Comorbidity and functional mobility in persons with Parkinson disease

Laurie King, Kelsey C. Priest, John Nutt, Yiyi Chen, Zunqiu Chen, Marsha Melnick, Fay Horak

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives To report the frequency, severity, and types of comorbidities in people with Parkinson disease (PD) using a validated self-report comorbidity screening tool, and to determine the relationship between comorbidity and functional mobility.

Design A secondary analysis and cross-sectional observational study design.

Setting University hospital; outpatient balance disorders laboratory.

Participantsg Persons with mild to moderate idiopathic PD (N=76). Intervention Not applicable.

Main Outcome Measures The Cumulative Illness Rating Scale-Geriatric (CIRS-G) and a comprehensive mobility assessment including gait (distance walked in 3min), balance (mini-Balance Evaluation Systems Test), and physical function (Physical Performance Test).

Results All participants reported comorbidities in addition to their diagnosed PD. The average ± SD number of comorbidities was 6.96±2.0 (range, 2-11), and the total CIRS-G score ± SD was 12.7±4.8. The most commonly reported organ systems with comorbidity were eyes and ears (89%), psychiatric (68%), musculoskeletal (64%), lower gastrointestinal (62%), respiratory (60.5%), upper gastrointestinal (59.2%), and genitourinary (53.9%). The total CIRS-G score was significantly related to functional mobility: gait (r=-.53, P=.0001), balance (r=-.43, P=.0003), and physical performance (r=-.36, P=.0041). Of the original 14 organ systems measured, there were 7 systems that, when combined, best predicted gait performance, 6 systems combined that best predicted balance performance, and 4 systems combined that predicted functional performance.

Conclusions This study reports a high frequency of multiple medical system comorbidity in people with mild to moderate PD. Furthermore, comorbidity scores were associated with mobility disability: gait, balance, and physical function. Early intervention is important to delay mobility disability in PD, and we recommend that people with PD found to have comorbidities should be screened for balance and gait deficits.

Original languageEnglish (US)
Pages (from-to)2152-2157
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume95
Issue number11
DOIs
StatePublished - Nov 1 2014

Fingerprint

Parkinson Disease
Comorbidity
Gait
Geriatrics
Self Report
Observational Studies
Ear
Psychiatry
Outpatients
Cross-Sectional Studies
Outcome Assessment (Health Care)

Keywords

  • Comorbidity
  • Parkinson disease
  • Postural balance
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Comorbidity and functional mobility in persons with Parkinson disease. / King, Laurie; Priest, Kelsey C.; Nutt, John; Chen, Yiyi; Chen, Zunqiu; Melnick, Marsha; Horak, Fay.

In: Archives of Physical Medicine and Rehabilitation, Vol. 95, No. 11, 01.11.2014, p. 2152-2157.

Research output: Contribution to journalArticle

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abstract = "Objectives To report the frequency, severity, and types of comorbidities in people with Parkinson disease (PD) using a validated self-report comorbidity screening tool, and to determine the relationship between comorbidity and functional mobility.Design A secondary analysis and cross-sectional observational study design.Setting University hospital; outpatient balance disorders laboratory.Participantsg Persons with mild to moderate idiopathic PD (N=76). Intervention Not applicable.Main Outcome Measures The Cumulative Illness Rating Scale-Geriatric (CIRS-G) and a comprehensive mobility assessment including gait (distance walked in 3min), balance (mini-Balance Evaluation Systems Test), and physical function (Physical Performance Test).Results All participants reported comorbidities in addition to their diagnosed PD. The average ± SD number of comorbidities was 6.96±2.0 (range, 2-11), and the total CIRS-G score ± SD was 12.7±4.8. The most commonly reported organ systems with comorbidity were eyes and ears (89{\%}), psychiatric (68{\%}), musculoskeletal (64{\%}), lower gastrointestinal (62{\%}), respiratory (60.5{\%}), upper gastrointestinal (59.2{\%}), and genitourinary (53.9{\%}). The total CIRS-G score was significantly related to functional mobility: gait (r=-.53, P=.0001), balance (r=-.43, P=.0003), and physical performance (r=-.36, P=.0041). Of the original 14 organ systems measured, there were 7 systems that, when combined, best predicted gait performance, 6 systems combined that best predicted balance performance, and 4 systems combined that predicted functional performance.Conclusions This study reports a high frequency of multiple medical system comorbidity in people with mild to moderate PD. Furthermore, comorbidity scores were associated with mobility disability: gait, balance, and physical function. Early intervention is important to delay mobility disability in PD, and we recommend that people with PD found to have comorbidities should be screened for balance and gait deficits.",
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