Objective: We try in this study to ascertain a link between the motor problems of gait and falls with panic attacks.
Design: Gait impairment, depression, and dementia are linked to anxiety. Falls can trigger fears in old persons. Physical rehabilitation is problematic in anxious patients, and fear of a further fall can prevent recovery from gait disorders. Cost for fall and anxiety is high both for patient and health service providers
Materials and Methods: All patients attending our daycare hospital from 01/01/2000 to 01/07/2001 were included. Patients were clinically screened for panic attack according to the DSM-IV criteria and tested using various scales for dependence (IRG), apathy (Marin), loss of motivation (EAD), cognitive efficiency (MMSE), depression (Cornell), and gait or balance impairment (Tinetti).
Results: 197 patients (134 of whom were demented) agreed to participate in this study (no refusals): 68 males aged 77.3 + 7.8 and 129 females aged 83.0 + 4.6. 33 patients presented at least one episode of panic attack; of these 20 had dementia, mainly Alzheimer’s type. Panicking and non-panicking patients did not differ in terms of sex ratio, age, dependence, apathy, motivation, degree of cognitive impairment or depression. Panicking patients had a lower Tinetti scale score for balance (7.1 + 3.2 versus 11.3 + 3.9; t=5.51, p<0.001) and for gait using the same test (9.2 + 2.9 versus 6.8 + 2.8; t=4.04, p<0.001). The main symptoms of panic associated with fear and uneasiness were a feeling of sweating hands (n=27), dizziness (n=25), sensations of shortness of breath or suffocation (n=24), trembling or twitching (n=24) and derealisation (n=22). Falls were more frequent in the panicking population (21/33 versus 6/164; Chi2= 78.5, p<0.001), as was remaining on the floor for more than one hour (10/33 versus 2/164; Chi2= 40.4, p<0.001) and living alone (23/33 versus 52/164; Chi2= 16.8, p<0.01).
Conclusion: Balance and gait impairment and falls are frequently observed in panicking patients, especially those living alone. The elderly may hide panic attacks, so screening is necessary
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