Characteristics of decision-making in persons with Parkinson’s disease with recurrent falls

Abstract

Previous studies have shown that persons with Parkinson's disease (PD) fall more frequently and recurrently. Since recurrent falls in persons with PD occur under the same situations, even if the person is aware of them, decision-making problems may be related. To date, impairment in decision-making function has been measured using Iowa Gambling Task (IGT). The purpose of this study was to examine recurrent falls in persons with PD by adding IGT to the traditional method. The subjects were 16 persons with PD living at home. Subjects were divided into two groups: recurrent fall group (10 subjects) with two or more falls in the past year and non-recurrent fall group (6 subjects) with one or fewer falls, and characteristic, H&Y classification, MDS-UPDRS, MMSE, TMT, FAB, MFES and IGT scores were compared. The results showed that the recurrent falls group had a significantly more severe H&Y classification and faster TMT than the non-recurrent fall group, as well as a significantly higher frequency of selecting the gambling deck on the IGT and lower performance on the final phase of the IGT. This suggests that persons with PD who have recurrent falls have problems with PD severity and attention, as well as difficulty avoiding major risks and learning from punishment and failure to change behavior. Further study based on the characteristics of persons with PD is needed in the future.