Objective: To prospectively investigate disease progression in the early-stage Parkinson’s disease (PD) patients who fall (PD-Falls) and do not fall (PD-NoFalls) in the fifth year of disease course and to analyze whether their temporospatial gait parameters at study entry were predictive of falls.

Background: Gait impairment and falls are reasons for disability in patients with PD. Prospective data on temporospatial characteristics of gait in PD patients in early disease stages are sparse.

Method: Consecutive PD outpatients at the stage of hemiparkinsonism (Hoehn and Yahr stage 1) and age, sex, and education-matched healthy controls (HC) were recruited at Neurology Clinic, Clinical Center of Serbia. At study entry PD patients and HC underwent clinical and neuropsychological evaluations using an extensive battery of test as well as gait analysis using GaitRite electronic walkway and dual task paradigm. Step time, step length, swing time and double support time were addressed. After 5 years of disease course patients with PD were reevaluated using the same battery of tests.

Results: We enrolled 65 PD patients and 40 HCs who did not experience falls at baseline. In the fifth year of follow up 14 (21.5%) PD patients reported falls (PD-Falls). At study entry PD-Falls patients had higher MDS-UPDRS I score (p=0.018), LEDD (p=0.027) and apathy score (p=0.007) and lower RAVLT delayed recall score (p=0.039) compared to PD-NoFalls group. Both patients’ groups demonstrated a significant motor and non-motor progression over five years follow up, with deterioration in almost all clinical parameters, with PD-Falls patients having overall more severe symptoms than PD-NoFalls. Compared to HC at baseline, PD-Falls patients had shorter step length on both the affected (p=0.021) and unaffected leg (p=0.036) with dual mental task. Logistic regression model for occurrence of falls employing step length of the affected leg across different task conditions was significant (p<0.001). Shorter step length during combined dual task at baseline was a predictor of occurrence of falls in the fifth year of disease course (p=0.016, OR=1.45).

Conclusion: More pronounced motor and nonmotor symptoms and shorter step length with dual task walking conditions in patients with hemiparkinsonism at study entry were associated with the occurrence of falls in the fifth year of follow up.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/gait-impairment-as-predictor-of-falls-in-patients-with-early-parkinsons-disease/