Objective: To investigate fatigue at baseline and 3.5 years later and its association with balance and gait over time.

Background: In Parkinson’s disease (PD), fatigue is considered one of the most common and disabling nonmotor symptoms that may persist or even worsen over time. Fatigue in generally has been described as a significantly diminished energy level or an increased perception of effort disproportionate to attempted activities. Fatigue has been associated to several nonmotor symptoms (e.g., depression, apathy, anxiety, sleep disturbances) and negatively impact quality of life in cross-sectional PD-studies. However, few studies have investigated fatigue over time and its association with other physical symptoms.

Method: A prospective cohort of 70 persons with mild to moderate PD was assessed at baseline and 3.5 years later. Mean (SD) age and PD duration at baseline were 66 (8.9) and 4 (4.0) years, respectively and median (q1-q3) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) were 11 (7-18). Fatigue was investigated with The Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F, higher=better). Multiple linear regression analysis was performed with FACIT-F scores at baseline as dependent variable and a battery of clinical balance and gait tests targeting functional, reactive, and dynamic balance (Bergs Balance Scale vs Nutt Retropulsion Test vs Tandem gait, respectively), comfortable and fast gait speed and functional mobility (Timed up and go, TUG) as independent variables. The results were controlled for age and motor symptoms.

Results: The median (q1-q3) FACIT-F scores at baseline (39 (30-36)) were significantly higher than corresponding value 3.5 years later (33.5 (22.5-41)). Significant association was found between FACIT-F scores at baseline and time needed to perform TUG 3.5 years later (B (95% CI); -0,568 (-0,925, -0.211), P=0.002)). These results suggest more than half a second longer time to perform the TUG for every point/score on the FACIT-F.

Conclusion: Fatigue in people with PD seem to increase substantially over a relatively short time of 3.5 years. Fatigue also impacts functional mobility incorporating components of balance and gait ability in PD (gait speed, turning and sit-to-stand transfers). More longitudinal studies are needed to investigate long-term impact of fatigue on physical function in daily live.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-fatigue-in-parkinsons-disease-impact-ones-physical-function-in-daily-live/