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Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study

BACKGROUND: Parkinson’s disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinic...

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Autores principales: Laurent, Louise, Koskas, Pierre, Estrada, Janina, Sebbagh, Mélanie, Lacaille, Sophie, Raynaud-Simon, Agathe, Lilamand, Matthieu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887890/
https://www.ncbi.nlm.nih.gov/pubmed/36717787
http://dx.doi.org/10.1186/s12877-023-03776-7
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author Laurent, Louise
Koskas, Pierre
Estrada, Janina
Sebbagh, Mélanie
Lacaille, Sophie
Raynaud-Simon, Agathe
Lilamand, Matthieu
author_facet Laurent, Louise
Koskas, Pierre
Estrada, Janina
Sebbagh, Mélanie
Lacaille, Sophie
Raynaud-Simon, Agathe
Lilamand, Matthieu
author_sort Laurent, Louise
collection PubMed
description BACKGROUND: Parkinson’s disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinical characteristics associated with these outcomes, in older community-dwelling patients with late-onset PD. METHODS: Retrospective, observational analysis of data from geriatric day hospital patients. Motor assessment included Unified Parkinson Disease Rating Scale (UPDRS) part III score, Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait tests, and gait speed. Levodopa equivalent dose, comorbidity, cognitive performance, Activities of Daily Living performance were examined. Cox proportional hazards models were performed to identify the factors associated with mortality and NH admission rate (maximum follow-up time = 5 years). RESULTS: We included 98 patients, mean age 79.4 (SD = 5.3) of whom 18 (18.3%) died and 19 (19.4%) were admitted into NH, over a median follow-up of 4 years. In multivariate Cox models, poor balance on the Tinetti POMA scale (HR = 0.82 95%CI (0.66–0.96), p = .023) and older age (HR = 1.12 95%CI (1.01–1.25), p = .044) were the only variables significantly associated with increased mortality risk. A Tinetti balance score below 11/16 was associated with a 6.7 hazard for mortality (p = .006). No specific factor was associated with NH admissions. CONCLUSIONS: Age and the Tinetti POMA score were the only factors independently associated with mortality. The Tinetti POMA scale should be considered for balance assessment and as a screening tool for the most at-risk individuals, in this population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-03776-7.
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spelling pubmed-98878902023-02-01 Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study Laurent, Louise Koskas, Pierre Estrada, Janina Sebbagh, Mélanie Lacaille, Sophie Raynaud-Simon, Agathe Lilamand, Matthieu BMC Geriatr Research BACKGROUND: Parkinson’s disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinical characteristics associated with these outcomes, in older community-dwelling patients with late-onset PD. METHODS: Retrospective, observational analysis of data from geriatric day hospital patients. Motor assessment included Unified Parkinson Disease Rating Scale (UPDRS) part III score, Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait tests, and gait speed. Levodopa equivalent dose, comorbidity, cognitive performance, Activities of Daily Living performance were examined. Cox proportional hazards models were performed to identify the factors associated with mortality and NH admission rate (maximum follow-up time = 5 years). RESULTS: We included 98 patients, mean age 79.4 (SD = 5.3) of whom 18 (18.3%) died and 19 (19.4%) were admitted into NH, over a median follow-up of 4 years. In multivariate Cox models, poor balance on the Tinetti POMA scale (HR = 0.82 95%CI (0.66–0.96), p = .023) and older age (HR = 1.12 95%CI (1.01–1.25), p = .044) were the only variables significantly associated with increased mortality risk. A Tinetti balance score below 11/16 was associated with a 6.7 hazard for mortality (p = .006). No specific factor was associated with NH admissions. CONCLUSIONS: Age and the Tinetti POMA score were the only factors independently associated with mortality. The Tinetti POMA scale should be considered for balance assessment and as a screening tool for the most at-risk individuals, in this population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-03776-7. BioMed Central 2023-01-30 /pmc/articles/PMC9887890/ /pubmed/36717787 http://dx.doi.org/10.1186/s12877-023-03776-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Laurent, Louise
Koskas, Pierre
Estrada, Janina
Sebbagh, Mélanie
Lacaille, Sophie
Raynaud-Simon, Agathe
Lilamand, Matthieu
Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title_full Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title_fullStr Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title_full_unstemmed Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title_short Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson’s disease: a longitudinal study
title_sort tinetti balance performance is associated with mortality in older adults with late-onset parkinson’s disease: a longitudinal study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887890/
https://www.ncbi.nlm.nih.gov/pubmed/36717787
http://dx.doi.org/10.1186/s12877-023-03776-7
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