Falls in persons with Parkinson's disease: Do non-motor symptoms matter as much as motor symptoms?
| Autor: | Mayela Rodríguez-Violante, Alonso Alvarado-Bolaños, Karla Salinas-Barboza, Amin Cervantes-Arriaga, Kenia Arredondo-Blanco, Sara Isais-Millán |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Multivariate analysis Parkinson's disease Movement disorders Time Factors Motor Disorders Disease Logistic regression Severity of Illness Index 0302 clinical medicine neurologic manifestations accidentes por caídas Risk Factors risk factors 030212 general & internal medicine Postural Balance Parkinson Disease Middle Aged Parkinson disease Neurology Enfermedad de Parkinson Female medicine.symptom RC321-571 medicine.medical_specialty Neurosciences. Biological psychiatry. Neuropsychiatry Bivariate analysis motor disorders Risk Assessment Statistics Nonparametric 03 medical and health sciences Rating scale trastornos motores manifestaciones neurológicas medicine Humans factores de riesgo Gait Disorders Neurologic Aged Gait Disturbance business.industry medicine.disease Cross-Sectional Studies Logistic Models Multivariate Analysis Physical therapy Accidental Falls Neurology (clinical) accidental falls business 030217 neurology & neurosurgery |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Volume: 77, Issue: 11, Pages: 761-767, Published: 05 DEC 2019 Arquivos de Neuro-Psiquiatria Arquivos de Neuro-Psiquiatria v.77 n.11 2019 Arquivos de neuro-psiquiatria Academia Brasileira de Neurologia instacron:ABNEURO |
| Popis: | Falls are common among persons with Parkinson's disease (PD). On the other hand, predicting falls is complex as there are both generic and PD-specific contributors. In particular, the role of non-motor symptoms has been less studied. Objective: The objective of this study was to identify the role of non-motor predictors of falling in persons with PD (PwP). Methods: A cross-sectional study was carried out in PwP recruited from a movement disorders clinic. Clinical and demographical data were collected. All PwP were assessed using the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Variables were assessed at the bivariate level. Significant variables were put into a logistic regression model. Results: A total of 179 PwP were included. Overall, 16.8% of PwP had fallen in the past 12 months, with 53.3% of them being recurrent fallers. The mean number of monthly falls was 2.5 ± 3.3. Factors associated with falling in the bivariate analysis included the disease duration, Hoehn and Yahr stage, MDS-UPDRS part I and II, postural instability/gait disturbance (PIGD) subtype, NMSS urinary domain, NMSS miscellaneous domain, and non-motor severity burden (all p-values < 0.05). After multivariate analysis, only the disease duration (p = 0.03) and PIGD (p = 0.03) remained as independent risk factors. Conclusion: Disease duration and the PIGD subtype were identified as relevant risk factors for falls in PwP Non-motor symptoms appear to have a less important role as risk factors for falls. RESUMEN Las caídas son frecuentes entre las personas con Parkinson (EP). La predicción de caídas es compleja ya que existen contribuyentes genéricos y específicos. El papel de los síntomas no motores ha sido menos estudiado. Objetivo: Identificar el papel de los factores no motores en caídas en personas con EP (PcP). Métodos: Estudio transversal en PcP reclutadas en una clínica de trastornos del movimiento. Se incluyeron datos clínicos y demográficos. Todos los PcP se evaluaron con la Escala Unificada de Enfermedad de Parkinson modificada por la Sociedad Internacional de Trastornos del Movimiento (MDS-UPDRS) y la Escala de Síntomas No Motores (NMSS). Se incluyeron variables significativas en un modelo de regresión logística. Resultados: Se incluyeron un total de 179 PcP El 16.8% había presentado una caída en los últimos doce meses y el 53.3% de forma recurrente. El número medio de caídas mensuales fue de 2.5 ± 3.3. Los factores asociados con la caída en el análisis bivariado fueron la duración de la enfermedad, Hoehn e Yahr, MDS-UPDRS parte I y II, subtipo de alteración de la marcha/inestabilidad postural (PIGD), dominio urinario del NMSS, dominio misceláneo del NMSS y carga de severidad no motora (todos los valores de p < 0.05). Después del análisis multivariado, solo la duración de la enfermedad (p = 0.03) y PIGD (p = 0.03) permanecieron como un factor de riesgo independiente. Conclusión: La duración de la enfermedad y PIGD se identificaron como factores de riesgo para caídas. Los síntomas no motores parecen tener un papel menos relevante en las caídas. |
| Databáze: | OpenAIRE |
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