Kelvin L Chou1, Jordan J Elm2, Catherine L Wielinski3, David K Simon4, Michael J Aminoff5, Chadwick W Christine5, Grace S Liang6, Robert A Hauser7, Lewis Sudarsky8, Chizoba C Umeh8, Tiffini Voss9, Jorge Juncos10, John Y Fang11, James T Boyd12, Ivan Bodis-Wollner13, Zoltan Mari14, John C Morgan15, Anne-Marie Wills16, Stephen L Lee17, Sotirios A Parashos3. 1. Departments of Neurology and Neurosurgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: klchou@med.umich.edu. 2. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States. 3. Struthers Parkinson's Center, Golden Valley, MN, United States. 4. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States. 5. Department of Neurology, University of California, San Francisco, CA, United States. 6. Neurocrine Biosciences, Inc., San Diego, CA, United States. 7. University of South Florida, Parkinson's Disease and Movement Disorders Center, Tampa, FL, United States. 8. Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States. 9. Merck & Co., North Wales, PA, United States. 10. Department of Neurology, Emory University, Atlanta, GA, United States. 11. Department of Neurology, Vanderbilt University, Nashville, TN, United States. 12. Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, VT, United States. 13. Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY, United States. 14. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States. 15. Department of Neurology, Medical College of Georgia, Augusta, GA, United States. 16. Department of Neurology, Massachusetts General Hospital, Boston, MA, United States. 17. Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.
Abstract
BACKGROUND: Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. OBJECTIVE: To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. METHODS: The LS-1 database included 1741 early treated PD subjects (median 4year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. RESULTS:728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. CONCLUSION: Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.
RCT Entities:
BACKGROUND: Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. OBJECTIVE: To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. METHODS: The LS-1 database included 1741 early treated PD subjects (median 4year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. RESULTS: 728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. CONCLUSION: Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.
Authors: Sotirios A Parashos; Jordan Elm; James T Boyd; Kelvin L Chou; Lin Dai; Zoltan Mari; John C Morgan; Lewis Sudarsky; Catherine L Wielinski Journal: J Parkinsons Dis Date: 2015 Impact factor: 5.568
Authors: Connie Marras; Michael P McDermott; Paula A Rochon; Caroline M Tanner; Gary Naglie; Anthony E Lang Journal: Mov Disord Date: 2008-04-15 Impact factor: 10.338
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Authors: Lorena R S Almeida; Catherine Sherrington; Natalie E Allen; Serene S Paul; Guilherme T Valenca; Jamary Oliveira-Filho; Colleen G Canning Journal: J Parkinsons Dis Date: 2015 Impact factor: 5.568
Authors: Katherine H O Deane; Helen Flaherty; David J Daley; Roland Pascoe; Bridget Penhale; Carl E Clarke; Catherine Sackley; Stacey Storey Journal: BMJ Open Date: 2014-12-14 Impact factor: 2.692
Authors: Natalie E Allen; Colleen G Canning; Lorena Rosa S Almeida; Bastiaan R Bloem; Samyra Hj Keus; Niklas Löfgren; Alice Nieuwboer; Geert Saf Verheyden; Tiê P Yamato; Catherine Sherrington Journal: Cochrane Database Syst Rev Date: 2022-06-06
Authors: Sotirios A Parashos; Bastiaan R Bloem; Nina M Browner; Nir Giladi; Tanya Gurevich; Jeffrey M Hausdorff; Ying He; Kelly E Lyons; Zoltan Mari; John C Morgan; Bart Post; Peter N Schmidt; Catherine L Wielinski Journal: Neurol Clin Pract Date: 2018-06