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Published on: June 9, 2018
Falls in Huntington's Disease: A Cross-Sectional Analysis of Clinical Features and Potential Contributors
Arthur Pena Ferreira1, Sarah Edith Souza de Assis Leão1, Ricardo Oliveira Horta Maciel1,2
1Movement Disorders Unit, Neurology Service, Department of Internal Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
Background:
Falls occur across all stages of Huntington's disease (HD) and are associated with poor quality of life and injury. However, there is limited information on falls in HD.
Objective:
The aim was to investigate the clinical features potentially associated with falls in HD.
Methods:
We conducted a cross-sectional, analytical observational study, including consecutive patients with genetically confirmed symptomatic HD, and assessed clinical features, fall characteristics, fear of falling, movement disorder phenomenology, gait characteristics, balance, and cognitive and neuropsychiatric symptoms. Those who had experienced ≥2 falls in the past 6 months were considered fallers. Stepwise forward logistic regression was performed to determine the variables related to recurrent falls.
Results:
We included 40 individuals, of whom 24 (60%) were considered recurrent fallers. The nonfallers (75%) and fallers (79%) had high fear of falling rates. Seventy-two percent of falls occurred indoors, and 76% were classified as intrinsic. The dose of neuroleptics was higher in the fallers group (10.0 vs. 5.85, P = 0.028). This group also exhibited a higher prevalence of balance disorders, chorea, and executive cognitive impairment than the nonfallers group. No significant differences were observed in the spatiotemporal gait parameters studied. The regression analysis revealed that only the Berg Balance Scale scores were retained in the model (odds ratio: 0.87, 95% confidence interval: 0.78-0.97).
Conclusion:
Falls and fear of falling were frequent in HD. High doses of neuroleptics, chorea, cognitive and behavioral symptoms, and particularly balance disorders contribute to falls in HD.
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