학술논문
Elderly Onset of Functional Motor Disorders: Clinical Correlates from the Italian Registry.
Document Type
Article
Author
Geroin, Christian; Petracca, Martina; Di Tella, Sonia; Marcuzzo, Enrico; Erro, Roberto; Cuoco, Sofia; Ceravolo, Roberto; Mazzucchi, Sonia; Pilotto, Andrea; Padovani, Alessandro; Romito, Luigi Michele; Eleopra, Roberto; Zappia, Mario; Nicoletti, Alessandra; Dallocchio, Carlo; Arbasino, Carla; Bono, Francesco; Laterza, Vincenzo; Demartini, Benedetta; Gambini, Orsola
Source
Subject
*MOVEMENT disorders
*OLDER people
*OLDER patients
*GAIT disorders
*NEUROLOGICAL disorders
*SYMPTOMS
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Language
ISSN
2330-1619
Abstract
Background: Functional motor disorders (FMD) are a frequent neurological condition affecting patients with movement disorders. Commonly described in younger adults, their manifestation can be also associated to an elderly onset. Objective: To assess the prevalence and describe the clinical manifestations of FMD with elderly and younger onset and their relationship with demographical and clinical variables. Methods: We recruited patients with a "clinically definite" diagnosis of FMD from the Italian Registry of FMD. Patients underwent extensive clinical assessments. For elderly onset, we set a chronological cut‐off at 65 years or older according to WHO definition. Multivariate regression models were implemented to estimate adjusted odds ratio of elderly FMD onset related to clinical characteristics. Results: Among the 410 patients, 34 (8.2%) experienced elderly‐onset FMD, with a mean age at onset of 70.9 years. The most common phenotype was tremor (47.1%), followed by gait disorders, weakness, and dystonia (29.4%, 23.5%, 14.7%, respectively). Eleven elderly patients had a combined phenomenology: 9 exhibited two phenotypes, 2 had three phenotypes. Weakness was isolated in 3/8 patients and combined with another phenotype in 5/8, manifesting as paraplegia (n = 4); upper limb diplegia (n = 2), hemiparesis/hemiplegia (n = 1), and tetraparesis/tetraplegia (n= 1). Non‐motor and other functional neurological disorders occurred more frequently in the younger group (89.1%) than the elderly (73.5%). Neurological and non‐neurological comorbidities were more prevalent in the elderly group (82.4%) as opposed to the younger (32.7%). In a multivariate regression analysis, elderly‐onset FMD was significantly associated with neurological comorbidities, including parkinsonism (OR 6.73) and cerebrovascular diseases (OR 5.48). Conclusions: These results highlight the importance of achieving an accurate diagnosis of FMD in the elderly, as it is crucial for effectively managing FMD symptoms and addressing neurological comorbidities. [ABSTRACT FROM AUTHOR]