Dataset Information

Impaired set shifting is associated with previous falls in individuals with and without Parkinson's disease.

ABSTRACT: BACKGROUND:Individuals with Parkinson's disease (PD) are at increased risk for falls, which lead to substantial morbidity and mortality. Understanding the motor and non-motor impairments associated with falls in PD is critical to informing prevention strategies. In addition to motor symptoms, individuals with PD exhibit non-motor deficits, including impaired set shifting, an aspect of executive function related to cognitive flexibility that can be measured quickly with the Trailmaking Test. RESEARCH QUESTION:To determine whether impaired set shifting is associated with fall history in people with and without PD. METHODS:We examined associations between set shifting, PD status, and fall history (?1 falls in the previous 6 months) in data from PD patients (n?=?65) with and without freezing of gait (FOG) and community-dwelling neurologically-normal older adults (NON-PD) (n?=?73) who had participated in our rehabilitation studies. RESULTS:Impaired set shifting was associated with previous falls after controlling for age, sex, overall cognitive function, PD status, FOG, and PD disease duration (OR?=?1.29 [1.03-1.60]; P?=?0.02). Consistent with literature, PD and FOG were also independently associated with increased fall prevalence (PD OR?=?4.15 [95% CI 1.65-10.44], P?

SUBMITTER: McKay JL

PROVIDER: S-EPMC5960619 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Impaired set shifting is associated with previous falls in individuals with and without Parkinson's disease.

McKay J Lucas JL Lang Kimberly C KC Ting Lena H LH Hackney Madeleine E ME

Gait & posture 20180306

<h4>Background</h4>Individuals with Parkinson's disease (PD) are at increased risk for falls, which lead to substantial morbidity and mortality. Understanding the motor and non-motor impairments associated with falls in PD is critical to informing prevention strategies. In addition to motor symptoms, individuals with PD exhibit non-motor deficits, including impaired set shifting, an aspect of executive function related to cognitive flexibility that can be measured quickly with the Trailmaking Te ...[more]

PMID: 29571090

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Project description:BackgroundFalls are a major health burden for older adults with Parkinson's disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD. This study aimed to develop a PD-specific falls questionnaire and to evaluate its test-retest reliability in older adults with PD.MethodsA novel PD-specific falls questionnaire (PDF-Q) was developed in two modes (online and paper-based version) and used to assess falls and near-falls events over the past 12-months. Questions were agreed upon by an expert group, with the domains based on previous falls-related questionnaires. The questions included the number and circumstances (activities, location and direction) of falls and near-falls, and consequences (injuries and medical treatment) of falls. The PDF-Q was distributed to 46 older adults with PD (online n = 30, paper n = 16), who completed the questionnaire twice, 4 weeks apart. Kappa (κ) statistics were used to establish test-retest reliability of the questionnaire items.ResultsPooled results from both questionnaires for all participants were used to assess the overall test-retest reliability of the questionnaire. Questions assessing the number of falls (κ = 0.41) and the number of near-falls (κ = 0.51) in the previous 12-months demonstrated weak agreement, while questions on the location of falls (κ = 0.89) and near-falls (κ = 1.0) demonstrated strong to almost perfect agreement. Questions on the number of indoor (κ = 0.86) and outdoor (κ = 0.75) falls demonstrated moderate to strong agreement, though questions related to the number of indoor (κ = 0.47) and outdoor (κ = 0.56) near-falls demonstrated weak agreement. Moderate to strong agreement scores were observed for the most recent fall and near-fall in terms of the direction (indoor fall κ = 0.80; outdoor fall κ = 0.81; near-fall κ = 0.54), activity (indoor fall κ = 0.70; outdoor fall κ = 0.82; near-fall κ = 0.65) and cause (indoor fall κ = 0.75; outdoor fall κ = 0.62; near-fall κ = 0.56).ConclusionsThe new PDF-Q developed in this study was found to be reliable for capturing the circumstances and consequences of recent falls and near-falls in older adults with PD.

Dataset Information

Impaired set shifting is associated with previous falls in individuals with and without Parkinson's disease.

Publications

Impaired set shifting is associated with previous falls in individuals with and without Parkinson's disease.

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