Objective: To compare the circumstances of falls among single fallers (1 fall over one year) and recurrent fallers (≥2 falls over one year) with Parkinson´s Disease (PD).

Background: Falls are common in people with PD, negatively impacting quality of life. Previous studies have suggested that single and recurrent fallers with PD show different clinical and functional characteristics, and it is important to investigate whether the circumstances in which they fall are also different.

Method: Prospective cohort study with 229 people with PD who were evaluated by disease-specific measures (UPDRS activities of daily living and motor sections and modified Hoehn & Yahr scale [H&Y]) and followed up for 12 months with a falls diary to identify the occurrence and circumstances of falls (i.e. time and location of the fall, activity preceding the fall, situation that led to falling and injuries). Data were analyzed using the chi square test.

Results: Among the participants, 105 (45%) reported at least one fall and 78 (74%) were recurrent fallers. The mean age was 71 years (SD = 6.6 years) and the median H&Y 2.5 (2-4). A total of 618 falls were recorded in the falls diaries. Outdoor falls were more common among single fallers, while indoor falls were more common among recurrent fallers (p=0.003). Most falls occurred while walking, with tripping (n=13, 48%) being the most common cause among single fallers and freezing of gait (n=201, 35%) among the recurrent fallers. Falls related to intrinsic factors were more common among recurrent fallers, while extrinsic factors were more common among single fallers (p=0.001). Soft tissue injury was the most common consequence.

Conclusion: Falls in single fallers occurred more in outdoor environments associated with extrinsic factors, such as tripping, while falls presented by recurrent fallers occurred more indoors due to intrinsic factors, such as freezing of gait. The identification of the circumstances of falls in single and recurrent fallers with PD may contribute to fall prevention programs, since such situations may help to identify specific strategies related to the mechanisms of falls.

References: [1]Allen NE, Schwarzel AK, & Canning CG. Recurrent falls in Parkinson’s disease: A systematic review. Parkinsons Dis, 2013, 906274. [2]Almeida LRS, Valenca GT, Negreiros NN, Pinto EB, Oliveira-Filho J. Predictors of recurrents falls in people with Parkinson`s disease and proposal for a predictive tool. Journal of Parkinson’s Disease,7:313, 2017. [3]Gazibara. T, Pekmezovic. T, Tepavcevic D.K. , Tomic. A, Stankovic .I, Kostic. V.S., Svetel. M. Circumstances of falls and fall-related injuries among patients with Parkinson’s disease in an outpatient setting. Geriatric Nursin, 2014.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/circumstances-of-falls-in-single-and-recurrent-fallers-with-parkinsons-disease/