Psychomotor disadaptation syndrome: a scoping review

Abstract

Background: Clinical features of psychomotor disadaptation syndrome (PDS) include posture, gait, psycho-behavioral, and neurological disorders, which increase the risk of falling. Psychomotor regression syndrome, described in 1986, was renamed PDS following improvements in its pathophysiological understanding, including the preeminent role of subcortical-frontal lesions. Because frailty in aging contributes to the appearance of PDS, the geriatric professionals need to be aware of its existence.

Purpose: This article aims to provide a scoping review on PDS. Moreover, we searched for epidemiological studies and assessed whether or not all the aspects of PDS are recognized.

Methods: The studies were retrieved from three electronic databases (PubMed, Science Direct, and Google Scholar) using these terms: psychomotor disadaptation syndrome, psychomotor regression syndrome, frontal-sub-cortical dysfunction syndrome, backward disequilibrium, retropulsion, post-fall syndrome, reactional hypertonia, axial akinesia, and older adults.

Results: Out of 456 shortlisted articles, 45 met the inclusion criteria. Our results show that PDS is poorly known, especially outside of France, which had the largest number of published studies on this syndrome. Abroad, only three aspects have been described (post-fall syndrome, retropulsion, and fear of falling). Often, they are not recognized as belonging to a real syndrome, but rather an association of signs. Post-fall syndrome, found in 14 studies, is the best known and most studied aspect of PDS. There were no epidemiological studies.

Conclusion: With the increasing number of frail older adults, there will be an inevitable growth in the incidence of PDS. Raising awareness about PDS among medical and paramedical geriatrics professionals is essential.

Keywords: Backward disequilibrium; Falls; Frontal sub-cortical dysfunction syndrome; Older adult; Post-fall syndrome; Psychomotor disadaptation syndrome.