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Prediction of falls and/or near falls in people with mild Parkinson's disease
Beata Lindholm1, Peter Hagell2, Oskar Hansson3
1Department of Neurology, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden.
Objective:
To determine factors associated with future falls and/or near falls in people with mild PD.
Methods:
The study included 141 participants with PD. Mean (SD) age and PD-duration were 68 (9.7) and 4 years (3.9), respectively. Their median (q1-q3) UPDRS III score was 13 (8-18). Those >80 years of age, requiring support in standing or unable to understand instructions were excluded. Self-administered questionnaires targeted freezing of gait, turning hesitations, walking difficulties in daily life, fatigue, fear of falling, independence in activities of daily living, dyskinesia, demographics, falls/near falls history, balance problems while dual tasking and pain. Clinical assessments addressed functional balance performance, retropulsion, comfortable gait speed, motor symptoms and cognition. All falls and near falls were subsequently registered in a diary during a six-month period. Risk factors for prospective falls and/or near falls were determined using logistic regression.
Results:
Sixty-three participants (45%) experienced ≥ 1 fall and/or near fall. Three factors were independent predictors of falls and/or near falls: fear of falling (OR = 1.032, p<0.001) history of near falls (OR = 3.475, p = 0.009) and retropulsion (OR = 2.813, p = 0.035). The strongest contributing factor was fear of falling, followed by a history of near falls and retropulsion.
Conclusions:
Fear of falling seems to be an important issue to address already in mild PD as well as asking about prior near falls.
Insights
Fear of falling and a history of near falls are key predictors of future falls in people with mild Parkinson's disease (PD). Addressing these factors early can help prevent future fall events.
Area of Science:
- Neurology
- Gerontology
- Movement Disorders
Background:
- Parkinson's disease (PD) is a progressive neurodegenerative disorder.
- Falls and near falls are common and significantly impact quality of life in individuals with PD.
- Identifying early predictors is crucial for timely intervention in mild PD.
Purpose of the Study:
- To identify factors predicting future falls and/or near falls in individuals with mild Parkinson's disease.
- To inform early intervention strategies for fall prevention in early-stage PD.
Main Methods:
- A cohort of 141 participants with mild PD was assessed.
- Data collected included questionnaires on freezing of gait, fatigue, fear of falling, and daily activities.
- Clinical assessments evaluated balance, gait speed, and motor symptoms; falls/near falls were tracked for six months.
Main Results:
- 45% of participants experienced at least one fall or near fall over six months.
- Independent predictors for falls/near falls included fear of falling (OR=1.032), prior near falls (OR=3.475), and retropulsion (OR=2.813).
- Fear of falling emerged as the strongest predictor, followed by history of near falls and retropulsion.
Conclusions:
- Fear of falling is a significant issue in mild Parkinson's disease and warrants early attention.
- Inquiring about previous near falls is essential for assessing fall risk in early PD.
- These findings highlight the importance of psychological and historical factors in fall prediction.
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