Development of a Parkinson\u2019s disease specific falls questionnaire

Dale M Harris,Gavin Abbott,Timo Rantalainen,Wei-Peng Teo,Liam Johnson,Rachel L Duckham,Robin M Daly

doi:10.1186/s12877-021-02555-6

Abstract

BackgroundFalls are a major health burden for older adults with Parkinson’s disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD. This study aimed to develop a PD-specific falls questionnaire and to evaluate its test-retest reliability in older adults with PD.MethodsA novel PD-specific falls questionnaire (PDF-Q) was developed in two modes (online and paper-based version) and used to assess falls and near-falls events over the past 12-months. Questions were agreed upon by an expert group, with the domains based on previous falls-related questionnaires. The questions included the number and circumstances (activities, location and direction) of falls and near-falls, and consequences (injuries and medical treatment) of falls. The PDF-Q was distributed to 46 older adults with PD (online n = 30, paper n = 16), who completed the questionnaire twice, 4 weeks apart. Kappa (κ) statistics were used to establish test-retest reliability of the questionnaire items.ResultsPooled results from both questionnaires for all participants were used to assess the overall test-retest reliability of the questionnaire. Questions assessing the number of falls (κ = 0.41) and the number of near-falls (κ = 0.51) in the previous 12-months demonstrated weak agreement, while questions on the location of falls (κ = 0.89) and near-falls (κ = 1.0) demonstrated strong to almost perfect agreement. Questions on the number of indoor (κ = 0.86) and outdoor (κ = 0.75) falls demonstrated moderate to strong agreement, though questions related to the number of indoor (κ = 0.47) and outdoor (κ = 0.56) near-falls demonstrated weak agreement. Moderate to strong agreement scores were observed for the most recent fall and near-fall in terms of the direction (indoor fall κ = 0.80; outdoor fall κ = 0.81; near-fall κ = 0.54), activity (indoor fall κ = 0.70; outdoor fall κ = 0.82; near-fall κ = 0.65) and cause (indoor fall κ = 0.75; outdoor fall κ = 0.62; near-fall κ = 0.56).ConclusionsThe new PDF-Q developed in this study was found to be reliable for capturing the circumstances and consequences of recent falls and near-falls in older adults with PD.

Highlights

Falls are a major health burden for older adults with Parkinson’s disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD
The main finding from this study was that the pooled results from the online and paper modes for the PD-specific falls questionnaire (PDF-Q) collectively demonstrated moderate to strong agreement scores for most questions related to the circumstances and consequences of falls and near-falls, though there was a weaker agreement for the number of falls and near-falls questions
In conclusion, the new PDF-Q developed in this study was found to be reliable for capturing the circumstances and consequences of recent falls and near-falls in older adults with PD, but showed weaker agreement for the questions concerning the number of falls and near-falls in the previous 12-months

Summary

Introduction

Falls are a major health burden for older adults with Parkinson’s disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD. Most of the previous research examining the circumstances and consequences of falls in older adults with PD have utilised either semistructured interviews or self-report falls diaries [17,18,19,20,21,22,23,24] While these methods are the preferred choice when collecting falls information [9, 25], they can be costly, timeconsuming, have high attrition rates, and often require continued use of resources (e.g., for data entry and checking, and follow-up phone calls) [25]. Retrospective analysis using questionnaires to capture falls information may represent a viable alternative, but there are potential limitations such as recall biases [26]

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