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Cognitive dysfunction associated with falls in progressive supranuclear palsy

 Sha-Lom Kim  ;  Myung-Jun Lee  ;  Myung-Sik Lee 
 GAIT & POSTURE, Vol.40(4) : 605-609, 2014 
Journal Title
Issue Date
Accidental Falls* ; Aged ; Aged, 80 and over ; Attention/physiology ; Cognition Disorders/etiology ; Cognition Disorders/physiopathology* ; Executive Function/physiology ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Risk Factors ; Supranuclear Palsy, Progressive/complications ; Supranuclear Palsy, Progressive/physiopathology*
Executive dysfunction ; Fall ; Progressive supranuclear palsy ; Visuospatial dysfunction
BACKGROUND: Attentional and executive dysfunctions are associated with falls in community-dwelling elderly individuals and patients with PD. Frontal cognitive dysfunction and falls are frequent symptoms of PSP. We studied to identify the cognitive domains associated with recurrent falls in patients with PSP. METHODS: We performed a battery of neuropsychological tests in 59 individuals with probable PSP. We categorized patients into infrequent fall (≤one fall during the last 12 months, n=29) or recurrent fall (≥two falls during the last 12 months, n=30) groups. RESULTS: UPDRS subscores for axial deficits were significantly higher in the recurrent fall group than the infrequent fall group, but there were no significant differences in UPDRS total motor scores or subscores for bradykinesia, rigidity, and tremor. There was no difference between groups in MMSE scores. ANCOVA with adjustment for confounding factors showed that, recurrent falls were associated with abnormalities in alternating hand movement, alternating square and triangle, RCFT copying task, and ideomotor apraxia. Group difference of abnormalities in Stroop test was marginal (p=0.054). However, there were no group differences in the frequency of abnormalities in forward or backward digit span, motor impersistence, fist-edge-palm, contrast programming, go-no-go, Luria loop drawing, or Controlled Oral Word Association Tests. Recurrent falls were not associated with memory or language dysfunction. CONCLUSIONS: Recurrent falls in patients with PSP were associated mainly with executive and visuospatial dysfunctions, including (1) impaired coordinated alternating uni- and bimanual motor programming and execution, (2) deficit of attention and decision making in the presence of interference, (3) visuospatial misperception and (4) ideomotor apraxia.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sha Lom(김샤롬)
Lee, Myung Sik(이명식) ORCID logo https://orcid.org/0000-0002-8413-1854
Lee, Myung Jun(이명준)
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