Fall frequency, predicting falls and participating in falls research: Similarities among people with Parkinson's disease with and without cognitive impairment

Amar, Khaled; Stack, Emma; Fitton, Carolyn; Ashburn, A.; Roberts, Helen

doi:10.1016/j.parkreldis.2014.11.001

Cited by 21 publications

(27 citation statements)

References 30 publications

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“…Based on a weighted sum, fall risk in the next 6 months is classified as low, moderate, or high. This 3‐item tool predicts falls with good accuracy (83%) and sensitivity (91%), but with poorer specificity (66%) in patients without severe cognitive impairment, a characteristic that should be kept in mind when comparing different tests . This test outperformed the single question concerning a history of falls; however, the magnitude of the added value was not explicitly reported.…”

Section: Assessing Risk and Classifying Falls: From Technology To CLImentioning

confidence: 99%

Falls in Parkinson's disease: A complex and evolving picture

et al. 2017

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Falls are a major determinant of poor quality of life, immobilization, and reduced life expectancy in people affected by Parkinson's disease (PD) and in older adults more generally. Although many questions remain, recent research has advanced the understanding of this complex problem. The goal of this review is to condense new knowledge of falls in PD from prodromal to advanced disease, taking into account risk factors, assessment, and classification as well as treatment. The fundamental steps of clinical and research-based approaches to falls are described, namely, the identification of fall risk factors, clinical and instrumental methods to evaluate and classify fall risk, and the latest evidence to reduce or delay falls in PD. We summarize recent developments, the direction in which the field should be heading, and what can be recommended at this stage. We also provide a practical algorithm for clinicians.© 2017 International Parkinson and Movement Disorder Society.

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Section: Assessing Risk and Classifying Falls: From Technology To CLImentioning

confidence: 99%

Falls in Parkinson's disease: A complex and evolving picture

et al. 2017

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“…Difficulties with gait and balance in Parkinson’s disease (PD) increase the risk of falls, institutionalization, and death [1–3]. Research studies have established that safe ambulation requires cortical input from areas involved with higher cognitive function [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Pal

O’Keefe

Robertson-Dick

et al. 2016

J NeuroEngineering Rehabil

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BackgroundOur primary objective was to determine the relationship between global cognitive function and specific domains of gait and balance in a cohort of Parkinson’s disease (PD) subjects. In a secondary analysis, we determined whether specific cognitive domains correlated with gait and balance performance.MethodsFourteen PD subjects (mean age 61.1 ± 7.8 years) were recruited from the Rush University Medical Center Movement Disorders clinic. Subjects underwent clinical assessment using the motor subsection of the Unified Parkinson’s Disease Rating Scale (UPDRS) followed by quantitative gait and balance assessments using the APDM Mobility Lab™ system (Mobility Lab, APDM Inc., Portland, OR). Subjects completed global cognitive testing using the Mattis Dementia Rating Scale (MDRS) as well as domain specific cognitive measures. Spearman’s rho was used to assess correlations between cognitive measures and gait and balance function, with False Discovery Rate (FDR) correction for multiple comparisons.ResultsGlobal cognitive function had the strongest correlation with stride velocity (r = 0.816, p = 0.001), turn duration (r = −0.806, p = 0.001), number of steps to turn (r = −0.830, p = 0.001), and mean velocity of postural sway in the medio-lateral direction (r = −0.726, p = 0.005). A significant correlation was found between processing speed and two turning measures (turn duration, r = −0.884, p = 0.001; number of steps to turn, r = −0.954, p < 0.001), but no other associations were found between specific cognitive domains and gait domains.ConclusionsThis pilot study provides preliminary data regarding the association between global cognitive function and pace-related measures of gait, turning, and postural sway. Furthermore, reduced processing speed was found to be associated with difficulty in performing turns.

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“…Falls lead to reduced independence and morbidity and markedly impact the quality of life of individuals with neurodegenerative diseases such as patients with Parkinson's disease (PD) [4,5]. Falls in PD were previously thought to be the result of motor deficits, in particular, balance and gait problems [31,34].…”

Section: Introductionmentioning

confidence: 99%

Fall risk is associated with amplified functional connectivity of the central executive network in patients with Parkinson’s disease

et al. 2015

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Falls are debilitating problems that markedly impact the health-related quality of life of many patients with Parkinson's disease (PD). Numerous studies point to the role of executive function and attention in falls; however, the brain mechanisms underlying these relationships are less clear. Here, we aim to evaluate the brain mechanisms underlying the role of executive function in falls. Patients with PD who were fallers (n = 27) or non-fallers (n = 53) and 27 healthy older adults were examined in a cross-sectional study. Gray matter volumes of the caudate head and posterior putamen were evaluated, as these striatal regions play a role in the executive and the sensorimotor cortico-striatal networks, respectively. The functional connectivity of the central executive network and of the sensorimotor network was measured using intrinsic brain connectivity during resting state functional magnetic resonance imaging. Compared to non-fallers and healthy controls, fallers had lower gray matter volume in the caudate head, but not in the posterior putamen, and increased connectivity between posterior partial regions of the central executive network, with no difference within the sensorimotor network. Mediation analysis demonstrated that the relationships between caudate head gray matter volume and fall history and risk were mediated by increased connectivity within the central executive network, apparently via attentional changes. The above findings provide additional converging evidence for the involvement of executive-related brain changes in falls in PD and support the important role of attention and executive function in fall risk.

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Fall frequency, predicting falls and participating in falls research: Similarities among people with Parkinson's disease with and without cognitive impairment

Cited by 21 publications

References 30 publications

Falls in Parkinson's disease: A complex and evolving picture

Falls in Parkinson's disease: A complex and evolving picture

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Fall risk is associated with amplified functional connectivity of the central executive network in patients with Parkinson’s disease

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