Objective: To determine predictors of all falls and recurrent falls in people with Parkinson’s disease (PD) who had not fallen in the past year; and to explore the timing of falls for single and recurrent fallers in a 12-month follow-up period.

Background: Predictors of falls and recurrent falls are yet to be investigated among people with PD without a history of falls.

Methods: Participants with PD (n = 130) were enrolled in this study. Demographic and clinical data were recorded and PD severity was assessed with the UPDRS motor section and the modified Hoehn and Yahr scale. Self-reported disability was ascertained by the UPDRS activities of daily living (ADL) section and the Schwab and England scale (S&E). Self-efficacy measures included the Activities-specific Balance Confidence scale and Falls Efficacy Scale-International. Balance measures included the Berg balance scale, Functional reach test, Timed up and go and Dynamic gait index. Univariate and multivariate analyses were used to determine predictors of falls. Kaplan-Meier survival analysis was used to investigate time to falling.

Results: Forty participants (31%) had ≥1 fall during follow-up and 21 (16%) had ≥2 falls. Disability, reduced balance confidence and greater concern about falling were associated with ≥1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with ≥2 falls (p < 0.05). Disability (S&E, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39–0.80; p = 0.002) was associated with ≥1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55–0.76; p = 0.005). Disability (UPDRS ADL, OR = 1.20; 95% CI 1.07–1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95–1.30; p = 0.19) were associated with ≥2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60–0.84; p = 0.001). Recurrent fallers experienced their first fall earlier than single fallers (p < 0.05).

Conclusions: Self-report disability was found to be an independent predictor for all falls and recurrent falls in people with PD who had not fallen in the prior 12 months, and should be considered in the assessment of fall risk in people with PD without a history of falls.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/disability-is-an-independent-predictor-of-falls-and-recurrent-falls-in-people-with-parkinsons-disease-without-a-history-of-falls-a-one-year-prospective-study/