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Longitudinal prediction of falls and near falls frequencies in Parkinson's disease:a prospective cohort study

Lindholm, Beata LU ; Brogårdh, Christina LU ; Odin, Per LU orcid and Hagell, Peter LU (2021) In Journal of Neurology 268(3). p.997-1005
Abstract

INTRODUCTION AND OBJECTIVE: Several prediction models for falls/near falls in Parkinson's disease (PD) have been proposed. However, longitudinal predictors of frequency of falls/near falls are poorly investigated. Therefore, we aimed to identify short- and long-term predictors of the number of falls/near falls in PD.

METHODS: A prospective cohort of 58 persons with PD was assessed at baseline (mean age and PD duration, 65 and 3.2 years, respectively) and 3.5 years later. Potential predictors were history of falls and near falls, comfortable gait speed, freezing of gate, dyskinesia, retropulsion, tandem gait (TG), pain, and cognition (Mini-Mental State Exam, MMSE). After each assessment, the participants registered a number of... (More)

INTRODUCTION AND OBJECTIVE: Several prediction models for falls/near falls in Parkinson's disease (PD) have been proposed. However, longitudinal predictors of frequency of falls/near falls are poorly investigated. Therefore, we aimed to identify short- and long-term predictors of the number of falls/near falls in PD.

METHODS: A prospective cohort of 58 persons with PD was assessed at baseline (mean age and PD duration, 65 and 3.2 years, respectively) and 3.5 years later. Potential predictors were history of falls and near falls, comfortable gait speed, freezing of gate, dyskinesia, retropulsion, tandem gait (TG), pain, and cognition (Mini-Mental State Exam, MMSE). After each assessment, the participants registered a number of falls/near falls during the following 6 months. Multivariate Poisson regression was used to identify short- and long-term predictors of a number of falls/near falls.

RESULTS: Baseline median (q1-q3) motor (UPDRS) and MMSE scores were 10 (6.75-14) and 28.5 (27-29), respectively. History of falls was the only significant short-time predictor [incidence rate ratio (IRR), 15.17] for the number of falls/near falls during 6 months following baseline. Abnormal TG (IRR, 3.77) and lower MMSE scores (IRR, 1.17) were short-term predictors 3.5 years later. Abnormal TG (IRR, 7.79) and lower MMSE scores (IRR, 1.49) at baseline were long-term predictors of the number of falls/near falls 3.5 years later.

CONCLUSION: Abnormal TG and MMSE scores predict the number of falls/near falls in short and long term, and may be indicative of disease progression. Our observations provide important additions to the evidence base for clinical fall prediction in PD.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Neurology
volume
268
issue
3
pages
997 - 1005
publisher
Springer
external identifiers
  • pmid:32970193
  • scopus:85091420679
ISSN
1432-1459
DOI
10.1007/s00415-020-10234-6
language
English
LU publication?
yes
id
b0953c2a-fbf2-4dd3-bee3-a1fa6ad23018
date added to LUP
2020-09-28 22:26:38
date last changed
2024-06-13 23:34:12
@article{b0953c2a-fbf2-4dd3-bee3-a1fa6ad23018,
  abstract     = {{<p>INTRODUCTION AND OBJECTIVE: Several prediction models for falls/near falls in Parkinson's disease (PD) have been proposed. However, longitudinal predictors of frequency of falls/near falls are poorly investigated. Therefore, we aimed to identify short- and long-term predictors of the number of falls/near falls in PD.</p><p>METHODS: A prospective cohort of 58 persons with PD was assessed at baseline (mean age and PD duration, 65 and 3.2 years, respectively) and 3.5 years later. Potential predictors were history of falls and near falls, comfortable gait speed, freezing of gate, dyskinesia, retropulsion, tandem gait (TG), pain, and cognition (Mini-Mental State Exam, MMSE). After each assessment, the participants registered a number of falls/near falls during the following 6 months. Multivariate Poisson regression was used to identify short- and long-term predictors of a number of falls/near falls.</p><p>RESULTS: Baseline median (q1-q3) motor (UPDRS) and MMSE scores were 10 (6.75-14) and 28.5 (27-29), respectively. History of falls was the only significant short-time predictor [incidence rate ratio (IRR), 15.17] for the number of falls/near falls during 6 months following baseline. Abnormal TG (IRR, 3.77) and lower MMSE scores (IRR, 1.17) were short-term predictors 3.5 years later. Abnormal TG (IRR, 7.79) and lower MMSE scores (IRR, 1.49) at baseline were long-term predictors of the number of falls/near falls 3.5 years later.</p><p>CONCLUSION: Abnormal TG and MMSE scores predict the number of falls/near falls in short and long term, and may be indicative of disease progression. Our observations provide important additions to the evidence base for clinical fall prediction in PD.</p>}},
  author       = {{Lindholm, Beata and Brogårdh, Christina and Odin, Per and Hagell, Peter}},
  issn         = {{1432-1459}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{997--1005}},
  publisher    = {{Springer}},
  series       = {{Journal of Neurology}},
  title        = {{Longitudinal prediction of falls and near falls frequencies in Parkinson's disease:a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1007/s00415-020-10234-6}},
  doi          = {{10.1007/s00415-020-10234-6}},
  volume       = {{268}},
  year         = {{2021}},
}