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Parkinson’s disease (PD) with dementia and falls is improved by AChEI? A preliminary study report

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Abstract

Background/objective

Advanced PD is often associated with cognitive impairment and frequent falls. We describe a suggestive case report of PD associated with mild cognitive impairment (MCI) and falls. The aim of our study was to test alteration in balance potentially related to use of acetylcholinesterase inhibitor (AchEI). We address this hypothesis after keeping the patient in stable dosage of dopamine agonist.

Methods/measurements

We describe an initial pharmacological management in a 78-year-old man affected by Parkinson disease (PD) associated with mild cognitive impairment (MCI) and history of falls. The diagnosis of PD was also confirmed by SPECT with DATSCAN, after CT-brain exclusion of potential other causes of the symptoms. Cognitive and motor performances of the patient were initially evaluated by Mini Mental Examination State Examination (MMSE), Short Physical Performance Battery (SPPB) and Romberg test. We also recorded gait parameters using an accelerometer, while balance and stability were assessed by stabilometric platform with open and closed eyes. We repeated cognitive and motor tests and gait and balance evaluation after stable dosage of dopamine agonist before and after introduction of AchEI.

Results

After starting dopamine agonist therapy, there was a significant improvement in gait parameters (speed, stride/min, stride length, swing duration, and decrease in gait cycle duration and rolling duration). When stable dosage of dopamine agonist was reached, AchEI was introduced obtaining not only a significant improvement of cognitive performance, but also a significant positive change in balance.

Conclusion and relevance

We hypothesize that AchEI could improve stability, balance and postural instability in addition to cognitive performance in PD with MCI and balance deficits.

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Acknowledgments

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

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Authors and Affiliations

  1. Geriatric Unit, Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci 14, 43100, Parma, Italy

    Fulvio Lauretani, Gianpaolo Ceda, Anna Nardelli & Marcello Maggio

  2. Learning Center for Health Systems and Health Services Organization, University of Parma, Parma, Italy

    Fulvio Lauretani, Gianpaolo Ceda & Marcello Maggio

  3. Rehabilitation Medicine, Department of Clinical and Experimental Medicine, Parma University Hospital, Parma, Italy

    Laura Galuppo & Cosimo Costantino

  4. Section of Geriatrics, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy

    Andrea Ticinesi, Gianpaolo Ceda & Marcello Maggio

  5. Nuclear Medicine Unit, Department of Radiology, Academic Hospital of Parma, Parma, Italy

    Livio Ruffini

Authors
  1. Fulvio Lauretani
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  2. Laura Galuppo
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  3. Cosimo Costantino
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  4. Andrea Ticinesi
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  5. Gianpaolo Ceda
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  6. Livio Ruffini
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  7. Anna Nardelli
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  8. Marcello Maggio
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Corresponding author

Correspondence to Fulvio Lauretani.

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On behalf of all authors, the corresponding author states that there is no actual or potential conflict of interest in relation to this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from participant included in the study.

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Lauretani, F., Galuppo, L., Costantino, C. et al. Parkinson’s disease (PD) with dementia and falls is improved by AChEI? A preliminary study report. Aging Clin Exp Res 28, 551–555 (2016). https://doi.org/10.1007/s40520-015-0437-x

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  • DOI: https://doi.org/10.1007/s40520-015-0437-x

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