Comorbid disorders and hospitalisation in Parkinson?s disease: a prospective study

Abstract

Parkinson's disease (PD) is often associated with other disorders, typical of the disease or of the age of PD patients, that can lead to hospitalisation, sometimes as emergencies. In this one-year prospective, longitudinal study, we investigated the comorbid events prompting the hospitalisation, or occurring during the planned hospitalisation, of an unselected group of 180 PD patients, admitted to 9 general hospitals in the course of the study. The most frequent acute comorbid events were trauma (30.5%), mostly due to falls, and vascular disorders (29.3%). Comorbidities were closely related to PD in 50% of cases. More than 50% of patients did not require (in addition to PD therapy) specific treatment for the acute comorbid event. Older age was associated with increased risk of complications. The setting up of multidisciplinary networks covering entire territories could help to improve the way in which we tackle the clinical and social problems generated by PD and its comorbidities.

A Prospective Study of Alterations in Balance among Patients with Parkinson’s Disease

“…Its clinical manifestations include 4 cardinal signs: tremor, rigidity, bradykinesia and postural instability. Postural instability, which does not appear until stage III of the Hoehn-Yahr functional classification [2], leads to loss of balance and frequent falls [3] that constitute the main cause of hospitalization among these patients [4]. Falls are not only responsible for considerable medical costs, but also have significant psychological and social consequences for patients, who tend to lose self-confidence and limit their physical activity for fear of falling [5].…”

Comorbidity was associated with neurologic and psychiatric diseases: A general practice-based controlled study

“…Most studies have focused on the association between a neurologic/psychiatric index disease and one (e.g., stroke-depression [5]) or a restricted set (e.g., [6][7][8][9]) of conditions. Furthermore, studies have mainly concentrated on either somatic (e.g., [10][11][12]) or psychiatric (e.g., [13][14][15]) comorbidity, with only a few investigating both types of comorbidity. In addition, most of the studies that have comprehensively examined occurrence of somatic or psychiatric comorbidity did not use a control group and/or were not population based (e.g., [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]).…”

Orthopedic Complications of Parkinson's Disease

“…In one study, 12 out of 49 (24%) PD patients admitted to the hospital for non-neurological reasons had a fall or other trauma; of 48 PD patients seen in the emergency department, nine had fractures, three had head trauma, and one had a hip prosthesis displacement. In total, 25 out of 90 (30.5%) PD patients presented to the hospital with an orthopedic issue [54]. In addition, PD patients have a high rate of in-hospital orthopedic complications: eight out of 50 inpatient consultations in one study were to orthopedists [54].…”

“…In total, 25 out of 90 (30.5%) PD patients presented to the hospital with an orthopedic issue [54]. In addition, PD patients have a high rate of in-hospital orthopedic complications: eight out of 50 inpatient consultations in one study were to orthopedists [54]. Levodopa treatment may paradoxically exacerbate the issue, as it improves mobility with less effect on postural stability, resulting in increased risk of falls even among those who are well managed medically [55].…”