Involvement of specific executive functions in mobility in Parkinson's disease

Postural instability and gait disorders (PIGD) in Parkinson's disease (PD) seem to be associated with executive dysfunction. We investigated which specific executive functions are associated with functional mobility in mildly affected PD patients. Functional mobility (Timed Up&Go Test, TUG), PIGD score, (spatial) working memory, set shifting, response inhibition and response generation were assessed in a large cohort of 232 non-demented PD patients. Both performance on the TUG and PIGD score were weakly associated with working memory and response generation (semantic and phonemic fluency). TUG also correlated with semantic fluency when corrected for disease severity and age. These results indicate that response generation and working memory are associated with (and possibly also causally related to) gait and balance deficits. In order to fully interpret gait and postural stability of PD patients in everyday situations, the role of impairments in working memory and response generation should be taken into account.