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Cognitive and psychiatric symptoms are associated with walking difficulties in mild Parkinson’s disease

Lindholm, Beata LU ; Brogårdh, Christina LU ; Hagell, Peter LU and Nilsson, Christer LU (2020) The MDS Virtual Congress 2020 p.549-549
Abstract
Objective: To investigate the association of different aspects of cognitive impairment, depression and anxiety with walking difficulties in daily life in persons with mild PD.
Background: Walking difficulties in daily life are common among persons with Parkinson’s disease (PD) and may cause falls and near falls, limitations in activity, restrictions in participation and decrease in quality of life. Motor symptoms are often cited as a major reason for these difficulties while the association with cognitive and psychiatric symptoms is still poorly explored.
Methods: The study included cross-sectional data from 73 persons with PD that visited a neurology outpatient clinic during 2012-2017. Mean (SD) age was 69 (8.9) years, mean (SD)... (More)
Objective: To investigate the association of different aspects of cognitive impairment, depression and anxiety with walking difficulties in daily life in persons with mild PD.
Background: Walking difficulties in daily life are common among persons with Parkinson’s disease (PD) and may cause falls and near falls, limitations in activity, restrictions in participation and decrease in quality of life. Motor symptoms are often cited as a major reason for these difficulties while the association with cognitive and psychiatric symptoms is still poorly explored.
Methods: The study included cross-sectional data from 73 persons with PD that visited a neurology outpatient clinic during 2012-2017. Mean (SD) age was 69 (8.9) years, mean (SD) disease duration was 8 (4.3) years and mean (SD) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) and cognition (Mini Mental State Examination, MMSE) were 16.4 (9.9) and 27.3 (2.6), respectively. Walking difficulties in daily life (the dependent variable) was investigated with the generic Walk-12 (Walk-12G). Multiple linear regression analysis (controlling for age and motor symptoms) included the following independent variables: cognition (MMSE), memory (Alzheimer's Disease Assessment Scale, ADAS, cognitive subscale), cognitive perception speed (A Quick Test of Cognitive Speed, AQT, part I-III) frontal lobe/executive impairment (Frontal Assessment Battery, FAB) and depression and anxiety (Hospital Anxiety and Depression Scale, HADS).
Results: The median Walk-12G scores was 11.5 (q1-q3, 5.5−25.5). Four significant independent variables were identified explaining 15.5% of the variance in the Walk-12G score. The factor with the strongest association with walking difficulties in daily life was cognitive perception speed (AQT part I) (explaining 4.9%) closed followed by anxiety (4.9%), cognitive perception speed (AQT part II) (3%) and frontal lobe/executive impairment (2.7%).
Conclusion: Cognitive and psychiatric symptoms are associated with walking difficulties in persons with mild PD. Targeting cognitive perception speed, anxiety and frontal lobe/executive impairments in PD rehabilitation may help improve walking ability in daily life.
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author
; ; and
organization
publishing date
type
Contribution to conference
publication status
published
subject
pages
1 pages
conference name
The MDS Virtual Congress 2020
conference dates
2020-09-12 - 2020-09-16
DOI
10.1002/mds.28269
language
English
LU publication?
yes
id
dfa39eae-3d2f-4f4c-9a85-2150c92de3a3
date added to LUP
2020-09-28 23:03:03
date last changed
2022-11-01 18:35:21
@misc{dfa39eae-3d2f-4f4c-9a85-2150c92de3a3,
  abstract     = {{Objective: To investigate the association of different aspects of cognitive impairment, depression and anxiety with walking difficulties in daily life in persons with mild PD.<br/>Background: Walking difficulties in daily life are common among persons with Parkinson’s disease (PD) and may cause falls and near falls, limitations in activity, restrictions in participation and decrease in quality of life. Motor symptoms are often cited as a major reason for these difficulties while the association with cognitive and psychiatric symptoms is still poorly explored.<br/>Methods: The study included cross-sectional data from 73 persons with PD that visited a neurology outpatient clinic during 2012-2017. Mean (SD) age was 69 (8.9) years, mean (SD) disease duration was 8 (4.3) years and mean (SD) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) and cognition (Mini Mental State Examination, MMSE) were 16.4 (9.9) and 27.3 (2.6), respectively. Walking difficulties in daily life (the dependent variable) was investigated with the generic Walk-12 (Walk-12G). Multiple linear regression analysis (controlling for age and motor symptoms) included the following independent variables: cognition (MMSE), memory (Alzheimer's Disease Assessment Scale, ADAS, cognitive subscale), cognitive perception speed (A Quick Test of Cognitive Speed, AQT, part I-III) frontal lobe/executive impairment (Frontal Assessment Battery, FAB) and depression and anxiety (Hospital Anxiety and Depression Scale, HADS). <br/>Results: The median Walk-12G scores was 11.5 (q1-q3, 5.5−25.5). Four significant independent variables were identified explaining 15.5% of the variance in the Walk-12G score. The factor with the strongest association with walking difficulties in daily life was cognitive perception speed (AQT part I) (explaining 4.9%) closed followed by anxiety (4.9%), cognitive perception speed (AQT part II) (3%) and frontal lobe/executive impairment (2.7%). <br/>Conclusion: Cognitive and psychiatric symptoms are associated with walking difficulties in persons with mild PD. Targeting cognitive perception speed, anxiety and frontal lobe/executive impairments in PD rehabilitation may help improve walking ability in daily life. <br/>}},
  author       = {{Lindholm, Beata and Brogårdh, Christina and Hagell, Peter and Nilsson, Christer}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{549--549}},
  title        = {{Cognitive and psychiatric symptoms are associated with walking difficulties in mild Parkinson’s disease}},
  url          = {{http://dx.doi.org/10.1002/mds.28269}},
  doi          = {{10.1002/mds.28269}},
  year         = {{2020}},
}