Objective: Evaluate the relationship between falls, freezing of gait and swallowing disturbance in Parkinson’s disease (PD).

Background: Dysphagia is a common non-motor symptom of PD and may occur at any stage. The response of dysphagia to dopaminergic medications is usually limited, similarly to other “axial” symptoms such as falls and gait disturbance. It is of interest to examine the relationship between these symptoms in PD, given the possibility of shared pathophysiology due to non-dopaminergic and extranigral dysfunction.

Methods: We recruited 23 consecutive non-demented patients with idiopathic PD and at least one clinically determined impairment in swallowing, falls or freezing of gait. Swallow dysfunction was assessed using the Swallowing Disturbance Questionnaire (SDQ). The Falls Efficacy Scale and Freezing-of-gait questionnaires were recorded. Total non-motor symptom burden was assessed using the non-motor symptoms questionnaire. Spearman’s correlation coefficient was used to determine the relationship between scores of interest.

Results: The mean age of the patients was 70±8 years with a mean disease duration of 10±6 years. Eleven had a clinical history of swallow impairment, while 21 had gait impairment and 17 reported freezing of gait. Total SDQ score correlated strongly with the falls efficacy scale (r=0.531, p=0.011), but not with the freezing-of-gait score. Falls efficacy score, but not swallow disturbance correlated with total non-motor burden (r=0.551, p=0.008).

Conclusions: The severity of dysphagia in PD is closely related to severity of falls, but not gait freezing. This may be helpful to more precisely determine the anatomical substrate of levodopa-resistant axial symptoms in PD and provide clues to further management.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-dysphagia-severity-and-gait-disturbance-in-parkinsons-disease/