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Association of Pisa Syndrome With Mortality in Patients With Parkinson's Disease
Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Catholic University of Medicine, Italy.ORCID iD: 0000-0002-3099-4830
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Number of Authors: 102019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 8, p. 1037-+Article in journal (Refereed) Published
Abstract [en]

Objectives: In Parkinson's disease, Pisa syndrom (PS) has been associated with disease stage and severity, combined treatment with levodopa and dopamine agonists, gait disorders, and comorbidities. Some forms of PS are potentially reversible; nevertheless, little is known about the impact of this syndrome on survival. Design: Prospective study with a median follow-up of 2 years. Setting and participants: Patients with Parkinson's disease, age 65 years and older (N = 189), attending a geriatric day hospital. Measurements: According to established criteria, PS was diagnosed in the presence of at least 10 degrees lateral flexion of the trunk reducible by passive mobilization or supine positioning. Cox regression was adopted to assess the association of PS with all-cause mortality. Results: PS was diagnosed in 40 patients (21%); over the follow-up, 21 (11%) subjects died. In Cox regression, PS was associated with higher mortality [hazard ratio (HR) 4.10; 95% confidence interval (CI) = 1.36-12.38], after adjusting; other variables associated with mortality were age (HR = 1.19, 95% CI = 1.08-1.32), beta blockers (HR = 4.35, 95% CI = 1.23-15.39), and albumin levels (HR = 0.05, 95% CI = 0.01-0.33). The association of PS with mortality remained significant also after adjusting for variables associated with this syndrome (HR = 4.04, 95% CI = 1.33-12.25). Conclusions/Implications: PS represents a risk factor for earlier mortality in Parkinson's disease; further studies are needed to ascertain the underlying causes and whether treatment of this condition might improve survival. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Place, publisher, year, edition, pages
2019. Vol. 20, no 8, p. 1037-+
Keywords [en]
Pisa syndrome, Parkinson's disease, survival
National Category
Geriatrics Gerontology, specialising in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:su:diva-171699DOI: 10.1016/j.jamda.2019.01.141ISI: 000476978200021PubMedID: 30872084OAI: oai:DiVA.org:su-171699DiVA, id: diva2:1343761
Available from: 2019-08-19 Created: 2019-08-19 Last updated: 2019-08-19Bibliographically approved

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Vetrano, Davide L.
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