Persistent Monoarthritis on the Patient of Parkinson’s Disease with Cognitive Impairment and Frequent Falls

Parkinson’s disease is often associated with cognitive impairment and frequent falls [1]. Postural control is severely reduced in PD and postural instability is thought to be one of the main symptoms of the disease [2-4]. Walking speed is reduced in PD patients and this is accompanied by a decrease in arm swing. In addition, there is an increase in cadence, double support, and left-right gait asymmetry and there is a decrease in bilateral coordination [1]. Gait disorders and postural instability increase the risk of falls in PD, which causes severe head trauma, fractures and mortality [1]. In addition, levodopa-induced dyskinesia, symptomatic orthostatic hypotension, sudden loss of postural reflexes, coexisting neurological or other medical disorders, and environmental factors are the other risk factors for falls in PD [5,6]. In the majority of the studies, the falls are related to the cognitive impairment. However, these studies evaluated advanced PD patients with gait disturbances and freezing problems. Cognitive disorders are observed from the early stages of the PD and may include several cognitive domains. Executive dysfunction and attention deficit are two of the most notable dysfunctions, and these are directly related to the risk of falls [7].