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Predictors of falls and fractures in bradykinetic rigid syndromes: a retrospective study
- Source :
- Journal of Neurology, Neurosurgery & Psychiatry. 77:468-473
- Publication Year :
- 2006
- Publisher :
- BMJ, 2006.
-
Abstract
- Background: Falls and fractures contribute to morbidity and mortality in bradykinetic rigid syndromes. Methods: The authors performed a retrospective case notes review at the Queen Square Brain Bank for Neurological Disorders and systematically explored the relation between clinical features and falls and fractures in 782 pathologically diagnosed cases (474 with Parkinson’s disease (PD); 127 progressive supranuclear palsy (PSP); 91 multiple system atrophy (MSA); 46 dementia with Lewy bodies (DLB); 27 vascular parkinsonism; nine Alzheimer’s disease; eight corticobasal degeneration). Results: Falls were recorded in 606 (77.5%) and fractures in 134 (17.1%). In PD, female gender, symmetrical onset, postural instability, and autonomic instability all independently predicted time to first fall. In PD, PSP, and MSA latency to first fall was shortest in those with older age of onset of disease. Median latency from disease onset to first fall was shortest in Richardson’s syndrome (12 months), MSA (42), and PSP-parkinsonism (47), and longest in PD (108). In all patients fractures of the hip were more than twice as common as wrist and forearm fractures. Fractures of the skull, ribs, and vertebrae occurred more frequently in PSP than in other diseases. Conclusion: Measures to prevent the morbidity associated with falls and fractures in bradykinetic rigid syndromes may be best directed at patients with the risk factors identified in this study.
- Subjects :
- Paper
Adult
Male
medicine.medical_specialty
Pediatrics
Parkinson's disease
Poison control
Hypokinesia
Progressive supranuclear palsy
Fractures, Bone
medicine
Humans
Dementia
Corticobasal degeneration
Retrospective Studies
Aged, 80 and over
Hip fracture
business.industry
Dementia with Lewy bodies
Incidence
Parkinson Disease
Middle Aged
Multiple System Atrophy
medicine.disease
Surgery
Psychiatry and Mental health
Accidental Falls
Female
Supranuclear Palsy, Progressive
Neurology (clinical)
Age of onset
Cognition Disorders
business
Subjects
Details
- ISSN :
- 00223050
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology, Neurosurgery & Psychiatry
- Accession number :
- edsair.doi.dedup.....b7d18fa4b37c8757519435682884c74e