Parkinson’s disease (PD) with dementia and falls is improved by AChEI? A preliminary study report

Parkinson’s disease (PD) with dementia and falls is improved by AChEI? A preliminary study report

Background/objective Advanced PD is often associated with cognitive impairment and frequent falls. We describe a suggestive case report of PD associated with mild cognitive impairment (MCI) and falls. The aim of our study was to test alteration in balance potentially related to use of acetylcholines...

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Bibliographic Details
Published in:Aging clinical and experimental research Vol. 28; no. 3; pp. 551 - 555
Main Authors: Lauretani, Fulvio, Galuppo, Laura, Costantino, Cosimo, Ticinesi, Andrea, Ceda, Gianpaolo, Ruffini, Livio, Nardelli, Anna, Maggio, Marcello
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01-06-2016
Springer Nature B.V
Subjects:
Accidental Falls
Aged
Balance
Cholinesterase Inhibitors - therapeutic use
Cognitive ability
Cognitive Dysfunction - etiology
Dementia
Dementia - etiology
Dopamine
Gait
Geriatrics/Gerontology
Humans
Male
Medicine
Medicine & Public Health
Parkinson Disease - complications
Parkinson Disease - drug therapy
Parkinson's disease
Short Communication
Falls
Postural instability
MCI
Gait
Donepezil
Rotigotine
Stabilometry
Parkinson’s disease
Accelerometry
Dementia
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Summary:Background/objective Advanced PD is often associated with cognitive impairment and frequent falls. We describe a suggestive case report of PD associated with mild cognitive impairment (MCI) and falls. The aim of our study was to test alteration in balance potentially related to use of acetylcholinesterase inhibitor (AchEI). We address this hypothesis after keeping the patient in stable dosage of dopamine agonist. Methods/measurements We describe an initial pharmacological management in a 78-year-old man affected by Parkinson disease (PD) associated with mild cognitive impairment (MCI) and history of falls. The diagnosis of PD was also confirmed by SPECT with DATSCAN, after CT-brain exclusion of potential other causes of the symptoms. Cognitive and motor performances of the patient were initially evaluated by Mini Mental Examination State Examination (MMSE), Short Physical Performance Battery (SPPB) and Romberg test. We also recorded gait parameters using an accelerometer, while balance and stability were assessed by stabilometric platform with open and closed eyes. We repeated cognitive and motor tests and gait and balance evaluation after stable dosage of dopamine agonist before and after introduction of AchEI. Results After starting dopamine agonist therapy, there was a significant improvement in gait parameters (speed, stride/min, stride length, swing duration, and decrease in gait cycle duration and rolling duration). When stable dosage of dopamine agonist was reached, AchEI was introduced obtaining not only a significant improvement of cognitive performance, but also a significant positive change in balance. Conclusion and relevance We hypothesize that AchEI could improve stability, balance and postural instability in addition to cognitive performance in PD with MCI and balance deficits.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-015-0437-x