Brook Galna

Background and aims: The use of wearable technology enables precise measurement of turning movements during walking. Cross-sectional studies have shown that a decline in turning can be detected in the early clinical and even preclinical stages of Parkinson's disease (PD). This prospective longitudinal study aims to quantify the change in turning performance among older adults and determine if turning performance predicts future PD diagnosis.

Methods: A total of 933 participants (mean age = 66.1 years) from the TREND study were included for this analysis over five 2-year intervals, with the development of clinically evident PD tracked. Participants walked up and down a 20-meter hallway for one minute at their preferred pace, wearing a digital device on their lower back to capture turning. Longitudinal trajectories of turning performance were modelled using random effects linear mixed models to establish the interval between initial turning changes and PD diagnosis. Cox regression was used to assess whether initial turning measures could predict the time to PD onset, controlling for age and sex.

Results: Of all participants, 23 were diagnosed with idiopathic PD, an average of 5.3 years after baseline assessment. Slower peak angular velocity at baseline was associated with a higher hazard of PD diagnosis, with deviations from controls emerging approximately 8.7 years before diagnosis (Figure 1). Other parameters showed no prediction value of PD diagnosis.
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Conclusion: Peak angular velocity during turning appears to be a promising marker for identifying and tracking motor progression in the pre-diagnostic phase of PD.

Disclosure: nothing to disclose.