Evidence map›Paper›PMID 25943529›Full record

ArticleParkinsonism & related disorders2015

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease.

V E Kelly, C O Johnson, E L McGough, A Shumway-Cook, F B Horak, K A Chung, A J Espay, F J Revilla, J Devoto, C Wood-Siverio and 8 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Parkinsonism & related disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Towards the Prevention of Freezing of Gait in Parkinson's Disease.The European journal of neuroscience · 2026
    Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Demographic and Clinical Profiles of Parkinson's Disease in India: Observations from a Nation-Wide Multicenter Study.Movement disorders : official journal of the Movement Disorder Society · 2025
    Article
  15. Article
  16. Article
  17. Review
  18. Changes in Action Tremor in Parkinson's Disease over Time: Clinical and Neuroimaging Correlates.Movement disorders : official journal of the Movement Disorder Society · 2025
    Article
  19. Article
  20. Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

V E KellyDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United States. Electronic address: vekelly@u.washington.edu.
C O JohnsonDepartment of Epidemiology, University of Washington, Seattle, WA, United States. Electronic address: johnsoco@uw.edu.
E L McGoughDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United States. Electronic address: emcg@uw.edu.
A Shumway-CookDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, United States. Electronic address: ashumway@uw.edu.
F B HorakDepartment of Neurology, Oregon Health and Science University, Portland, OR, United States; Portland Veterans Affairs Medical Center, Portland, OR, United States. Electronic address: horakf@ohsu.edu.
K A ChungDepartment of Neurology, Oregon Health and Science University, Portland, OR, United States; Portland Veterans Affairs Medical Center, Portland, OR, United States. Electronic address: chungka@ohsu.edu.
A J EspayDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United States. Electronic address: alberto.espay@uc.edu.
F J RevillaDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United States; Division of Neurology, Greenville Health System and University of South Carolina Medical School-Greenville, United States. Electronic address: fredy.revilla@uc.edu.
J DevotoDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United States. Electronic address: devotoj@ucmail.uc.edu.
C Wood-SiverioDepartment of Neurology, Emory University, Atlanta, GA, United States. Electronic address: cwoodsi@emory.edu.
S A FactorDepartment of Neurology, Emory University, Atlanta, GA, United States. Electronic address: sfactor@emory.edu.
B CholertonGeriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States. Electronic address: bchol@uw.edu.
K L EdwardsDepartment of Epidemiology, University of Washington, Seattle, WA, United States; Department of Epidemiology, University of California, Irvine, CA, United States. Electronic address: kedward1@uci.edu.
A L PetersonDepartment of Neurology, Oregon Health and Science University, Portland, OR, United States; Portland Veterans Affairs Medical Center, Portland, OR, United States. Electronic address: peterami@ohsu.edu.
J F QuinnDepartment of Neurology, Oregon Health and Science University, Portland, OR, United States; Portland Veterans Affairs Medical Center, Portland, OR, United States. Electronic address: quinnj@ohsu.edu.
T J MontineDepartment of Pathology, University of Washington, Seattle, WA, United States. Electronic address: tmontine@uw.edu.
C P ZabetianGeriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Parkinson's Disease Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Neurology, University of Washington, Seattle, WA, United States. Electronic address: zabetian@u.washington.edu.
J B LeverenzLou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, United States. Electronic address: leverej@ccf.org.

Funding

Udall Center Director's meeting poster awardP50NS062684 · NINDS · UNIVERSITY OF WASHINGTON · PI MONTINE, THOMAS J · 2009 to 2020
$18.3M
Using Multiplex Families to map Genes that Modify Susceptibility and Age at OnsetR01NS065070 · NINDS · UNIVERSITY OF WASHINGTON · PI ZABETIAN, CYRUS P · 2009 to 2012
$2.0M
Identification of Issues and Expectations of Subjects Participating in Genetic StR01CA149051 · NCI · UNIVERSITY OF WASHINGTON · PI EDWARDS, KAREN L · 2011 to 2013
$1.2M
Genetic Risk Factors for Parkinson's DiseaseI01BX000531 · VA · VA PUGET SOUND HEALTHCARE SYSTEM · PI ZABETIAN, CYRUS P · 2009 to 2013
–
Frontal Cortex and Gait Freezing in Parkinson's Disease: Rehabilitation ImpactI01RX001075 · VA · PORTLAND VA MEDICAL CENTER · PI HORAK, FAY BAHLING · 2015 to 2017
–
BLRD VA I01 BX000531NCI NIH HHS R01 CA149051NINDS NIH HHS P50 NS062684NINDS NIH HHS R01 NS065070RRD VA I01 RX001075
6 · The paper itself

Abstract

introductionResearch suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD.

methodsCognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language. PIGD symptoms were measured using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, Motor Examination subscale. Multiple linear regression analyses were performed to assess the relationship between cognition and PIGD symptoms with models adjusting for age, sex, education, enrollment site, disease duration, and motor symptom severity.

resultsThe analysis included 783 participants, with mean (standard deviation) age of 67.3 (9.7) years and median (interquartile range) MDS-UPDRS Motor Subscale score of 26 (17, 35). Deficits in global cognition, executive function, memory, and phonemic fluency were associated with more severe PIGD symptoms. Deficits in executive function were associated with impairments in gait, freezing, and postural stability, while visuospatial impairments were associated only with more severe freezing, and poorer memory function was associated only with greater postural instability. DISCUSSION: While impairments in global cognition and aspects of executive functioning were associated with more severe PIGD symptoms, specific cognitive domains were differentially related to distinct PIGD components, suggesting the presence of multiple neural pathways contributing to associations between cognition and PIGD symptoms in persons with PD.

Indexed as

Postural BalanceAgedCognitionCognition DisordersCross-Sectional StudiesFemaleGait Disorders, NeurologicHumansLongitudinal StudiesMaleMiddle AgedNeuropsychological TestsParkinson DiseaseBalanceCognitionExecutive functionFreezing of gaitGait

Identifiers

PMID25943529
PMCPMC4524498

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.