and use of antipsychotics were identified as the relevant predictors of pDDIs. Lexi-interact software detected significantly more pDDIs than Micromedex (p<0.001). Conclusion: Neurologists should pay special attention when deciding whether to administer new drug to a PD patient with multiple comorbidities, hospitalized in a neurodegenerative ward and/or taking antidepressant or antipsychotic drugs.

scholarly journals Association between heart rate response during orthostatic test and falls in polymorbid patients aged 60 years and older

2019 ◽  
Vol 25 (4) ◽  
pp. 433-441
Author(s):  
A. V. Turusheva ◽  
Yu. V. Kotovskaya ◽  
E. V. Frolova
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
High Risk ◽  
Orthostatic Hypotension ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Vertical Position ◽  
Orthostatic Test ◽  
Cross Sectional ◽  
Risk Of Falls

Background. Orthostatic hypotension is a significant risk factor of falling in older adults. To diagnose the orthostatic hypotension an orthostatic test is used with assessment of heart rate (HR) response, systolic (SBP) and diastolic blood pressure (DBP) at the 3rd minute after the rise. However, according to studies, measurement of SBP and DBP at the 1st minute after rising can be more sensitive to detect older adults at risk of falling than at 3rd minute.Objective. The purpose of this study was to evaluate the role of changes in SBP, DBP and HR at the 1st, 2nd and 3rd minutes when performing an orthostatic test for identification of the elderly at high-risk of falls.Design and methods. This cross-sectional study included 100 adults aged 59+. Among them women comprise 56 % (n = 56). The following procedures were performed: the orthostatic test, anthropometry, medical history, assessment of drug treatment, depression evaluation, dementia and the degree of autonomy decline.Results. HR response at the 1st minute after the transition from horizontal to vertical position is more significant factor of falls risk than SBP and DBP changes during performing of orthostatic test. Absence of HR increasing during the transition from horizontal to vertical position associates with 10‑fold of risk falls among older adults: odds ratio 95 % confidence interval (OR 95 % CI) 10,5 (2,9–37,8). This association remained significant even after adjusting for age, gender, β-blockers use and comorbidity.Conclusion. Absence of HR increasing during the transition from horizontal to vertical position is a high sensitive marker of detecting older adults with polymorbidity in patients with the high risk of falls.

scholarly journals Does nephrotic syndrome without chronic kidney disease increase the risk of Parkinson’s disease and secondary parkinsonism? A nationwide population-based study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020821 ◽  
Author(s):  
Zheng-Hao Huang ◽  
Hsiang-Cheng Chen ◽  
Yu-Ching Chou ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nephrotic Syndrome ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Neurodegenerative Disorder ◽  
Age Groups ◽  
Positive Association ◽  
Research Database ◽  
Increased Risk

ObjectivesPrevious research has shown that patients with nephrotic syndrome (NS) have a higher risk of cognitive impairment, dementia or neurodegenerative disorder. The present study aimed to examine a relationship, if any exists between NS and Parkinson’s disease (PD), a neurodegenerative disorder and secondary parkinsonism (sPS).MethodsA nationwide retrospective observational study conducted using data from the 2000–2010 Taiwan National Health Insurance Research Database. This study included 3663 patients with NS and 14 652 randomly selected, age-matched and sex-matched patients without NS. A Cox multivariable proportional hazards model was used to evaluate the risk of PD and sPS (PDsPS) in the NS cohort.ResultsThis study identified a positive association between NS and the risk of PDsPS in both men and women and in all age groups (adjusted HR 1.51; 95% CI 1.37 to 1.66). Compared with patients without NS and comorbidities, those with NS with two or more comorbidities exhibited an 8.23-fold higher risk of PDsPS (95% CI 6.22 to 10.9) and patients with NS and one comorbidity exhibited a 2.93-fold higher risk of PDsPS (95% CI 2.37 to 3.63).ConclusionsPatients with NS have an increased risk of PDsPS. This increased risk may be related to brain vascular damage or blood–brain barrier impairment. Further research is necessary to explore the underlying relationship between NS and PDsPS.

scholarly journals 145 Antihypertensive Medications and Falls in the Older Person

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Jing Yao Quah ◽  
Reena Nadarajah ◽  
Elizabeth Gar Mit Chong ◽  
Rizah Mazzuin Razali ◽  
Fatt Soon Lee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Logistic Regression ◽  
Control Group ◽  
Older Person ◽  
Antihypertensive Medications ◽  
Recurrent Falls ◽  
Increased Risk ◽  
Geriatric Clinic ◽  
Risk Of Falls

Abstract Background There have always been concerns about the increased risk of falls in the older person taking antihypertensive medications. This retrospective study is aimed to determine whether different classes and number of antihypertensive medication used were associated with increased risk of falls in the older person. Methods Data was obtained from the geriatric clinic database in HKL from 2015-2018. The data for fallers were extracted from the Falls Clinic while data for the control group of non-fallers were extracted from the General Geriatric clinic. Socio-demographic details, types of falls, types of medications, and risk factors of falls were analysed. Results 117 of the cases who were fallers and 39 cases of non-fallers were analysed. Univariate logistic regression revealed that age, Parkinson’s disease and hypertension to have significant association with falls. The fallers were then analysed to assess falls risk with the use of antihypertensive medications. Those on one anti-hypertensive medication had an increased risk of recurrent falls (AOR = 3.16; 95% CI: 1.47–6.82) compared to those without antihypertensive medications (AOR = 0.37; CI: 0.13-1.03) and those with two or more antihypertensive medications (AOR = 0.56; CI: 0.27-1.16). Multivariate logistic regression also revealed that the use of all antihypertensive classes were not associated with recurrent falls and injuries from falls. However, patients who were on diuretics had significant odds of admission for falls (AOR 3.05; 95% CI 1.14-8.21) compared to ACE inhibitors or angiotensin receptor blockers (AOR 0.88; CI 0.38-2.10), beta blockers (AOR 0.88; CI 0.35-2.24), calcium channel blockers (AOR 0.96; CI 0.42-2.23) or alpha blockers (AOR 0.41; CI 0.09-1.99). Conclusion Older person with advanced age and Parkinson’s disease should be screened for risk of falling. In addition, all older people on antihypertensive medications especially diuretics should also be monitored for increased risk of falls.

scholarly journals An examination of three prescribing cascades in a cohort of older adults with dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shanna C. Trenaman ◽  
Susan K. Bowles ◽  
Susan Kirkland ◽  
Melissa K. Andrew
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nova Scotia ◽  
Cholinesterase Inhibitors ◽  
Cox Regression ◽  
Inappropriate Prescribing ◽  
Administrative Databases ◽  
Increased Risk ◽  
Prescribing Cascade

Abstract Background Prescribing cascades are a source of inappropriate prescribing for older adults with dementia. We aimed to study three prescribing cascades in older Nova Scotians with dementia using administrative databases. Methods Cohort entry for Nova Scotia Seniors’ Pharmacare Program beneficiaries was the date of dementia diagnosis. Prescription drug dispensing data was extracted for inciting medication and second treatment (cholinesterase inhibitor and bladder anticholinergic, metoclopramide and Parkinson’s disease medication, or calcium channel blocker (CCB) and diuretic) over the six-year period April 1, 2009 to March 31, 2015. In three separate analyses, dispensing an inciting medication signaled a look back of 365 days from the date of first dispensing to confirm that the second treatment was started after the inciting medication. The prescribing cascade was considered when the second treatment was started within 180 days of the inciting treatment. Sex differences in the prescribing cascade were tested using t-tests or chi square tests as appropriate. Both univariate (unadjusted) and multivariate (adjusted) logistic regression (adjusted for age, rurality, and sex) and Cox proportional hazards regression was used to identify risk factors for the prescribing cascade. Results From March 1, 2005 to March 31, 2015, 28,953 Nova Scotia Seniors' Pharmacare beneficiaries with dementia (NSSPBD) were identified. There were 60 cases of bladder anticholinergics following cholinesterase inhibitors, 11 cases of Parkinson’s disease medication following metoclopramide, and 289 cases of a diuretic following CCB in the cohort. Regression analysis demonstrated that risk of bladder anticholinergics following cholinesterase inhibitors and diuretics following CCBs were associated with female sex. Cox regression suggested that bladder anticholinergics were less often used by those on cholinesterase inhibitors and did not identify CCB use as leading more frequently to diuretic use. Conclusions The combination of diuretics following CCB was the most common prescribing cascade and bladder anticholinergics following cholinesterase inhibitors the second most common. However, exposure to the inciting medications did not increase risk of exposure to the second treatments. Combinations of bladder anticholinergics following cholinesterase inhibitors and diuretics following CCBs were more common for women raising concern that women may be at increased risk of these prescribing cascades.

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