Objective: To investigate the association of different aspects of cognitive impairment, depression and anxiety with walking difficulties in daily life in persons with mild PD.
Background: Walking difficulties in daily life are common among persons with Parkinson’s disease (PD) and may cause falls and near falls, limitations in activity, restrictions in participation and decrease in quality of life. Motor symptoms are often cited as a major reason for these difficulties while the association with cognitive and psychiatric symptoms is still poorly explored.
Method: The study included cross-sectional data from 73 persons with PD that visited a neurology outpatient clinic during 2012-2017. Mean (SD) age was 69 (8.9) years, mean (SD) disease duration was 8 (4.3) years and mean (SD) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) and cognition (Mini Mental State Examination, MMSE) were 16.4 (9.9) and 27.3 (2.6), respectively. Walking difficulties in daily life (the dependent variable) was investigated with the generic Walk-12 (Walk-12G). Multiple linear regression analysis (controlling for age and motor symptoms) included the following independent variables: cognition (MMSE), memory (Alzheimer’s Disease Assessment Scale, ADAS, cognitive subscale), cognitive perception speed (A Quick Test of Cognitive Speed, AQT, part I-III) frontal lobe/executive impairment (Frontal Assessment Battery, FAB) and depression and anxiety (Hospital Anxiety and Depression Scale, HADS).
Results: The median Walk-12G scores was 11.5 (q1-q3, 5.5−25.5). Four significant independent variables were identified explaining 15.5% of the variance in the Walk-12G score. The factor with the strongest association with walking difficulties in daily life was cognitive perception speed (AQT part I) (explaining 4.9%) followed by anxiety (4.9%), cognitive perception speed (AQT part II) (3%) and frontal lobe/executive impairment (2.7%).
Conclusion: Cognitive and psychiatric symptoms are associated with walking difficulties in persons with mild PD. Targeting cognitive perception speed, anxiety and frontal lobe/executive impairments in PD rehabilitation may help improve walking ability in daily life.
To cite this abstract in AMA style:
B. Lindholm, C.H Brogårdh, P. Hagell, C.H Nilsson. Cognitive and psychiatric symptoms are associated with walking difficulties in mild Parkinson’s disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/cognitive-and-psychiatric-symptoms-are-associated-with-walking-difficulties-in-mild-parkinsons-disease/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-and-psychiatric-symptoms-are-associated-with-walking-difficulties-in-mild-parkinsons-disease/