Impaired executive function can predict recurrent falls in Parkinson's disease

Area of Science:

• Neurology
• Gerontology
• Movement Disorders

Background:

• Parkinson's disease (PD) is a neurodegenerative disorder affecting motor control.
• Recurrent falls are a common and serious complication in people with PD, leading to injury and reduced quality of life.
• Executive function deficits are increasingly recognized in PD, but their independent predictive value for falls requires further investigation.

Purpose of the Study:

• To determine if impaired executive function independently predicts recurrent falls in individuals with Parkinson's disease.
• To assess the combined predictive power of executive function and fear of falling on fall recurrence in PD.

Main Methods:

• A prospective cohort study design was employed.
• 144 community-dwelling individuals with PD were recruited.
• Executive function (Mattis Dementia Rating Scale Initiation/Perseveration subtest) and fear of falling (Activities-specific Balance Confidence Scale) were assessed at baseline. Participants were followed for 12 months to record fall events.

Main Results:

• 42 participants (29%) were classified as recurrent fallers (≥2 falls).
• Logistic regression revealed that lower scores on the Mattis Dementia Rating Scale Initiation/Perseveration subtest (indicating poorer executive function) and lower Activities-specific Balance Confidence Scale scores (indicating greater fear of falling) significantly predicted recurrent falls.
• The prediction model achieved 85.9% accuracy in identifying recurrent fallers.

Conclusions:

• Impaired executive function is a significant independent predictor of recurrent falls in people with Parkinson's disease.
• Individuals with both executive dysfunction and greater fear of falling at baseline face a substantially higher risk of recurrent falls within 12 months.
• These findings highlight the importance of assessing executive function and fear of falling for fall risk stratification in PD management.