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Disability is an Independent Predictor of Falls and Recurrent Falls in People with Parkinson's Disease Without a History of Falls: A One-Year Prospective Study.
Almeida, Lorena R S; Sherrington, Catherine; Allen, Natalie E; Paul, Serene S; Valenca, Guilherme T; Oliveira-Filho, Jamary; Canning, Colleen G.
Afiliación
  • Almeida LR; Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital, Salvador, BA, Brazil.
  • Sherrington C; Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, BA, Brazil.
  • Allen NE; Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
  • Paul SS; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
  • Valenca GT; Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
  • Oliveira-Filho J; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
  • Canning CG; Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital, Salvador, BA, Brazil.
J Parkinsons Dis ; 5(4): 855-64, 2015.
Article en En | MEDLINE | ID: mdl-26444093
BACKGROUND: Predictors of falls in people with Parkinson's disease (PD) who have not previously fallen are yet to be identified. OBJECTIVES: We aimed to identify predictors of all falls and recurrent falls in people with PD who had not fallen in the previous year and to explore the timing of falls in a 12-month follow-up period. METHODS: Participants with PD (n = 130) were assessed by disease-specific, self-report and balance measures. Falls were recorded prospectively for 12 months. Univariate and multivariate analyses were performed. Kaplan-Meier survival analysis was used to investigate time to falling. RESULTS: Forty participants (31%) had ≥1 fall during follow-up and 21 (16%) had ≥2 falls. Disability, reduced balance confidence and greater concern about falling were associated with ≥1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with ≥2 falls (p <  0.05). Disability (Schwab and England scale, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39-0.80; p = 0.002) was associated with ≥1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55-0.76; p = 0.005). Disability (Unified Parkinson's Disease Rating Scale activities of daily living, OR = 1.20; 95% CI 1.07-1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95-1.30; p = 0.19) were associated with ≥2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60-0.84; p = 0.001). Recurrent fallers experienced their first fall earlier than single fallers (p <  0.05). CONCLUSIONS: Self-reported disability was the strongest single predictor of all falls and recurrent falls.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Índice de Severidad de la Enfermedad / Accidentes por Caídas / Trastornos Neurológicos de la Marcha / Equilibrio Postural Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Parkinsons Dis Año: 2015 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Índice de Severidad de la Enfermedad / Accidentes por Caídas / Trastornos Neurológicos de la Marcha / Equilibrio Postural Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Parkinsons Dis Año: 2015 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Países Bajos