Why Do Patients with Parkinson Disease Fall? A Single Center Experience

Objective: Why Do Patients with Parkinson Disease Fall? A Single Center Experience. Background: Falls are a major cause of disability in Parkinson disease (PD) patients. In this study, we investigated the risks associated with repeated falls in PD. Design/Methods: Data were collected from 404 PD patients followed for one year in an outpatient setting. Results: Of the 404 patients, 197 (49[percnt]) were non-fallers, 142 (35[percnt]) single fallers and 65 (16[percnt]) recurrent fallers. Single fallers(5.9 + 2.5 yrs., 19.7 + 8.3 UPDRS score) resembled non-fallers(5.4 + 2.2 yrs., 18.9 + 8.3 UPDRS score ) in duration and severity of PD. Recurrent fallers differed significantly from single and non-fallers, having longer disease duration (12.6 + 6.8 yrs., P <0.001) and greater disease severity (32.3 + 12.6 UPDRS score , P <0.001). Recurrent fallers differed significantly from single and non-fallers in postural stability: “pull test” (23 (12[percnt]) of non-fallers, 19 (13[percnt]) of single fallers and 31 (48[percnt]) of recurrent fallers scored abnormally on this test) and one-leg stance test (11 (6[percnt]) of non-fallers, 22 (16[percnt]) of single fallers and 43 (66[percnt]) of recurrent fallers were impaired on this test). Recurrent fallers differed from single and non-fallers with a higher prevalence of Freezing of Gait, “FOG” (12 (6[percnt]) non-fallers, 19 (13[percnt]) single fallers, and 31(48[percnt]) recurrent fallers received an abnormal score of greater than 1 on this test. The odds of obtaining an abnormal score on the FOG test were 2.4 times higher for single fallers in comparison to non-fallers, 5.9 times higher for recurrent fallers in comparison to single fallers, and 14.1 times higher for recurrent fallers in comparison to non-P <0.001). Conclusions: Among fallers, postural stability was more impaired than locomotion. Strategies that improve the evaluation and treatment of postural stability should be emphasized in PD patients who fall. Disclosure: Dr. Lieberman has nothing to disclose. Dr. Deep has nothing to disclose. Dr. Lockhart has nothing to disclose. Dr. Frames has nothing to disclose. Dr. Shafer has nothing to disclose. Dr. McCauley has nothing to disclose.