Clinical issues in the treatment of anxiety and depression in older adults with Parkinson's disease

Abstract Background Identification of individual gait events is essential for clinical gait analysis, because it can be used for diagnostic purposes or tracking disease progression in neurological diseases such as Parkinson’s disease. Previous research has shown that gait events can be detected from a shank-mounted inertial measurement unit (IMU), however detection performance was often evaluated only from straight-line walking. For use in daily life, the detection performance needs to be evaluated in curved walking and turning as well as in single-task and dual-task conditions. Methods Participants (older adults, people with Parkinson’s disease, or people who had suffered from a stroke) performed three different walking trials: (1) straight-line walking, (2) slalom walking, (3) Stroop-and-walk trial. An optical motion capture system was used a reference system. Markers were attached to the heel and toe regions of the shoe, and participants wore IMUs on the lateral sides of both shanks. The angular velocity of the shank IMUs was used to detect instances of initial foot contact (IC) and final foot contact (FC), which were compared to reference values obtained from the marker trajectories. Results The detection method showed high recall, precision and F1 scores in different populations for both initial contacts and final contacts during straight-line walking (IC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%), slalom walking (IC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%), and turning (IC: recall $$\ge$$ ≥ 85%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 91%; FC: recall $$\ge$$ ≥ 84%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 89%). Conclusions Shank-mounted IMUs can be used to detect gait events during straight-line walking, slalom walking and turning. However, more false events were observed during turning and more events were missed during turning. For use in daily life we recommend identifying turning before extracting temporal gait parameters from identified gait events.

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Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽

10.1159/000515940 ◽

2021 ◽

pp. 1-7

Author(s):

Ram kinker Mishra ◽

Catherine Park ◽

He Zhou ◽

Bijan Najafi ◽

T. Adam Thrasher

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Performance ◽

Pairwise Comparison ◽

Walking Test ◽

Cognitively Normal ◽

Early Results ◽

Trail Making ◽

Changes Over Time

Introduction: Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. Purpose: This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. Method: Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. Results: All participants enabled to complete iTMT with <3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s d = 1.7, p = 0.024) and CN-older versus MCI (d = 1.57, p < 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (r = −0.4, p = 0.011) and MoCA score (r = −0.56, p < 0.01). Conclusion: This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

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Sleep fragmentation and Parkinson's disease pathology in older adults without Parkinson's disease

Movement Disorders ◽

10.1002/mds.27200 ◽

2017 ◽

Vol 32 (12) ◽

pp. 1729-1737 ◽

Cited By ~ 20

Author(s):

Shahmir Sohail ◽

Lei Yu ◽

Julie A. Schneider ◽

David A. Bennett ◽

Aron S. Buchman ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Fragmentation

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Response to Telemedicine Visits From Patients With Parkinsonism During the COVID-19 Pandemic on Postvisit Surveys

Journal of Patient Experience ◽

10.1177/2374373521997224 ◽

2021 ◽

Vol 8 ◽

pp. 237437352199722

Author(s):

Wissam Deeb ◽

Christopher W Hess ◽

Noheli Gamez ◽

Bhavana Patel ◽

Kathryn Moore ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neurodegenerative Disorders ◽

Tertiary Care ◽

Specialty Clinic ◽

Cognitive Limitations ◽

Time Savings ◽

Ease Of Access ◽

Almost All

Parkinson’s disease and parkinsonism are common chronic neurodegenerative disorders that tend to affect older adults and cause physical and sometimes cognitive limitations. Given that these limitations could impact successful telemedicine use, we aimed to investigate the experiences of patients with parkinsonism using telemedicine during the COVID-19 pandemic. A 19-item survey was emailed to patients with parkinsonism following telemedicine visits at a single US tertiary care parkinsonism specialty clinic. Seventy-four individuals responded, out of 270 invitations sent. Almost two-thirds (61.6%) of the respondents were comfortable with using technology in general, and almost all were very satisfied with their telemedicine experience. The most commonly reported benefits included cost and travel savings, ease of access to a specialist, and time savings. Issues with technology and previsit instructions were the most commonly identified challenges (28%). Urgent implementation, due to the pandemic, of telemedicine care for patients with parkinsonism was feasible and well received. The challenges most commonly reported by patients could be potentially alleviated by better education and support.

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Anxiety and depression severity are related to right but not left onset Parkinson's disease duration

Journal of the Neurological Sciences ◽

10.1016/j.jns.2011.02.023 ◽

2011 ◽

Vol 305 (1-2) ◽

pp. 131-135 ◽

Cited By ~ 21

Author(s):

Paul S. Foster ◽

Valeria Drago ◽

Gregory P. Crucian ◽

William K. Sullivan ◽

Robert D. Rhodes ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Duration ◽

Anxiety And Depression ◽

Depression Severity

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A protocol to examine vision and gait in Parkinson’s disease: impact of cognition and response to visual cues

F1000Research ◽

10.12688/f1000research.7320.2 ◽

2016 ◽

Vol 4 ◽

pp. 1379 ◽

Cited By ~ 5

Author(s):

Samuel Stuart ◽

Brook Galna ◽

Sue Lord ◽

Lynn Rochester

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Visual Cues ◽

Saccadic Eye Movements ◽

Eye Tracker ◽

Motor Tasks ◽

3D Motion Analysis ◽

Visual Sampling ◽

Measure Of Performance

BackgroundCognitive and visual impairments are common in Parkinson’s disease (PD) and contribute to gait deficit and falls. To date, cognition and vision in gait in PD have been assessed separately. Impact of both functions (which we term ‘visuo-cognition’) on gait however is likely interactive and can be tested using visual sampling (specifically saccadic eye movements) to provide an online behavioural measure of performance. Although experiments using static paradigms show saccadic impairment in PD, few studies have quantified visual sampling during dynamic motor tasks such as gait.This article describes a protocol developed for testing visuo-cognition during gait in order to examine the: 1) independent roles of cognition and vision in gait in PD, 2) interaction between both functions, and 3) role of visuo-cognition in gait in PD.Methods Two groups of older adults (≥50 years old) were recruited; non-demented people with PD (n=60) and age-matched controls (n=40). Participants attended one session and a sub-group (n=25) attended two further sessions in order to establish mobile eye-tracker reliability. Participants walked in a gait laboratory under different attentional (single and dual task), environmental (walk straight, through a door and turning), and cueing (no visual cues and visual cues) conditions. Visual sampling was recorded using synchronised mobile eye-tracker and electrooculography systems, and gait was measured using 3D motion analysis.Discussion This exploratory study examined visuo-cognitive processes and their impact on gait in PD. Improved understanding of the influence of cognitive and visual functions on visual sampling during gait and gait in PD will assist in development of interventions to improve gait and reduce falls risk. This study will also help establish robust mobile eye-tracking methods in older adults and people with PD.

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Analysis of Movement Entropy during Community Dance Programs for People with Parkinson’s Disease and Older Adults: A Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020655 ◽

2022 ◽

Vol 19 (2) ◽

pp. 655

Author(s):

Peter Gates ◽

Fred M. Discenzo ◽

Jin Hyun Kim ◽

Zachary Lemke ◽

Joan Meggitt ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cohort Study ◽

Knee Flexion ◽

Movement Patterns ◽

Body Movements ◽

Community Dance ◽

Significant Difference ◽

Dance Movements

Dance therapy can improve motor skills, balance, posture, and gait in people diagnosed with Parkinson’s disease (PD) and healthy older adults (OA). It is not clear how specific movement patterns during dance promote these benefits. The purpose of this cohort study was to identify differences and complexity in dance movement patterns among different dance styles for PD and OA participants in community dance programs using approximate entropy (ApEn) analysis. The hypothesis was that PD participants will show greater ApEn during dance than OA participants and that the unique dance style of tango with more pronounced foot technique and sharp direction changes will show greater ApEn than smoother dance types such as foxtrot and waltz characterized by gradual changes in direction and gliding movement with rise and fall. Individuals participated in one-hour community dance classes. Movement data were captured using porTable 3D motion capture sensors attached to the arms, torso and legs. Classes were also video recorded to assist in analyzing the dance steps. Movement patterns were captured and ApEn was calculated to quantify the complexity of movements. Participants with PD had greater ApEn in right knee flexion during dance movements than left knee flexion (p = 0.02), greater ApEn of right than left hip flexion (p = 0.05), and greater left hip rotation than right (p = 0.03). There was no significant difference in ApEn of body movements (p > 0.4) or mean body movements (p > 0.3) at any body-segment in OA. ApEn analysis is valuable for quantifying the degree of control and predictability of dance movements and could be used as another tool to assess the movement control of dancers and aid in the development of dance therapies.

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Research Progress on Natural Product Ingredients’ Therapeutic Effects on Parkinson’s Disease by Regulating Autophagy

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5538200 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Sicong Li ◽

Xu Sun ◽

Lei Bi ◽

Yujia Tong ◽

Xin Liu

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Natural Products ◽

Research And Development ◽

Neurodegenerative Disease ◽

Natural Product ◽

Research Progress ◽

Therapeutic Effects ◽

Middle Aged

Parkinson’s disease (PD) is a common neurodegenerative disease in middle-aged and older adults. Abnormal proteins such as α-synuclein are essential factors in PD’s pathogenesis. Autophagy is the main participant in the clearance of abnormal proteins. The overactive or low function of autophagy leads to autophagy stress. Not only is it difficult to clear abnormal proteins but also it can cause damage to neurons. In this article, the effects of natural products ingredients, such as salidroside, paeoniflorin, curcumin, resveratrol, corynoxine, and baicalein, on regulating autophagy and protecting neurons were discussed in detail to provide a reference for the research and development of drugs for the treatment of PD.

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