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J Neurol Neurosurg Psychiatry. Jun 2002; 72(6): 721–725.
PMCID: PMC1737913

Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study

Abstract

Objectives: To accurately establish the incidence of falls in Parkinson's disease (PD) and to investigate predictive risk factors for fallers from baseline data.

Methods: 109 subjects with idiopathic PD diagnosed according to the brain bank criteria underwent a multidisciplinary baseline assessment comprising demographic and historical data, disease specific rating scales, physiotherapy assessment, tests of visual, cardiovascular and autonomic function, and bone densitometry. Patients were then prospectively followed up for one year using weekly prepaid postcards along with telephone follow up.

Results: Falls occurred in 68.3% of the subjects. Previous falls, disease duration, dementia, and loss of arm swing were independent predictors of falling. There were also significant associations between disease severity, balance impairment, depression, and falling.

Conclusions: Falls are a common problem in PD and some of the major risk factors are potentially modifiable. There is a need for future studies to look at interventions to prevent falls in PD.

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Selected References

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  • Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986 Mar;80(3):429–434. [PubMed]
  • Ivers RQ, Cumming RG, Mitchell P, Attebo K. Visual impairment and falls in older adults: the Blue Mountains Eye Study. J Am Geriatr Soc. 1998 Jan;46(1):58–64. [PubMed]
  • Tinetti ME, Baker DI, Garrett PA, Gottschalk M, Koch ML, Horwitz RI. Yale FICSIT: risk factor abatement strategy for fall prevention. J Am Geriatr Soc. 1993 Mar;41(3):315–320. [PubMed]
  • Davies AJ, Kenny RA. Falls presenting to the accident and emergency department: types of presentation and risk factor profile. Age Ageing. 1996 Sep;25(5):362–366. [PubMed]
  • Hornbrook MC, Stevens VJ, Wingfield DJ. Seniors' Program for Injury Control and Education. J Am Geriatr Soc. 1993 Mar;41(3):309–314. [PubMed]
  • Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988 Dec 29;319(26):1701–1707. [PubMed]
  • Bennett DA, Beckett LA, Murray AM, Shannon KM, Goetz CG, Pilgrim DM, Evans DA. Prevalence of parkinsonian signs and associated mortality in a community population of older people. N Engl J Med. 1996 Jan 11;334(2):71–76. [PubMed]
  • Ebmeier KP, Calder SA, Crawford JR, Stewart L, Besson JA, Mutch WJ. Mortality and causes of death in idiopathic Parkinson's disease: results from the Aberdeen whole population study. Scott Med J. 1990 Dec;35(6):173–175. [PubMed]
  • Coughlin L, Templeton J. Hip fractures in patients with Parkinson's disease. Clin Orthop Relat Res. 1980 May;(148):192–195. [PubMed]
  • Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O'Brien LA, Hoffman S, Kaplan F. Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med. 1991 May 9;324(19):1326–1331. [PubMed]
  • Hammer AJ. Intertrochanteric and femoral neck fractures in patients with parkinsonism. S Afr Med J. 1991 Feb 16;79(4):200–202. [PubMed]
  • Johnell O, Melton LJ, 3rd, Atkinson EJ, O'Fallon WM, Kurland LT. Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing. 1992 Jan;21(1):32–38. [PubMed]
  • Turcotte R, Godin C, Duchesne R, Jodoin A. Hip fractures and Parkinson's disease. A clinical review of 94 fractures treated surgically. Clin Orthop Relat Res. 1990 Jul;(256):132–136. [PubMed]
  • Hely MA, Morris JG, Traficante R, Reid WG, O'Sullivan DJ, Williamson PM. The sydney multicentre study of Parkinson's disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry. 1999 Sep;67(3):300–307. [PMC free article] [PubMed]
  • de Boer AG, Wijker W, Speelman JD, de Haes JC. Quality of life in patients with Parkinson's disease: development of a questionnaire. J Neurol Neurosurg Psychiatry. 1996 Jul;61(1):70–74. [PMC free article] [PubMed]
  • Koller WC, Glatt S, Vetere-Overfield B, Hassanein R. Falls and Parkinson's disease. Clin Neuropharmacol. 1989 Apr;12(2):98–105. [PubMed]
  • Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. Age Ageing. 2001 Jan;30(1):47–52. [PubMed]
  • Charlett A, Weller C, Dobbs SM, Dobbs RJ. What makes a faller in early parkinsonism? Eur Neurol. 1997;38(4):312–314. [PubMed]
  • Paulson GW, Schafer K, Hallum B. Avoiding mental changes and falls in older Parkinson's patients. Geriatrics. 1986 Aug;41(8):59–67. [PubMed]
  • Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc. 1988 Jul;36(7):613–616. [PubMed]
  • Magalhães M, Wenning GK, Daniel SE, Quinn NP. Autonomic dysfunction in pathologically confirmed multiple system atrophy and idiopathic Parkinson's disease--a retrospective comparison. Acta Neurol Scand. 1995 Feb;91(2):98–102. [PubMed]
  • McIntosh S, Da Costa D, Kenny RA. Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a 'syncope' clinic. Age Ageing. 1993 Jan;22(1):53–58. [PubMed]
  • Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181–184. [PMC free article] [PubMed]
  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. [PubMed]
  • Lesher EL, Berryhill JS. Validation of the Geriatric Depression Scale--Short Form among inpatients. J Clin Psychol. 1994 Mar;50(2):256–260. [PubMed]
  • Sachs C, Berglund B, Kaijser L. Autonomic cardiovascular responses in parkinsonism: effect of levodopa with dopa-decarboxylase inhibition. Acta Neurol Scand. 1985 Jan;71(1):37–42. [PubMed]
  • Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. [PMC free article] [PubMed]
  • Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zwinderman AH. Prospective assessment of falls in Parkinson's disease. J Neurol. 2001 Nov;248(11):950–958. [PubMed]
  • Gray P, Hildebrand K. Fall risk factors in Parkinson's disease. J Neurosci Nurs. 2000 Aug;32(4):222–228. [PubMed]
  • Smithson F, Morris ME, Iansek R. Performance on clinical tests of balance in Parkinson's disease. Phys Ther. 1998 Jun;78(6):577–592. [PubMed]
  • Kao CH, Chen CC, Wang SJ, Chia LG, Yeh SH. Bone mineral density in patients with Parkinson's disease measured by dual photon absorptiometry. Nucl Med Commun. 1994 Mar;15(3):173–177. [PubMed]
  • Sato Y, Kikuyama M, Oizumi K. High prevalence of vitamin D deficiency and reduced bone mass in Parkinson's disease. Neurology. 1997 Nov;49(5):1273–1278. [PubMed]
  • Taggart H, Crawford V. Reduced bone density of the hip in elderly patients with Parkinson's disease. Age Ageing. 1995 Jul;24(4):326–328. [PubMed]
  • Yamada T, Kachi T, Ando K. [Osteoporosis and fractures in Parkinson's disease]. Nihon Ronen Igakkai Zasshi. 1995 Oct;32(10):637–640. [PubMed]
  • Nevitt MC, Cummings SR, Hudes ES. Risk factors for injurious falls: a prospective study. J Gerontol. 1991 Sep;46(5):M164–M170. [PubMed]
  • Bloem BR, van Vugt JP, Beckley DJ. Postural instability and falls in Parkinson's disease. Adv Neurol. 2001;87:209–223. [PubMed]
  • Shaw FE, Kenny RA. Can falls in patients with dementia be prevented? Age Ageing. 1998 Jan;27(1):7–9. [PubMed]
  • Bloem BR, Beckley DJ, van Hilten BJ, Roos RA. Clinimetrics of postural instability in Parkinson's disease. J Neurol. 1998 Oct;245(10):669–673. [PubMed]

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