Objective: This study retrospectively investigated whether the occurrence of non-motor symptoms and the decline in cognitive function in patients with Parkinson’s disease (PD) influence fall risk and clinical outcomes.
Background: Fall risk in PD has been widely reported to be influenced by both disease severity and motor symptoms such as gait disturbances and impaired postural reflexes. As PD progresses, various non-motor symptoms emerge, contributing to a decline in activities of daily living (ADL). Cognitive dysfunction has been suggested as a contributing factor; however, many aspects of the relationship between non-motor symptoms and fall risk remain unclear.
Method: PD patients who were hospitalized for treatment and underwent rehabilitation between January 2020 and August 2024 were included. Clinical data, including Timed Up and Go (TUG) test, Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Frontal Assessment Battery (FAB), motor/non-motor symptoms, subjective improvement, hospital stay length, and daily levodopa dosage, were extracted. The relationship between non-motor symptoms and fall risk (TUG ≥ 11.5 sec) [1]was analyzed. Stepwise logistic regression identified factors associated with improvement at discharge. Principal component analysis of cognitive function tests was performed to explore characteristic cognitive effects.
Results: Of 227 identified patients, 76 met inclusion criteria (mean age: 70.2 ± 8.6 years, 45% male, disease duration: 9.9 ± 5.6 years, Hoehn & Yahr stage: 3.0 ± 0.8). No significant differences were found in non-motor symptom prevalence or cognitive test scores between those with TUG ≥ 11.5 sec and those below the threshold. However, hallucinations were significantly more frequent in patients with fall-related fractures (P=0.039). Factors independently associated with subjective improvement at discharge included age (OR 1.09, 95% CI 1.008–1.169, P=0.017), TMT-A score (OR 0.98, 95% CI 0.967–0.997, P=0.017), and sex (OR 0.25, 95% CI 0.081–0.785, P=0.029). Principal component analysis suggested that patients with cognitive impairment tended to have TUG ≥ 11.5 sec, though this was not statistically significant.
Conclusion: In addition to motor function assessment, evaluating TMT-A, recognizing non-motor symptoms, and checking fall history are essential for predicting clinical outcomes in PD patients.
References: ¹ Nocera JR, Stegemöller EL, Malaty IA, et al. Using the Timed Up & Go Test in a Clinical Setting to Predict Falling in Parkinson’s Disease. Arch Phys Med Rehabil. 2013;94(7):1300–1305. doi:10.1016/j.apmr.2013.02.020.
To cite this abstract in AMA style:
R. Nakagawa, M. Shiraishi, N. Takao, H. Matsumoto. Tendencies of Non-Motor Symptoms and Short-Term Clinical Predictors in Patients with Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/tendencies-of-non-motor-symptoms-and-short-term-clinical-predictors-in-patients-with-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/tendencies-of-non-motor-symptoms-and-short-term-clinical-predictors-in-patients-with-parkinsons-disease/