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| 2. |
- Jonasson, Stina, et al.
(författare)
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Concerns About Falling in Parkinson's Disease: Associations with Disabilities and Personal and Environmental Factors.
- 2015
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Ingår i: Journal of Parkinson's Disease. - 1877-718X. ; 5:2, s. 341-349
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Tidskriftsartikel (refereegranskat)abstract
- Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related self-efficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors.
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| 4. |
- Kader, Manzur, et al.
(författare)
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Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease
- 2017
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Ingår i: Journal of Parkinson's Disease. - 1877-718X. ; 7:2, s. 397-407
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Tidskriftsartikel (refereegranskat)abstract
- Background: While walking difficulties are common in people with Parkinson's disease (PD), little is known about factors that independently contribute to their perceived walking difficulties. Objective: To identify factors that independently contribute to perceived walking difficulties in people with PD.Methods: This study involved 243 (62% men) participants; their mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey preceded a home visit that included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties (dependent variable) were assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher=worse). Independent variables included personal (e.g., age and general self-efficacy) and social environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and postural instability) and non-motor symptoms (e.g., fatigue and orthostatic hypotension). Linear multiple regression analysis was used to identify factors that independently contributed to perceived walking difficulties.Results: Eight significant independent variables explained 56.3% of the variance in perceived walking difficulties. FOG was the strongest significant contributing factor to perceived walking difficulties, followed by general self-efficacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability.Conclusion: Motor and non-motor symptoms as well as personal factors (i.e., general self-efficacy) seem to be of importance for perceived walking difficulties in PD. These findings might nurture future interventions that address modifiable factors in order to enhance walking ability in people with PD.
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| 6. |
- Lindh-Rengifo, Magnus, et al.
(författare)
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Components of gait in people with and without mild cognitive impairment
- 2022
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362. ; 93, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several objective gait parameters are associated with cognitive impairment, but there is limitedknowledge of gait models in people with mild cognitive impairment (MCI).Research question: How can 18 objective gait characteristics be used to define different components of gait inpeople with MCI (with suspected incipient neurocognitive disorder) and cognitively unimpaired people (CU),respectively?Methods: Spatiotemporal gait data were collected by using an electronic walkway (GAITRite®), i.e. assessmentsin comfortable gait speed. Using cross-sectional gait data, two principal component analyses (PCA) were performed(varimax rotation) to define different components of gait in people with MCI (n = 114) and CU (n = 219),respectively, from the BioFINDER-2 study.Results: Both PCAs produced four components, here called Variability, Pace/Stability, Rhythm and Asymmetry.Total variance explained was 81.0% (MCI) versus 80.3% (CU). The Variability component explained the largestamount of variance (about 25%) in both groups. The highest loading gait parameter was the same for bothgroups in three out of four components, i.e. step velocity variability (Variability), mean step length (Pace/Stability)and mean step time (Rhythm). In the asymmetry component, stance time asymmetry (MCI) and swingtime asymmetry (CU) loaded the highest.Significance: The gait components seem similar in people with and without MCI, although there were somedifferences. This study may aid the identification of gait variables that represent different components of gait.Gait parameters such as step velocity variability, mean step length, mean step time as well as swing and stancetime asymmetry could serve as interesting core variables of different gait components in future research in peoplewith MCI (with suspected incipient neurocognitive disorder) and CU. However, the selection of gait variablesdepends on the purpose. It needs to be noted that assessment of variability measures requires more advancedtechnology than is usually used in the clinic.
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| 7. |
- Lindh-Rengifo, Magnus, et al.
(författare)
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Effects of Brain Pathologies on Spatiotemporal Gait Parameters in Patients with Mild Cognitive Impairment
- 2023
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877. ; 96:1, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- Background: Impaired gait can precede dementia. The associations between gait parameters and brain pathologies are therefore of interest. Objective: To explore how different brain pathologies (i.e., vascular and Alzheimer's) are associated with specific gait parameters from various gait components in persons with mild cognitive impairment (MCI), who have an increased risk of developing dementia. Methods: This cross-sectional study included 96 patients with MCI (mean 72, ±7.5 years; 52% women). Gait was evaluated by using an electronic walkway, GAITRite®. Four gait parameters (step velocity variability; step length; step time; stance time asymmetry) were used as dependent variables in multivariable linear regression analyses. Independent variables included Alzheimer's disease pathologies (amyloid-β and tau) by using PET imaging and white matter hyperintensities (WMH) by using MRI. Covariates included age, sex, comorbidities (and intracranial volume in analyses that includedWMH). Results: Increased tau-PET (Braak I-IV region of interest [ROI]) was associated with step velocity variability (standardized regression coefficient, β= 0.383, p < 0.001) and step length (β= 0.336, p < 0.001), which remained significant when using different Braak ROIs (I-II, III-IV, V-VI). The associations remained significant when adjusting for WMH (p < 0.001). When also controlling for gait speed, tau was no longer significantly (p = 0.168) associated with an increased step length. No significant associations between gait and Aβ-PET load or WMH were identified. Conclusions: The results indicate that one should pay specific attention to assess step velocity variability when targeting single task gait in patients with MCI. Future studies should address additional gait variability measures and dual tasking in larger cohorts.
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| 8. |
- Lindh-Rengifo, Magnus, et al.
(författare)
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Perceived walking difficulties in Parkinson’s disease – predictors and changes over time
- 2021
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. Methods: One hundred forty-eight people with PD (mean age 67.9 years) completed the Generic Walk-12 (Walk-12G) questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results: Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p < 0.001. Concerns about falling was the strongest predictor (β = 0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β = 0.268) and pain (β = 0.153). Perceived balance problems while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β = − 0.107). Conclusions: Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.
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| 9. |
- Lindh-Rengifo, Magnus, et al.
(författare)
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Predictive Factors of Concerns about Falling in People with Parkinson's Disease : A 3-Year Longitudinal Study
- 2019
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Ingår i: Parkinson's Disease. - : Hindawi Limited. - 2042-0080 .- 2090-8083. ; 2019
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Fear of falling (FOF) is more common in people with Parkinson's disease (PD) than in healthy controls. It can lead to several negative consequences such as restrictions in everyday life. Moreover, FOF is a risk factor for future falls. Aim: This study aimed to identify predictive factors of FOF (conceptualized as concerns about falling) after three years, with and without adjusting for concerns about falling at baseline, in people with PD. Methods: This study included 151 participants (35% women) with PD. At baseline, their mean (SD) age and PD duration were 68 (±9.0) and 9 (±6.1) years, respectively. The Falls Efficacy Scale-International (FES-I) was used as the dependent variable in multivariable linear regression analyses. Results: The mean (SD) FES-I score increased from 28.1 (11.9) to 33.1 (14.0) three years later (p<0.001). The strongest (according to the standardized regression coefficient, β) predictor of concerns about falling was walking difficulties (β = 0.378), followed by age (0.227), problems maintaining balance while dual tasking (0.172), and needing help in daily activities (0.171). When adjusting for baseline FES-I scores, the strongest predictive factor was problems maintaining balance while dual tasking (β = 0.161), which was followed by age (0.131) and female sex (0.105). Conclusions: This study pinpoints several predictive factors of concerns about falling that are modifiable and which could be addressed in rehabilitation: perceived walking difficulties, having problems maintaining balance while dual tasking, and dependence on others in daily activities. The importance of dual tasking is a novel finding, which future studies need to confirm or refute. One should be aware of the fact that an increased age predicts concerns about falling with and without adjusting for baseline FES-I scores, whereas female sex predicts concerns about falling only when adjusting for baseline FES-I scores.
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| 10. |
- Nilsson, Maria H., et al.
(författare)
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The association between indicators of health and housing in people with Parkinson's disease
- 2016
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are knowledge gaps about the life situation for people ageing with Parkinson's disease (PD), with virtually no understanding of home and health dynamics. Therefore, the aim of the present study was to explore the association between aspects of health and objective as well as perceived housing in people with PD. Methods: Participants were recruited from three hospitals in the region of Skåne in southern Sweden. The sample for the present study included 231 (62 % men) participants with PD, with a mean age of 75 (min-max, 45-93) years. The data collection procedure included a self-administered postal survey and a subsequent home visit where structured interviews, observations and clinical assessments were administered. To study the association between aspects of health and housing canonical correlation was applied. Twelve variables (6 in the health and 6 in the housing set) were included. This corresponds to about 20 individuals per variable and is considered sufficient to accurately interpret the largest (i.e., first) canonical correlation. Results: The analysis between the health variables and housing variables set yielded two significant pairs of variates with the canonical correlations 0.68 (p <0.0001) and 0.33 (p = 0.0112), respectively. For the first pair of variates the canonical R2 was 0.46. The results showed that external control beliefs and behavioral aspects of meaning of home contributed the most to the housing variate, whereas difficulties/dependence in activities of daily living (ADL) and functional limitations contributed the most to the health variate. Although a significant relationship was found for the second canonical correlation, the shared variance between the two variates was considerably lower; R2 = 0.11. Conclusions: This study suggests that people with PD who have more functional limitations, difficulties in ADL and are more dependent perceive their homes as less meaningful from a behavioral perspective. Moreover, they tend to rely on external influences managing their housing situation. With this kind of knowledge at hand, health care and social services professionals are in a better position to observe and efficiently address problems related to health and housing among people with PD.
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