Stage-Related Sensory Integration Deficits and Fall Risk in Parkinson's Disease

Postural balance dysfunction in Parkinson's disease (PD) is associated with sensory integration deficits, yet stage-related changes and their relationship with falls remain incompletely understood. This study evaluated sensory integration across Hoehn-Yahr stages and prospectively monitored falls over 6 months.

Seventy-five PD patients (26 early-stage and 49 advanced-stage) and 26 healthy controls (HCs) were assessed using the Sensory Organization Test. Demographic and motor assessments were performed, and falls were tracked for 6 months. Group comparisons used 1-way analysis of variance or Kruskal-Wallis tests, as appropriate. Associations with fall status were analyzed using χ² tests.

Advanced-stage PD patients were older and exhibited more severe motor symptoms than early-stage patients. Sensory integration deteriorated with disease progression. Compared with HCs and early-stage PD patients, advanced-stage PD patients demonstrated significantly reduced composite balance scores (P < .001). Significant overall group differences were observed for visual (P = .029), vestibular (P < .001), and preference ratios (P < .001), whereas somatosensory ratios remained preserved. Falls occurred in 33.3% of PD patients and were more frequent in advanced stages (44.9% vs 11.5%; P < .001). Vestibular dysfunction was significantly associated with fall occurrence (76.0% vs 38.0%; P = .002).

Sensory integration deficits in PD progress with disease advancement and are primarily characterized by impairments in visual and vestibular domains. Vestibular dysfunction was significantly associated with fall risk. These findings suggest that vestibular assessment and targeted interventions may be beneficial for fall-risk management in PD.