Motor and non-motor predictors of freezing of gait in Parkinson's ' s disease: A retrospective cohort study

Introduction: Freezing of gait (FOG) is a debilitating episodic gait disorder that significantly reduces the quality of life (QoL) in patients with Parkinson's disease (PD). Diagnosing and treating FOG remains a major medical challenge. This study aimed to assess the correlation between FOG and both motor and non-motor clinical characteristics in patients with PD. Methods: In this retrospective cohort study, 112 patients with PD were divided into two groups using the New Freezing of Gait Questionnaire (NFOG-Q): one group with FOG (PD-FOG, 53 patients) and one group without FOG (PD-nFOG, 59 patients). The severity of PD and FOG was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), the Hoehn-Yahr (H-Y) staging system, and the NFOG-Q. The study also analyzed non- motor symptoms, including sleep disturbances, cognitive impairments, depression, anxiety, apathy, fatigue, and QoL. Result: The prevalence of FOG was 47.3%. The PD-FOG group exhibited a longer duration of PD (P = 0.002), a higher H-Y stage indicating PD progression (P = 0.003), and elevated anxiety levels (P = 0.003) compared to the PD-nFOG group. According to binary logistic regression analysis, the higher H-Y stage (P = 0.022), anxiety level (P = 0.005), UPDRS part II (P = 0.001), and part III (P = 0.008) were significant predictors for the occurrence of FOG. Conclusion: Patients with Parkinson's disease who have a higher Hoehn-Yahr (H-Y) stage, higher UPDRS score, and elevated levels of anxiety are more likely to experience FOG.