Objective: This study elucidated the incidence and features of complications in patients with progressive supranuclear palsy (PSP).

Background: PSP is a progressive neurodegenerative disorder accompanied by several complications, such as falls, head injuries, and pneumonia. Therefore, preventing these complications is crucial for improving patient well-being and suppressing disease progression. However, these issues have not been comprehensively studied.

Method: The JALPAC project is a Japanese longitudinal observational study of a cohort of patients with PSP and corticobasal degeneration (UMIN18468). To date (2022/2/11), 378 participants from 45 institutions have been registered in JALPAC. In the present study, we observed the incidence and complications of patients with PSP in the past year at baseline. We also analyzed the relationship between each complication and age, clinical type of PSP, disease duration, and the PSP rating scale score using the Fisher’s test. Age, years of illness, and PSP rating scale scores were divided into two groups based on average. The clinical type was divided into whether Richardson’s syndrome existed or not.

Results: We identified 171 patients with PSP who had data of complications at baseline. Age at onset and baseline was 70.0 ± 6.9 years (mean ± SD) and 73.7 ± 6.6 years, respectively. Year of illness was 3.8 ± 2.5 years, and the PSP rating scale at baseline was 35.9 ± 18.1. 69.6% of patients with PSP experienced at least one complication. The most frequent complications were falls (64.9%), followed by head injuries (26.3%), fractures (20.3%), and pneumonia (9.3%). Both patient’s ages at onset and baseline were not associated with any complications. Head injuries more frequently occurred in patients with Richardson’s syndrome than those with other clinical types (p= 0.026). Patients with an illness of four years or more experienced significantly more frequent pneumonia than those with less than four years (p= 0.028). Falls were frequently observed during the entire course. Pneumonia and head injuries more frequently occurred in patients with a PSP rating scale of 36 or higher than those with less than 36 (p= 0.001, p= 0.047, respectively).

Conclusion: In PSP, falls and associated injuries were the most common complications. Falls frequently occurred not only at the early stage but also at the advanced stage. Head injuries were more common both in severe patients and those with Richardson’s syndrome.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/complications-in-patients-with-progressive-supranuclear-palsy/