A Ashburn1, E Stack, R M Pickering, C D Ward. 1. University Medical Statistics Department, Southampton General Hospital, UK. A.M.Ashburn@soton.ac.uk
Abstract
BACKGROUND: people with Parkinson's disease often fall. OBJECTIVES: to report the frequency of falls and characteristics of fallers and non-fallers in a community-based sample of people with Parkinson's disease. METHOD: we administered a battery of standardized tests in the home and the laboratory. RESULTS: we recruited 63 people with Parkinson's disease through general practices. Forty (64%, 95% confidence interval 51-74%) had fallen in the previous 12 months. Many factors associated with falling in the general population were associated with Parkinson's disease fallers (e.g. use of multiple medication and greater physical disability). Fallers were more likely to be depressed and anxious than non-fallers. Condition-specific factors associated with falling included greater disease severity (although there were exceptions) and more marked response to levodopa treatment, including more dyskinesia and on-off phenomena. Fallers took more steps to complete a test of mobility. They also had a shorter functional reach and greater postural sway whilst completing a dual task than non-fallers. CONCLUSION: this community-based study confirms the high risk of falling in Parkinson's disease. Our results suggest that disease-specific factors contribute to the increased risk and that there is scope for specific therapeutic interventions.
BACKGROUND:people with Parkinson's disease often fall. OBJECTIVES: to report the frequency of falls and characteristics of fallers and non-fallers in a community-based sample of people with Parkinson's disease. METHOD: we administered a battery of standardized tests in the home and the laboratory. RESULTS: we recruited 63 people with Parkinson's disease through general practices. Forty (64%, 95% confidence interval 51-74%) had fallen in the previous 12 months. Many factors associated with falling in the general population were associated with Parkinson's disease fallers (e.g. use of multiple medication and greater physical disability). Fallers were more likely to be depressed and anxious than non-fallers. Condition-specific factors associated with falling included greater disease severity (although there were exceptions) and more marked response to levodopa treatment, including more dyskinesia and on-off phenomena. Fallers took more steps to complete a test of mobility. They also had a shorter functional reach and greater postural sway whilst completing a dual task than non-fallers. CONCLUSION: this community-based study confirms the high risk of falling in Parkinson's disease. Our results suggest that disease-specific factors contribute to the increased risk and that there is scope for specific therapeutic interventions.
Authors: Fuzhong Li; Peter Harmer; Kathleen Fitzgerald; Elizabeth Eckstrom; Ronald Stock; Johnny Galver; Gianni Maddalozzo; Sara S Batya Journal: N Engl J Med Date: 2012-02-09 Impact factor: 91.245
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