The incidence and risk factors of falls in Parkinson disease: prospective study

• Published in: Neurologia i neurochirurgia polska 2013-09, Vol.47 (5), p.431-437
• Main Authors: Rudzińska, Monika, Bukowczan, Sylwia, Stożek, Joanna, Zajdel, Katarzyna, Mirek, Elżbieta, Chwała, Wiesław, Wójcik-Pędziwiatr, Magdalena, Banaszkiewicz, Krzysztof, Szczudlik, Andrzej
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Accidental Falls - statistics & numerical data; Activities of Daily Living; Aged; Causality; choroba Parkinsona; Comorbidity; czynniki ryzyka; falls; Female; Gait; Gait Disorders, Neurologic - epidemiology; Gait Disorders, Neurologic - prevention & control; Humans; Incidence; Male; Middle Aged; obserwacja prospektywna; Parkinson disease; Parkinson Disease - epidemiology; Parkinson's disease; Poland; prospective observation; Prospective Studies; Reference Values; Risk Assessment; Risk Factors; Severity of Illness Index; upadki
• ISSN: 0028-3843; 1897-4260
• DOI: 10.5114/ninp.2013.38223

Although Parkinson disease (PD) patients suffer falls more frequently than other old people, only a few studies have focused on identifying the specific risk factors for falls in PD patients. The aim of this study was to assess the incidence and risk factors of falls in a prospective study in comparison to a control group. One hundred patients with PD were recruited to the study along with 55 gender- and age-matched healthy controls. Both groups were examined twice; the second examination took place one year after the first one. Examination of the PD group included: medical history including falls, neurological examination, assessment of the severity of parkinsonism [Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scale (S&E), Hoehn and Yahr scale (H&Y), Mini-Mental State Examination (MMSE)], Hamilton scale and quality of life scales (SF-36, EQ-5D) and Freezing of Gait Questionnaire (FOG-Q). In both groups falls were recorded over the 12 months. Frequent fallers are defined as having more than 3 falls a year. Over the year falls occurred in 54% of PD patients and 18% of controls. In a prospective study 28% of PD patients fell more frequently than in retrospective analysis. Frequent fallers were found in 20% of patients and in 7% of controls. Fallers showed higher scores in UPDRS, H&Y, S&E, MMSE, and Hamilton scale than non-fallers. Independent risk factors for falls were: age, previously reported falls and higher score in the FOG-Q. Falls in PD patients occurred three times more frequently than in controls. Independent risk factors for falls were: high score in FOG-Q, older age and presence of falls in medical history. Mimo że upadki są częstsze u chorych na chorobę Parkinsona (ChP) niż u innych starszych osób, dotąd tylko kilka prac koncentrowało się na określeniu specyficznych czynników ryzyka upadków w ChP. Celem badania była ocena częstości występowania i czynników ryzyka upadków w badaniu prospektywnym w porównaniu z grupą kontrolną. Stu chorych na ChP oraz 55 zdrowych osób dobranych pod względem wieku i płci zostało włączonych do badania. Obie grupy były oceniane dwukrotnie, na początku badania i po upływie roku. Ocena chorych na ChP obejmowała: wywiad lekarski z uwzględnieniem upadków, badanie neurologiczne, ocenę nasilenia objawów parkinsonizmu [Unified Parkinson's Disease Rating Scale (UPDRS), skalę Schwaba i Englanda (S&E), skalę Hoehn i Yahra (H&Y), Mini-Mental State Examination (MMSE)], skalę Hamiltona, ocenę jakości życia