Association of Pisa Syndrome With Mortality in Patients With Parkinson's Disease

Alice Laudisio, Maria Rita Lo Monaco, Davide L. Vetrano, Maria Stella Pisciotta, Vincenzo Brandi, Antonella Gemma, Domenico Fusco, Roberto Bernabei, Raffaele Antonelli Incalzi, Giuseppe Zuccala'

Risultato della ricerca: Contributo in rivistaArticolo in rivista


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° 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.
Lingua originaleEnglish
pagine (da-a)30175-30176
Numero di pagine2
RivistaJournal of the American Medical Directors Association
Stato di pubblicazionePubblicato - 2019


  • Parkinson
  • Pisa Syndrome


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