Objective: Assess the prevalence of falls in Parkinson’s disease and evaluate change in care needs and institutionalisation in this cohort over a 5 year follow-up period.

Background: Falls are common in People with Parkinson’s (PwP) both in early stages and more commonly in advancing stages of Parkinson’s. They lead to morbidity and mortality in addition to escalation of care needs which often results in admission to institutional care. Falls continue to be a cause of hospital admissions both pre and post care home admission.

Methods: Pooled data from 2 specialist Parkinson’s centres in South Wales were reviewed. A random selection of patients diagnosed with Parkinson’s in 2010 was selected to explore prevalence of falls, baseline characteristics, care needs and residence. Comparison was made to their last known clinical review to assess progression upto 2015.

Results: Out of 74 PwP (Mean age 73, range 55-88), M: F= 36:38. Mean clinical frailty score(CFS) was 3.67, Mean Hoehn and Yahr (H&Y) score, 1.7. Patients took an average of 4.6 medications at diagnosis. A total of 60% experienced falls (44/74). This group appeared to demonstrate a need for increased care – social support at home and placement (89%) versus non fallers (37%). Of significance was that 48% of PwP with falls experienced a change in residence to a care home whereas 7% of non fallers needed this change over the 5 year period. 50% of akinetic rigid group did not report any falls. Deteriorating H&Y between stages 1 to 3 is associated with falls but a move towards stages 4 and 5 revealed a reduced falls rate (perhaps explained by immobility). Over the period of follow-up, the H&Y in the falls group had deteriorated to 3.53 and the CFS to 5.81 with an average no of 6 medications. There was 15% mortality in this cohort (11/74).

Conclusions: There appears to be a trend of increasing dependency and need for care home accommodation in PwP experiencing falls even within 5 years of diagnosis. Frailty appears to underpin the progressive deterioration in this cohort and a holistic assessment of their multimorbidity should be central to their care. Routine assessment of falls at first contact and subsequent visits is vital. Phenotypic presentation of Parkinson’s did not predict fallers in our cohort. This needs further evaluation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/falls-and-frailty-predicate-escalating-care-needs-in-parkinsons-disease/