59 research outputs found
Motor Functioning and Parkinson’s Disease: Insights from the general population
No full textMotor functioning strongly impacts the ability to maintain functional independence, in particular among the elderly. The detrimental influence of motor impairments on functional independence is painfully noticeable in individuals with neurodegenerative movement disorders, in particular in those with the most widely recognized among these disorders: Parkinson’s Disease (PD). As the number of elderly individuals is expected to grow due to ageing of populations worldwide, there is now a growing sense of urgency to unravel determinants of motor functioning and PD. This thesis provides novel insight on determinants of motor functioning and PD.
Intriguingly, deterioration of motor functioning begins well before individuals are clinically diagnosed with PD, as a result of accumulating pathology in the brain, in the ‘prediagnostic’ phase of the disease. This thesis describes the identification of risk factors (both genetic and non-genetic) and prodromal features of PD, which adds to our understanding of the prediagnostic phase of PD. Furthermore, this thesis examines modalities to identify individuals at high risk of PD.
Progressive motor impairments may also occur in the prediagnostic phase of other neurodegenerative diseases than PD, including those that are primarily characterized by dementia. Motor impairments are often accompanied by cognitive deficits across neurodegenerative diseases, typically adding to the loss of functional independence. This thesis seeks to fill the gap on knowledge on overlap of cognitive and motor impairments in the prediagnostic phase of neurodegenerative diseases and on overlap in their lifetime risk by presenting observational data from the general population. Taken together, these observations add to our understanding of determinants of motor impairments, which has implications not only for PD but also for other neurodegenerative diseases.
This thesis concludes by placing its main observations in a broader clinical context, pointing out methodological considerations that merit attention in the interpretation of these observations, and offering directions for future research
Palliative Programs for Persons With Parkinsonism-The Next Frontier
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220516.pdf (Publisher’s version ) (Open Access
Physical Activity May Reduce Apolipoprotein E4-Associated Cognitive Decline in Parkinson Disease
No full textConsiderations on How to Prevent Parkinson's Disease Through Exercise.
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311139.pdf (Publisher’s version ) (Open Access)The increasing prevalence of people with Parkinson's disease (PD) necessitates a high priority for finding interventions to delay or even prevent the onset of PD. There is converging evidence that exercise may exert disease-modifying effects in people with clinically manifest PD, but whether exercise also has a preventive effect or is able to modify the progression of the pathology in the prodromal phase of PD is unclear. Here we provide some considerations on the design of trials that aim to prevent PD through exercise. First, we discuss the who could benefit from exercise, and potential exercise-related risks. Second, we discuss what specific components of exercise mediate the putative disease-modifying effects. Third, we address how methodological challenges such as blinding, adherence and remote monitoring could be handled and how we can measure the efficacy of exercise as modifier of the course of prodromal PD. We hope that these considerations help in designing exercise prevention trials for persons at risk of developing PD
The impact of multiple gender dimensions on health-related quality of life in persons with Parkinson's disease: an exploratory study
No full textBACKGROUND: There is a growing recognition that sex characteristics and gender-related aspects can have a substantial impact on the health-related quality of life (HRQoL) of persons with Parkinson's disease (PD). Gender is a multidimensional construct, including dynamic social norms and relations that influence health and impact quality of life. Even when gender is investigated in the field of PD, it is frequently conceptualized as gender identity while other dimensions, such as roles or relations, are generally ignored. The aim of this study was to explore the impact of several gender dimensions on HRQoL among people with PD. METHODS: We performed a survey-based, cross-sectional study in the Netherlands to explore the impact of several gender dimensions, namely; gender identity, gender roles and gender relations on HRQoL (PDQ-39) of people with PD. RESULTS: In our study population (N = 307), including 127 (41%) women, we did not observe an association between gender identity and overall HRQoL. In contrast, an androgynous gender role and higher engagement in household tasks were associated with better overall HRQoL among people with PD. CONCLUSIONS: This study offers the first detailed description of the impact of different gender dimensions on the HRQoL of people with PD and highlights the need for more precise gender-measures to inform actionable gender-sensitive health interventions for people with PD
Quantitative Motor Functioning in Prodromal Parkinson Disease
No full textContains fulltext :
215509.pdf (Publisher’s version ) (Open Access
Clinical Trial Highlights – Aerobic Exercise for Parkinson’s Disease
No full text Converging lines of evidence suggest that aerobic exercise impacts Parkinson’s disease (PD) motor symptoms and might slow it’s progression. We provide an overview of the ongoing randomized clinical trials (RCTs) on aerobic exercise in PD. We found six RCTs with sample sizes between 28 and 370 and a follow-up between 8 weeks and 18 months. PD motor symptoms is mostly used as primary outcome while various secondary outcomes are reported. We need more trials that use both clinical endpoints and markers of neuroplasticity, and provide insight into the optimal exercise mode, duration and intensity
The association of comorbidity with Parkinson's disease-related hospitalizations
No full textIntroduction: Unplanned hospital admissions associated with Parkinson's disease could be partly attributable to comorbidities. Methods: We studied nationwide claims databases and registries. Persons with newly diagnosed Parkinson's disease were identified based on the first Parkinson's disease-related reimbursement claim by a medical specialist. Comorbidities were classified based on the Charlson Comorbidity Index. We studied hospitalization admissions because of falls, psychiatric diseases, pneumonia and urinary tract infections, PD-related hospitalizations-not otherwise specified. The association between comorbidities and time-to-hospitalization was estimated using Cox proportional hazard modelling. To better understand pathways leading to hospitalizations, we performed multiple analyses on causes for hospitalizations. Results: We identified 18 586 people with newly diagnosed Parkinson's disease. The hazard of hospitalization was increased in persons with peptic ulcer disease (HR 2.20, p = 0.009), chronic obstructive pulmonary disease (HR 1.61, p < 0.001), stroke (HR 1.37, p = 0.002) and peripheral vascular disease (HR 1.31, p = 0.02). In the secondary analyses, the hazard of PD-related hospitalizations-not otherwise specified (HR 3.24, p = 0.02) and pneumonia-related hospitalization (HR 2.90, p = 0.03) was increased for those with comorbid peptic ulcer disease. The hazard of fall-related hospitalization (HR 1.57, p = 0.003) and pneumonia-related hospitalization (HR 2.91, p < 0.001) was increased in persons with chronic obstructive pulmonary disease. The hazard of pneumonia-related hospitalization was increased in those with stroke (HR 1.54, p = 0.03) or peripheral vascular disease (HR 1.60, p = 0.02). The population attributable risk of comorbidity was 8.4%. Conclusion: Several comorbidities increase the risk of Parkinson's disease related-hospitalization indicating a need for intervention strategies targeting these comorbid disorders.Pattern Recognition and Bioinformatic
The salience of gender in the illness experiences and care preferences of people with Parkinson's disease
No full textGöttgens I, Modderkolk L, Jansen C, Darweesh SKL, Bloem BR, Oertelt-Prigione S. The salience of gender in the illness experiences and care preferences of people with Parkinson's disease. Social Science & Medicine. 2023;320: 115757.Rationale: In recent years, interest in sex characteristics and gender dimensions of Parkinson's disease (PD) has increased. Yet, much remains to be understood about how gender-related aspects specifically impact the illness and experiences of care in persons living with PD.Objective: The purpose of this study was to explore the salience of gender-related aspects in the illness experiences and care provision preferences of people with PD.Methods: A descriptive qualitative study including semi-structured life story interviews was conducted with men and women living with PD in the Netherlands. Between September 2020 and February 2021, forty people with PD (20 men and 20 women) participated in digital interviews of which thirty-one (18 men and 13 women) were included in the thematic analyses for this specific study.Results: Overall, most participants did not consider gender-related aspects salient towards their illness experiences. However, when prompted, a number of participants described several stereotypical views about gender as related to the visibility of PD, emotional experiences, help seeking, role patterns and physical appearance. While most men and women with PD did not express specific gender-related preferences for their healthcare providers, those that did, all preferred women as healthcare providers. These preferences were generally related to attributed feminine traits which are considered relevant in routine, particularly sensitive, physical examinations of people with PD.Conclusion: This study demonstrates that although every person has a gender identity, the salience attributed to gender varies with illness experiences and in care provision preferences between people with PD. These findings highlight the need for precise and personalized methodologies to capture more nuanced insights into the impact of gender dimensions on PD. Furthermore, drivers behind gender-related preferences in care provision are multifactorial and warrant further investigation among people with PD
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