@article{cda49f8d23364229ba541eae31a4ed06,
title = "Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease",
abstract = "Introduction: Research suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD. Methods: Cognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language. PIGD symptoms were measured using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, Motor Examination subscale. Multiple linear regression analyses were performed to assess the relationship between cognition and PIGD symptoms with models adjusting for age, sex, education, enrollment site, disease duration, and motor symptom severity. Results: The analysis included 783 participants, with mean (standard deviation) age of 67.3 (9.7) years and median (interquartile range) MDS-UPDRS Motor Subscale score of 26 (17, 35). Deficits in global cognition, executive function, memory, and phonemic fluency were associated with more severe PIGD symptoms. Deficits in executive function were associated with impairments in gait, freezing, and postural stability, while visuospatial impairments were associated only with more severe freezing, and poorer memory function was associated only with greater postural instability. Discussion: While impairments in global cognition and aspects of executive functioning were associated with more severe PIGD symptoms, specific cognitive domains were differentially related to distinct PIGD components, suggesting the presence of multiple neural pathways contributing to associations between cognition and PIGD symptoms in persons with PD.",
keywords = "Balance, Cognition, Executive function, Freezing of gait, Gait",
author = "Kelly, {V. E.} and Johnson, {C. O.} and McGough, {E. L.} and A. Shumway-Cook and Horak, {F. B.} and Chung, {K. A.} and Espay, {A. J.} and Revilla, {F. J.} and J. Devoto and C. Wood-Siverio and Factor, {S. A.} and B. Cholerton and Edwards, {K. L.} and Peterson, {A. L.} and Quinn, {J. F.} and Montine, {T. J.} and Zabetian, {C. P.} and Leverenz, {J. B.}",
note = "Funding Information: Dr. Kelly reports no disclosures and is funded by the National Institutes of Health (NIH). Dr. Johnson reports no disclosures. Dr. McGough reports no disclosures and is funded by the Alzheimer{\textquoteright}s Association International and NIH. Dr. Shumway-Cook reports no disclosures. Dr. Horak is funded by the NIH, Department of Veterans Affairs, National Multiple Sclerosis Society, and Michael J. Fox Foundation. She is Chief Scientific Officer and receives compensation from APDM, Inc. Dr. Chung reports no disclosures and is funded by the Department of Veterans Affairs. Dr. Espay is supported by the NIH; has received grant support from CleveMed/Great Lakes Neurotechnologies, and the Michael J. Fox Foundation; personal compensation as a consultant/scientific advisory board member for Solvay (now Abbvie), Chelsea Therapeutics, TEVA, Impax, Merz, Pfizer, Solstice Neurosciences, Eli Lilly, and USWorldMeds; royalties from Lippincott Williams & Wilkins and Cambridge; and honoraria from Novartis, UCB, TEVA, the American Academy of Neurology, and the Movement Disorders Society. He serves as Associate Editor of Movement Disorders and Frontiers in Movement Disorders and is on the editorial boards of Parkinsonism and Related Disorders and The European Neurological Journal . Dr. Revilla is a consultant and speaker for Lundbeck Speaker's Bureau and UCB Speaker{\textquoteright}s Bureau. Dr. Devoto is supported by the Michael J. Fox Foundation. Ms. Wood-Siverio reports no disclosures. Dr. Factor reports consulting fees from Ipsen Biopharmaceuticals and Merz; grant support from Teva Neurosciences, Ipsen Biopharmaceuticals, EMD Serono, Ceregene, the Michael J. Fox Foundation, and NIH; and royalties from UpToDate, Blackwell Futura, and Demos. Dr. Cholerton reports no disclosures and is funded by the NIH. Dr. Edwards reports no disclosures and is funded by the NIH. Dr. Peterson reports no disclosures and is funded by the Department of Veterans Affairs, Michael J. Fox Foundation, and NIH. Dr. Quinn reports consulting fees from Merck and speaking fees from Novartis; is reimbursed by Elan, Baxter, Bristol-Meyers Squibb, and Roche for the conduct of clinical trials; and is funded by the NIH and Department of Veterans Affairs. Dr. Montine reports honoraria from invited scientific presentations to universities and professional societies not exceeding $5,000 per year and is funded by grants from the NIH. Dr. Zabetian reports no disclosures and is funded by grants from the American Parkinson Disease Association, Department of Veterans Affairs, NIH, Northwest Collaborative Care, and Parkinson's Disease Foundation. Dr. Leverenz reports consulting fees from Boehringer-Ingelheim, Citigroup, Piramal Healthcare, and Navidea Biopharmaceuticals and has received grant support from Genzyme/Sanof{\textquoteright}i, the Department of Veterans Affairs, American Parkinson Disease Association, Michael J. Fox Foundation, NIH, and Parkinson{\textquoteright}s Disease Foundation. Funding Information: This work was supported by the Department of Veterans Affairs, grants from the American Parkinson Disease Association , National Institutes of Health ( P50 NS062684 and R01 NS065070 ), Consolidated Anti-Aging Foundation, and the Jane and Lee Seidman Fund. The funding sources did not provide scientific input for this study. ",
year = "2015",
month = jul,
day = "1",
doi = "10.1016/j.parkreldis.2015.04.002",
language = "English (US)",
volume = "21",
pages = "692--697",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",
number = "7",
}