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Causes and consequences of falls in Parkinson disease patients in a prospective study
Affiliations- 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Department of Clinical Rehabilitation, University School of Physical Education in Krakow, Poland
- Institute of Otolaryngology, Department of Otolaryngology, Jagiellonian University Medical College, Krakow, Poland
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Abstract
Falls are common events in Parkinson disease (PD) but only a few prospective studies have focused on causes and consequences of falls in PD patients. The aim of the study was prospective analysis of direct causes and consequences of falls in PD patients in comparison to the control group.
Material and methodsOne hundred PD patients and 55 age-matched controls were enrolled in the study. The diagnostic workup in all patients included neurological examination, Unified Parkinson's Disease Rating Scale, magnetic resonance imaging, electroencephalography, ultrasonography, otolaryngological, ophthalmological and autonomic function examination. During 12 months of follow-up, falls were registered in both groups, direct causes were classified according to the St. Louis and Olanow classification, and consequences were established.
ResultsFalls occurred in 54% of PD patients and in 18% of control subjects. Analysis of direct causes of falls revealed that sudden falls were the most common (31%), followed by episodes of freezing and festination (19.6%), neurological and sensory disturbances (mostly vertigo) (12%), environmental factors (12%), postural instability (11%), orthostatic hypotension (4%), and severe dyskinesia (3.6%); 6.19% of falls were unclassified; 22% of patients had the same etiology of subsequent falls. In PD patients, intrinsic factors were dominant, whereas in the control group intrinsic and extrinsic factors occurred with the same frequency. Every third fall intensified fear of walking. 34% of falls caused injuries; among them bruises of body parts other than the head were most frequent.
ConclusionsIntrinsic factors are the most common causes of falls in PD. Every third fall intensifies fear of walking and causes injuries.
Abstract
Falls are common events in Parkinson disease (PD) but only a few prospective studies have focused on causes and consequences of falls in PD patients. The aim of the study was prospective analysis of direct causes and consequences of falls in PD patients in comparison to the control group.
Material and methodsOne hundred PD patients and 55 age-matched controls were enrolled in the study. The diagnostic workup in all patients included neurological examination, Unified Parkinson's Disease Rating Scale, magnetic resonance imaging, electroencephalography, ultrasonography, otolaryngological, ophthalmological and autonomic function examination. During 12 months of follow-up, falls were registered in both groups, direct causes were classified according to the St. Louis and Olanow classification, and consequences were established.
ResultsFalls occurred in 54% of PD patients and in 18% of control subjects. Analysis of direct causes of falls revealed that sudden falls were the most common (31%), followed by episodes of freezing and festination (19.6%), neurological and sensory disturbances (mostly vertigo) (12%), environmental factors (12%), postural instability (11%), orthostatic hypotension (4%), and severe dyskinesia (3.6%); 6.19% of falls were unclassified; 22% of patients had the same etiology of subsequent falls. In PD patients, intrinsic factors were dominant, whereas in the control group intrinsic and extrinsic factors occurred with the same frequency. Every third fall intensified fear of walking. 34% of falls caused injuries; among them bruises of body parts other than the head were most frequent.
ConclusionsIntrinsic factors are the most common causes of falls in PD. Every third fall intensifies fear of walking and causes injuries.
Keywords
Parkinson disease, falls, risk factors
About this articleTitle
Causes and consequences of falls in Parkinson disease patients in a prospective study
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
423-430
Page views
695
Article views/downloads
802
DOI
10.5114/ninp.2013.38222
Bibliographic record
Neurol Neurochir Pol 2013;47(5):423-430.
Keywords
Parkinson disease
falls
risk factors
Authors
Monika Rudzińska
Sylwia Bukowczan
Joanna Stożek
Katarzyna Zajdel
Elżbieta Mirek
Wiesław Chwata
Magdalena Wójcik-Pędziwiatr
Krzysztof Banaszkiewicz
Andrzej Szczudlik
