Objective: To establish whether there is an association between frailty and falls in early Parkinson’s (PD).

Background: PD is a syndrome in which postural control, falls and gait impairments dominate. PD also is present in the context of ageing in which ageing syndromes such as frailty and multi-morbidity coexist. Frailty has been defined as a state where multiple body systems lose their in-built reserves. To date there has been little exploration of falls risk with respect to frailty.

Method: As part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation – Parkinson’s disease – GAIT (ICICLE – GAIT) study, participants were classified as robust, pre-frail or frail according to the electronic frailty index, comprised of 36 health deficits. They were also categorised as fallers on non-fallers, depending on whether they had fallen in the previous 12 months.

Results: Mean age of the 119 participants was 66.9 (±10.5) years, 66.4% were male, with a disease duration 6.3 (±4.7) months, mean MDS UPDRS III score of 25.4 and Montreal Cognitive Assessment of 25.2. 37 (31.1%) were classified as robust, 52 (43.7%) as pre-frail, and 30 (25.2%) as frail. Of the 119, 26 (21.8%) had fallen in the prior 12 months. Those that were frail were more likely to have fallen (50% fallers were frail vs. 17.3% pre-frail and 5.4% robust, X2=20.4, p<0.001).

Conclusion: Even at very early disease, a considerable proportion of PD patients are classified as frail. Frailty status was associated with retrospective falls, suggesting that these may form a different falls phenotype which requires a different approach to falls risk reduction. (Also presented at the Parkinson’s UK Research Conference, York, UK, 12th November 2018)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frailty-status-predicts-falls-in-early-parkinsons-disease/