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Observational Study
. 2023 Jan 30;23(1):54.
doi: 10.1186/s12877-023-03776-7.

Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson's disease: a longitudinal study

Louise Laurent  1 , Pierre Koskas  1 , Janina Estrada  1 , Mélanie Sebbagh  1 , Sophie Lacaille  1 , Agathe Raynaud-Simon  1   2 , Matthieu Lilamand  3   4   5   6
Affiliations
Observational Study

Tinetti balance performance is associated with mortality in older adults with late-onset Parkinson's disease: a longitudinal study

Louise Laurent et al. BMC Geriatr. .

Abstract

Background: Parkinson's disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinical characteristics associated with these outcomes, in older community-dwelling patients with late-onset PD.

Methods: Retrospective, observational analysis of data from geriatric day hospital patients. Motor assessment included Unified Parkinson Disease Rating Scale (UPDRS) part III score, Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait tests, and gait speed. Levodopa equivalent dose, comorbidity, cognitive performance, Activities of Daily Living performance were examined. Cox proportional hazards models were performed to identify the factors associated with mortality and NH admission rate (maximum follow-up time = 5 years).

Results: We included 98 patients, mean age 79.4 (SD = 5.3) of whom 18 (18.3%) died and 19 (19.4%) were admitted into NH, over a median follow-up of 4 years. In multivariate Cox models, poor balance on the Tinetti POMA scale (HR = 0.82 95%CI (0.66-0.96), p = .023) and older age (HR = 1.12 95%CI (1.01-1.25), p = .044) were the only variables significantly associated with increased mortality risk. A Tinetti balance score below 11/16 was associated with a 6.7 hazard for mortality (p = .006). No specific factor was associated with NH admissions.

Conclusions: Age and the Tinetti POMA score were the only factors independently associated with mortality. The Tinetti POMA scale should be considered for balance assessment and as a screening tool for the most at-risk individuals, in this population.

Keywords: Balance; Older adults; Parkinson’s disease; Tinetti.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of study participants (A) and cumulative number of events by year, during 5-year monitoring (B)
Fig. 2
Fig. 2
Main clinical symptoms of the study participants at baseline
Fig. 3
Fig. 3
Survival probability according to the Tinetti Performance Oriented Mobility Assessment performance, in tertiles
See this image and copyright information in PMC

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