Predicting Falls in Parkinson Disease Patients

Abstract

Background: Falls are a major risk for Parkinson disease patients (PD). Single falls, in older people may be related to the underlying disease or may be accidental. Recurrent falls are more likely to be related to the underlying disease. Objectives: To predict falls in patients with Parkinson disease. Patients and Methods: Between July 1, 2011 and June 30, 2012 we examined 452 persons with PD in the Muhammad Ali Parkinson Clinic during their outpatient visits. Results: We followed 401 persons with PD for a year, 205 of whom, 51.0% fell: 161 fell once and 44 fell more than once (recurrent fallers). Recurrent fallers had PD significantly longer, 12.6 + 7.0 versus 5.9 + 4.5 years, had significantly higher, worse, motor unified parkinson disease rating scale (UPDRS) scores” 31.2 + 12.7 versus 19.7 + 8.3. The major difference between recurrent and single fallers was an inability of recurrent fallers to stand on one leg for < 3 seconds: 95% versus 11%, odds ratio 178 CI 95% 39.5 - 801.2. Conclusions: Single fallers who are unable to stand on one foot for < 3 seconds may be at risk for recurrent falls. Gait and balance training focused on improving a patient’s ability to stand on one leg may decrease the risk of recurrent falls in PD.