Objective: To investigate the prevalence of falls in patients with Parkinson’s disease (PD) and their associations with age, disease stage, gait freezing and speed, postural sway, cognition, and contrast sensitivity.

Background: Falls are difficult to manage in patients with PD and can lead to substantial disability, caregiver burden and healthcare costs. Little is known about falls and their causes in people with PD in Singapore. Such information can be useful to provide clinicians with possible targets for falls prevention strategies.

Methods: This prospective cross-sectional study utilised baseline data of consecutive idiopathic PD patients seen at the PD Assessment Clinic at the Singapore General Hospital from June 2015 to Feb 2017, for annual evaluation by trained staff. Each patient was evaluated on their past history of falls in the past one year, disease stage, Montreal Cognitive Assessment (MoCA) scale, postural sway, contrast sensitivity (Melbourne Edge Test) and gait performance (Timed Up and Go (TUG) and gait speed). Descriptive statistics for falls characteristics were reported. Associations between falls and other continuous variables were analysed using the Spearman bivariate correlations. Significance was set at p<0.05.

Results: 101 patients (67% male, mean age 67.3 years, median Hoehn & Yahr stage= 1, range 1 -5) were included. At baseline assessment, 32.7% (n=33) reported a history of falls in the past 1 year. A total of 80 falls were reported. 70% were indoor falls while 25% occurred outdoor. About 60% of the falls occurred during walking, while 28% occurred during other activities such as climbing stairs or during toileting. The main causes of falls were trips (30%), gait freezing (28%) and loss of balance (15%). Increased number of baseline falls was significantly associated only with higher levels of self-reported gait freezing (rs=0.24, p=0.013).

Conclusions: Falls are common in people with PD, even in a population with largely early stage disease. A large proportion of these falls occurred indoors, during walking and were due to trips and gait freezing. Only higher levels of gait freezing was significantly associated with increased number of falls reported at baseline. Future studies should look into detail at other factors such as lower limb strength and physical activity, which may be associated with falls in this group of patients to understand its pathomechanism.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/falls-in-people-with-parkinsons-disease-results-from-a-multidisciplinary-movement-disorders-clinic-in-singapore/