Longitudinal prediction of falls and near falls frequencies in Parkinson's disease: a prospective cohort study

Beata Lindholm, Christina Brogårdh, Per Odin, Peter Hagell

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

INTRODUCTION AND OBJECTIVE: Several prediction models for falls/near falls in Parkinson's disease (PD) have been proposed. However, longitudinal predictors of frequency of falls/near falls are poorly investigated. Therefore, we aimed to identify short- and long-term predictors of the number of falls/near falls in PD.

METHODS: A prospective cohort of 58 persons with PD was assessed at baseline (mean age and PD duration, 65 and 3.2 years, respectively) and 3.5 years later. Potential predictors were history of falls and near falls, comfortable gait speed, freezing of gate, dyskinesia, retropulsion, tandem gait (TG), pain, and cognition (Mini-Mental State Exam, MMSE). After each assessment, the participants registered a number of falls/near falls during the following 6 months. Multivariate Poisson regression was used to identify short- and long-term predictors of a number of falls/near falls.

RESULTS: Baseline median (q1-q3) motor (UPDRS) and MMSE scores were 10 (6.75-14) and 28.5 (27-29), respectively. History of falls was the only significant short-time predictor [incidence rate ratio (IRR), 15.17] for the number of falls/near falls during 6 months following baseline. Abnormal TG (IRR, 3.77) and lower MMSE scores (IRR, 1.17) were short-term predictors 3.5 years later. Abnormal TG (IRR, 7.79) and lower MMSE scores (IRR, 1.49) at baseline were long-term predictors of the number of falls/near falls 3.5 years later.

CONCLUSION: Abnormal TG and MMSE scores predict the number of falls/near falls in short and long term, and may be indicative of disease progression. Our observations provide important additions to the evidence base for clinical fall prediction in PD.

Original languageEnglish
Pages (from-to)997-1005
Number of pages9
JournalJournal of Neurology
Volume268
Issue number3
DOIs
Publication statusPublished - 2021

Swedish Standard Keywords

  • Health Sciences (303)

Keywords

  • Cognition
  • Falls/near falls
  • Parkinson’s disease
  • Prediction
  • Tandem gait
  • Prospective Studies
  • Humans
  • Parkinson Disease/complications
  • Gait Disorders, Neurologic
  • Cohort Studies

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