Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Predicting Falls in Patients with Parkinson Disease

Neurol Clin Pract; 2018 Jun 1; Parashos, et al

A recent large-scale analysis identified several predictors of progression to falling in Parkinson disease (PD), and such identifiers may help target patient subgroups for falls prevention intervention. Researchers analyzed data in the National Parkinson Foundation Quality Improvement Initiative database to identify factors predicting which patients with PD, with no or rare falls at the baseline visit, will report at least monthly falls at the annual follow-up visit. Variables were introduced in 4 blocks: in the 1st block, variables present at or before the baseline visit were entered; in the 2nd, baseline visit assessments; in the 3rd, interventions implemented during baseline visit; and, in the 4th block, changes in comorbidities, living situation, and treatment between visits. They found:

  • Of 3,795 eligible participants, 3,276 (86.3%) reported no or rare falls at baseline visit, and of them, 382 (11.7%) reported at least monthly falls at follow-up visit.
  • Predictors included female sex, <90% diagnostic certainty, motor fluctuations, levodopa treatment, antidepressant treatment, prior deep brain stimulation (DBS), worse quality of life, Hoehn & Yahr stage 2 or 3, and worse semantic fluency.

Citation:

Parashos SA, Bloem BR, Browner NM, et al, on behalf of The National Parkinson Foundation Quality Improvement Initiative Investigators. What predicts falls in Parkinson disease? Observations from the Parkinson’s Foundation registry. Neurol Clin Pract. 2018;8(3):214-222. doi:10.1212/CPJ.0000000000000461.

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