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Article type: Research Article
Authors: Roper, Jaimie A.a; * | Schmitt, Abigail C.b | Gao, Hanzhic | He, Yingd | Wu, Samuelc | Schmidt, Petere | Okun, Michael S.f; g | Hass, Chris J.b; f | Cubillos, Fernandog | on behalf of the Parkinson’s Foundation Quality Improvement Initiative Investigators
Affiliations: [a] Auburn University, Auburn, School of Kinesiology, AL, USA | [b] University of Florida, Department of Applied Physiology and Kinesiology, Gainesville, FL, USA | [c] University of Florida, Department of Biostatistics, Gainesville, FL, USA | [d] Clarkson University, Department of Mathematics, Potsdam, NY, USA | [e] East Carolina University, Greenville, NC, USA | [f] University of Florida, Department of Neurology, Norman Fixel Institute for Neurological Diseases, Gainesville, FL, USA | [g] Parkinson’s Foundation, FL, USA
Correspondence: [*] Correspondence to: Jaimie A. Roper, PhD, Auburn University, 301 Wire Road, Auburn, AL, USA. Tel.: +1 334 844 1597; E-mail: jroper@auburn.edu.
Abstract: Background:The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective:We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods:In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results:More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion:Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.
Keywords: Comorbidity, Parkinson’s disease, arthritis, mobility, mortality
DOI: 10.3233/JPD-202170
Journal: Journal of Parkinson's Disease, vol. 10, no. 4, pp. 1601-1610, 2020
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