BACKGROUND: Predictors of falls in people with Parkinson's disease (PD) who have not previously fallen are yet to be identified. OBJECTIVES: We aimed to identify predictors of all falls and recurrent falls in people with PD who had not fallen in the previous year and to explore the timing of falls in a 12-month follow-up period. METHODS: Participants with PD (n = 130) were assessed by disease-specific, self-report and balance measures. Falls were recorded prospectively for 12 months. Univariate and multivariate analyses were performed. Kaplan-Meier survival analysis was used to investigate time to falling. RESULTS: Forty participants (31%) had >/=1 fall during follow-up and 21 (16%) had >/=2 falls. Disability, reduced balance confidence and greater concern about falling were associated with >/=1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with >/=2 falls (p < 0.05). Disability (Schwab and England scale, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39-0.80; p = 0.002) was associated with >/=1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55-0.76; p = 0.005). Disability (Unified Parkinson's Disease Rating Scale activities of daily living, OR = 1.20; 95% CI 1.07-1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95-1.30; p = 0.19) were associated with >/=2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60-0.84, p = 0.001).Recurrent fallers experienced their first fall earlier than single fallers (p < 0.05). CONCLUSIONS: Self-reported disability was the strongest single predictor of all falls and recurrent falls.
AD - Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital, Salvador, BA, Brazil.BACKGROUND: Predictors of falls in people with Parkinson's disease (PD) who have not previously fallen are yet to be identified. OBJECTIVES: We aimed to identify predictors of all falls and recurrent falls in people with PD who had not fallen in the previous year and to explore the timing of falls in a 12-month follow-up period. METHODS: Participants with PD (n = 130) were assessed by disease-specific, self-report and balance measures. Falls were recorded prospectively for 12 months. Univariate and multivariate analyses were performed. Kaplan-Meier survival analysis was used to investigate time to falling. RESULTS: Forty participants (31%) had >/=1 fall during follow-up and 21 (16%) had >/=2 falls. Disability, reduced balance confidence and greater concern about falling were associated with >/=1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with >/=2 falls (p < 0.05). Disability (Schwab and England scale, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39-0.80; p = 0.002) was associated with >/=1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55-0.76; p = 0.005). Disability (Unified Parkinson's Disease Rating Scale activities of daily living, OR = 1.20; 95% CI 1.07-1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95-1.30; p = 0.19) were associated with >/=2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60-0.84, p = 0.001).Recurrent fallers experienced their first fall earlier than single fallers (p < 0.05). CONCLUSIONS: Self-reported disability was the strongest single predictor of all falls and recurrent falls.
PY - 2015 SN - 1877-718X (Electronic)