Mobility and falls in people with Huntington's disease

Abstract

Objective: The aim of this study was to estimate the frequency of falls in people with Huntington's disease (HD) and make a preliminary assessment of tools appropriate for assessing the risk of falling. Design: Observational study. Setting: Hospital clinic. Subjects: 24 people with HD. Main measures: Balance was assessed using the Berg Balance Scale (BBS) and Timed ''Up & Go'' (TUG) test. Walking speed over 10 m was recorded. Long-term monitoring of walking activity was undertaken. Unified Huntington Disease Rating Scale (UHDRS) motor, Functional Assessment Scale (FAS), Independence Scale (IS) and Total Functional Capacity (TFC) scores were obtained as well as data about falls and stumbles. Differences between ''recurrent fallers'' (>2 falls/year) and ''non-fallers'' ((1 fall/year) for the range of outcome measures were investigated and probabilities calculated. Results: Mean (SD) age (years) of people with HD (n = 24) tested was 56.6 (11.7) and BMI (kg/m 2 ) 24.7 (5.5). Median (range) UHDRS motor scores were 48 (28-80). Ten (41.6%) patients reported (1 fall and 14 (58.3%) >2 falls in the previous 12 months. Recurrent fallers walked less (p,0.01) and slower than non-fallers. Their balance (BBS) (p,0.01) was worse and TUG scores were higher (p,0.01). People with HD had increased risk of falls if TUG scores were >14 s or BBS scores (40. Conclusion: A high proportion of HD patients have recurrent falls, and the BBS and TUG appear to be useful in falls risk assessment.

Motor-cognitive dual-task deficits in individuals with early-mid stage Huntington disease

“…Falls in HD have been linked with slower walking speed and poorer balance [15], but their relationship with dual-task performance has not been evaluated.…”

“…Individuals with HD commonly experience falls [15]; in one prospective study, 21% of participants experienced 1 fall and 58% experienced at least 2 falls over the course of a year [15].…”

First use of creatine hydrochloride in premanifest Huntington disease

“…These changes in body composition represent a striking benefit given that there is typically progressive weight loss and musculoskeletal atrophy in individuals with Huntington's disease 18,[151][152][153][154] . Likewise, reduced decline in postural stability is likely to afford considerable benefit to individuals with Huntington's disease, as fall-related injuries are a significant problem for this population 6,13 . Our finding that the decline in postural stability in intervention recipients is significantly reduced by the intervention, with a stepwise reduction in the number of individuals experiencing deterioration occurring after 9 months, and reaching statistical significance after 18 months, is a welcome and much anticipated outcome of this research.…”

“…Implementation of a targeted multidisciplinary rehabilitation program into the Huntington's disease population is anticipated to reduce dependence on the health system due to a reduction in the utilisation of health services as a result of a reduction in fall-related injuries, and may delay placement into residential and end-stage facilities by encouraging and maintaining patient independence. Huntington's disease is characterised by progressive cognitive, affective and motor deterioration over a 15-25 year period, together with a spectrum of associated physical deficits including postural instability [6][7][8][9][10] , gait impairments [11][12][13][14][15][16] and lean and fat tissue loss 17,18 .…”

Chronic subdural hematomas in Finnish patients with Huntington’s disease

“…There are many features inherent to Huntington's disease (HD), such as cortical brain atrophy [7], balance impairment, and high frequency of falls [4,6], which predispose patients to chronic SDH. However, there is only one previous report on chronic SDH in patients with HD [11].…”