Objective: To identify predictors of falls with injuries in people with Parkinson’s disease (PD).
Background: Falls are common in people with PD and can lead to activity limitations and reduced quality of life. Several predictors of falls have been determined, such as increased disease severity and reduced balance and mobility [1,2]. However, predictors of falls with injuries need further investigation.
Method: Participants with PD (n=229) and independent gait ability were assessed by disease-specific, self-report and balance measures, and followed-up for 12 months. Individuals were required to complete a falls diary with every fall experienced, their circumstances (time, location – indoor vs outdoor falls, fall-related activities and perceived causes of falling – intrinsic vs extrinsic factors) and consequences. Injurious falls were defined as those resulting in (abrasions/lacerations, contusion, pain and/or fracture. Predictors with p<0.05 in univariate analysis were chosen for entry into the logistic regression multivariate model.
Results: 1290 falls were reported by 111 (48%) participants and 805 falls were described. Predictors entered into the multivariate logistic regression model were age, dyskinesia, freezing of gait, disease severity (PD duration, UPDRS motor examination and H&Y), medications (levodopa equivalent dosage and polypharmacy), disability (UPDRS AVD), balance/mobility (Dynamic Gait Index [DGI], functional reach test and Timed Up & Go), balance confidence (Activities-specific Balance Confidence [ABC] Scale), use of walking aid, location, fall-related activities and perceived causes of falling. Disease duration (Odds Ratio [OR]=0.92; 95% confidence interval [CI] 0.86-0.98;), DGI (OR=1.24; 95% CI 1.10-1.39), ABC Scale (OR=0.98; 95% CI 0.96-0.999), outdoor falls (OR=2.17; 95% CI 1.27-3.72) and falls related to extrinsic factors (OR=3.13; 95% IC 1.71-5.75) (p<0.05) were independent predictors of falls with injuries.
Conclusion: Better balance during gait and falls occurring outdoors by extrinsic factors were predictors of falls with injuries. However, longer PD duration and better balance confidence were protective factors for falls with injuries in people with PD.
References: [1] Allen NE, Schwarzel AK, & Canning CG (2013) 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. (2017) Predictors of Recurrent Falls in People with Parkinson’s Disease and Proposal for a Predictive Tool. Journal of Parkinson’s Disease, 7(2), 313–324.
To cite this abstract in AMA style:
H. Meira, I. Rosa, G. Valença, J. Oliveira-Filho, L. Almeida. Predictors of Falls with Injuries in People with Parkinson’s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/predictors-of-falls-with-injuries-in-people-with-parkinsons-disease/. Accessed November 22, 2024.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-falls-with-injuries-in-people-with-parkinsons-disease/