Better tools needed to predict falls in PD patients
MedWire News: Falls are common among patients with early Parkinson's disease (PD), but assessment tools and methods for predicting future falls in patients without previous ones are lacking, report researchers.
Their study findings show that the probability of PD patients experiencing falls is linked to their fall history, age, and quality of life, but that "standard rating scales do not sufficiently explain future fall risk in the absence of a prior fall history."
Tiffini Voss (University of Virginia, Charlottesville, USA) and colleagues used data from two randomized, placebo-controlled studies involving 413 people with early PD to assess the frequency of falls, overall and by age, over a period of up to 18 months.
Among the 93 participants who reported a fall at some point during the study, nine reported one at baseline, and 84 sustained one after baseline.
A total of 47 patients (11%) were classed as habitual fallers, defined as reporting a fall at two or more physician visits at least 1 month apart, and habitual fallers accounted for a larger proportion of fallers as participants' ages increased.
Indeed, falling was less frequent among younger patients, at 13% among those aged under 50 years compared with 46% in those aged 80 years and above.
Multivariate analysis revealed that age, baseline Parkinson Disease Quality of Life (PDQoL) summary (rather than subsection) score, and a Unified Parkinson's Disease Rating Scale score of more than 0 for falling, were all significantly associated with post-baseline falls.
Further analysis showed that increasing age and lower PDQoL significantly increased the odds for future falls in patients with no previous falls, , but that if a fall had occurred at baseline, these factors had no effect on future fall chances.
In addition, the odds for remaining fall-free after baseline was reduced in patients who had already experienced a fall at baseline (OR=0.14) and after a fall, the relative risk for further falls was 2.92 times that for patients without prior falls.
"Falls are... a critical factor in the management of PD, with significant impact on morbidity, nursing home placement, and healthcare costs," write Voss et al in Parkinsonism and Related Disorders.
"Our results... highlight the need for novel therapies to reduce falls in PD," they conclude.
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By Sarah Guy