Predictors of nursing home placement in Huntington disease

Wheelock, Vicki; Tempkin, Teresa; Marder, Karen; Nance, Martha; Myers, Richard H.; Zhao, Hongwei; Kayson, Elise; Orme, Constance; Shoulson, Ira; Hedges, Phillipa; McCusker, Elizabeth; Pearce, Samantha; Trent, Ronald J.; Abwender, David A.; Como, Peter; Gardiner, Irenita; Hickey, Charlyne; Kieburtz, Karl; Marshall, Frederick J.; Pearson, Nancy; Zimmerman, Carol; Louis, Elan D.; Moskowitz, Carol; Polanco, Carmen; Zubin, Naomi; Brown, Catherine; Burke-Holder, Jill; Guttman, Mark; Russell, Sandra; Stewart, Dwight J.; Thomson, Jackie; Sax, Daniel S.; Saint‐Hilaire, Marie; Gray, J.; Hunter, Cindy; Mercado, Nanette; Siemers, Eric; Wojeieszek, Joanne; Dawson, Ted M.; Leritz, Elizabeth C.; Rosenblatt, Adam; Sherr, M.; Young, Candace; Ashizawa, Tetsuo; Beach, Jenny; Jankovic, Joseph; Jaglin, Jeana; Shannon, Kathleen M.; Lundin, Anders; Francis, Kathleen; Lane, Kim; Auchus, Alexander P.; Greenamyre, J. Timothy; Hersch, Steven M.; Jones, Randi; Olson, David P.; John, Jang Ho; Cudkowicz, Merit; Koroshetz, Walter J.; Penney, John B.; Rudolf, Greg; Sexton, Paula; Young, Anne B.; Albin, Roger L.; Wernette, Kris; Higgins, Donald S.; Reider, Carson; Hunt, Vicki; Walker, Francis O.; Hauscr, Robert; Sanchez‐Ramos, Juan; Walker, Audrey; Pantello, Carol; Rohs, Gina; Suchowersky, Oksana; Duncan, Kerry; Seeberger, Lauren; Corey–Bloom, Jody; Paulsen, Jane S.; Swenson, Michael R.; Swerdlow, Neal R.; Martin, W. R. Wayne; Wieler, Marguerite; Facca, Alicia; Rey, Gustavo; Weiner, William J.; Adler, Charles; Caviness, John N.; Lied, Cindy; Newman, Stephanie; Feigin, Andrew; Mazurkiewicz, Jennifer; Caplan, Karen; Cellar, Janet S.; Marck, Kenneth; Hayden, Michael R.; Raymond, Lynn A.; Dure, Leon S.; Lane, Jane

doi:10.1212/01.wnl.0000052992.58107.67

Cited by 131 publications

(102 citation statements)

References 16 publications

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“…Accurate and responsive measurement of mobility and balance is very important because such impairments predict long-term care placement in HD [2]. While quantitative gait measures have been shown to be accurate and reliable in HD [8], they are not easy to administer in community-based studies due to lack of availability of expensive laboratory equipment at clinical facilities.…”

Section: Discussionmentioning

confidence: 99%

Clinical measurement of mobility and balance impairments in Huntington's disease: Validity and responsiveness

Rao

Muratori

Louis³

et al. 2009

Gait & Posture

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Section: Discussionmentioning

confidence: 99%

Clinical measurement of mobility and balance impairments in Huntington's disease: Validity and responsiveness

Rao

Muratori

Louis³

et al. 2009

Gait & Posture

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“…A significant number of HD patients would require long-term care during the course of the disease, and they are frequently admitted to the nursing homes until their deaths. Wheelock et al [20] found that patients in skilled nursing facilities had a longer duration of HD, and that more female than male HD patients resided the nursing homes. However, this explanation was not applicable in this study since families took care for majority of our patients (70% and 73% of male and female patients, respectively) ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Survival of Huntington’s disease patients in Serbia: longer survival in female patients

et al. 2007

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The objective of this study was to estimate probability of survival of Huntington's disease (HD) patients in Serbia as a function of CAG repeat length and selected demographic variables. This follow-up study was carried out at the Institute of Neurology, Clinical Centre of Serbia, Belgrade, 1982-2004. The study group consisted of 112 HD patients. The significant inverse correlation was found between CAG repeat length and age at onset of HD (r = -0.732, P = 0.001) and age at death (r = -0.760, P = 0.001). The cumulative probabilities of survival in a five, ten, fifteen, and twenty-years' period were 90.9, 63.2, 10.3 and 4.5%, respectively. Higher survival probabilities were registered in female patients, as well as in those with older age at onset and lower number of CAG repeat length (

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“…Care could be provided at home for most of the patients: only 2 patients required institutionalization. Motor symptoms (marked chorea, 33 bradykinesia, and impaired gait and balance 42 ), rather than psychiatric symptoms, have been shown to be predictors of nursing home placement in HD.…”

Section: -22mentioning

confidence: 99%

Deep brain stimulation for Huntington's disease: long-term results of a prospective open-label study

González

Cif

Biolsi

et al. 2014

JNS

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Object To date, experience of globus pallidus internus (GPi) deep brain stimulation (DBS) in the treatment of Huntington's disease (HD) has been limited to a small number of case reports. The aim of this study was to analyze long-term motor outcome of a cohort of HD patients treated with GPi DBS. Methods Seven patients with pharmacologically resistant chorea and functional impairment were included in a prospective open-label study from 2008 to 2011. The main outcome measure was the motor section of the Unified Huntington's Disease Rating Scale. The primary end point was reduction of chorea. Results Patients underwent MRI-guided bilateral GPi implantation. The median duration of follow-up was 3 years. A significant reduction of chorea was observed in all patients, with sustained therapeutic effect; the mean improvement on the chorea subscore was 58.34% at the 12-month follow-up visit (p = 0.018) and 59.8% at the 3-year visit (p = 0.040). Bradykinesia and dystonia showed a nonsignificant trend toward progressive worsening related to disease evolution and partly to DBS. The frequency of stimulation was 130 Hz for all patients. DBS-induced bradykinesia was managed by pulse-width reduction or bipolar settings. Levodopa mildly improved bradykinesia in 4 patients. Regular off-stimulation tests confirmed a persistent therapeutic effect of DBS on chorea. Conclusions GPi DBS may provide sustained chorea improvement in selected HD patients with pharmacologically resistant chorea, with transient benefit in physical aspects of quality of life before progression of behavioral and cognitive disorders. DBS therapy did not improve dystonia or bradykinesia. Further studies including quality of life measures are needed to evaluate the impact of DBS in the long-term outcome of HD.

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Predictors of nursing home placement in Huntington disease

Cited by 131 publications

References 16 publications

Clinical measurement of mobility and balance impairments in Huntington's disease: Validity and responsiveness

Clinical measurement of mobility and balance impairments in Huntington's disease: Validity and responsiveness

Survival of Huntington’s disease patients in Serbia: longer survival in female patients

Deep brain stimulation for Huntington's disease: long-term results of a prospective open-label study

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