Objective: We aimed to investigate the relationship between the PD clinical features, the presence of FOF and its impact on QoL. We explored whether the reduction of patient mobility – measured through a 24-hour continuous remote monitoring essay – might depend on FOF.

Background: The fear of falling (FOF) is defined as a lasting concern about falling and can impact severely quality of life (QoL). Parkinson’s Disease (PD) patients frequently manifest postural instability, recurrent falls and FOF.

Method: Fifty non-dement, PD patients were enrolled by our movement disorders outpatient clinic. The PD status and severity were assessed with UPDRS part III, modified Hoehn and Yahr scale, Non Motor Symptom Questionnaire (NMSQ), Montreal Cognitive Assessment (MoCA) and Schwab & England ADL scale (ADL). The FOF presence and its severity were scored through the Fall Efficacy Scale (FES); FOF was defined as a FES score >19. All patients were equipped with a smartphone  with an embedded application to monitor their quantity of motion (activity index, AI) for a 24-hour period. A Timed-Up-and-Go test (TUG, 10 m) was registered using the smartphone.

Results: Thirty patients (60%) reported a previous history of falling. The median FES score was 17; 19 (38%) patients reported FOF. Various motor and non-motor parameters were associated with a higher FES score. Patients with FOF had also significantly lower QoL and ADL, independently by motor and non-motor disease features. Forty-seven out 50 subjects (94%) have been investigated though a 24-hour motion monitoring tool. The FES score and the AI had a mutual direct relationship (p=0.010). Patients with FOF had lower AI than patients without FOF (p = 0.025). Both are associated to the mobility related quality of life, while FOF had a more widespread and independent association with several non-mobility related QoL issues.

Conclusion: The presented data confirm that FOF is a prevalent and pervasive condition affecting mobility and various QoL aspects of patients with PD. FOF identification and treatment strategies are of critical importance in the management of PD.

This abstract has been already presented to “8° Congresso Accademia LIMPE-DISMOV” held in Naples in October 2022.

References: Lindholm B, Hagell P, Hansson O, Nilsson MH. Factors associated with fear of falling in people with Parkinson’s disease. BMC Neurol. 2014 Jan 24;14:19. doi: 10.1186/1471-2377-14-19. PMID: 24456482; PMCID: PMC3904169.
Grimbergen YA, Schrag A, Mazibrada G, Borm GF, Bloem BR. Impact of falls and fear of falling on health-related quality of life in patients with Parkinson’s disease. J Parkinsons Dis. 2013 Jan 1;3(3):409-13. doi: 10.3233/JPD-120113. PMID: 23948987.

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