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H37 Fear of choking and fear of falling in huntington’s disease
  1. Kristel Kalkers1,2,
  2. Els Derksen3,
  3. Jacques CL Neyens2,
  4. Jos MGA Schols4,
  5. Raymund AC Roos1
  1. 1Leiden University Medical Center, Leiden, The Netherlands
  2. 2De Riethorst Stromenland, VX Raamsdonksveer, The Netherlands
  3. 3Radboud University Medical Center, Nijmegen, The Netherlands
  4. 4Maastricht University, Maastricht, The Netherlands

Abstract

Background Dysphagia and accidental falls are common in patients with HD; they can have serious consequences and may, therefore, lead to fear of choking (FoC) and fear of falling (FoF). In an initial exploration into fear of falling, Dutch HD nursing home residents were compared to non-HD residents. Although fall incidents were more common in Huntington residents than in non-Huntington residents, Huntington residents were less fearful of falling. It is not clear which emotional and cognitive factors contribute to the development of FoC or FoF.

Aims To explore the relationship between cognition, awareness and anxiety and experiencing FoC or FoF in HD. As the literature on HD is expected to be limited, the study population will be expanded by also looking at PD and dementia, both of which are neurodegenerative diseases that share symptoms and signs with HD.

Methods a systematic review of English, German and Dutch articles using the electronic databases: MEDLINE, Embase, CINAHL and Psychinfo. Studies describing the influence of cognition, awareness and anxiety on the outcome measures FoF and FoC in patients with HD, PD or dementia were included.

Results For HD, no reports were found related to the objective of the study and no studies on FoC were found for PD or dementia. The results of studies addressing FoF in PD and dementia were contradictory as far as the relationship with cognition (PD n=5; dementia n=8) and anxiety (PD n=2) was concerned. No study on FoF in relation to awareness was found in any patient group.

Conclusions Data on emotional and cognitive factors and their relationship with FoC and FoF are limited in HD and Parkinson’s disease and dementia. Available data are inconsistent. Future research focusing specifically on these topics might lead to better insight. Better insight in these subjects could result in therapeutic options for patients or guidelines for caregivers, with regard to prevention and coping strategies, to improve quality of care. Therefore, currently a study is conducted into the relationship between FoC and FoF and cognitive, emotional and behavioral functioning in 200 HD patients and their caregivers.

  • Huntington’s disease
  • Accidental falls
  • Choking
  • Fear

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