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Natural history of falls in an incident cohort of Parkinson’s disease: early evolution, risk and protective features

Lookup NU author(s): Dr Susan Lord, Dr Brook Galna, Dr Alison Yarnall, Dr Rosie Morris, Dr Shirley Coleman, Professor David Burn, Professor Lynn Rochester

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2017 The Author(s) The natural history of falls in early Parkinson’s disease (PD) is poorly understood despite the profound effect of falls on outcome. The primary aim of this study was to describe the natural history of falls, and characterise fallers over 54 months in 99 newly diagnosed people with PD. Seventy-nine (79.7%) participants fell over 54 months and 20 (20.3%) remained falls-naïve. Twenty six (26.2%) reported retrospective falls at baseline. Gait outcomes, disease severity and self-efficacy significantly discriminated across groups. Subjective cognitive complaints emerged as the only significant cognitive predictor. Without exception, outcomes were better for non-fallers compared with fallers at any time point. Between group differences for 54 month fallers and non-fallers were influenced by the inclusion of retrospective fallers and showed a broader range of discriminant characteristics, notably stance time variability and balance self-efficacy. Single fallers (n = 7) were significantly younger than recurrent fallers (n = 58) by almost 15 years (P = 0.013). Baseline performance in early PD discriminates fallers over 54 months, thereby identifying those at risk of falls. Clinical profiles for established and emergent fallers are to some extent distinct. These results reiterate the need for timely interventions to improve postural control and gait.


Publication metadata

Author(s): Lord S, Galna B, Yarnall AJ, Morris R, Coleman S, Burn D, Rochester L

Publication type: Article

Publication status: Published

Journal: Journal of Neurology

Year: 2017

Volume: 264

Issue: 11

Pages: 2268-2276

Print publication date: 01/11/2017

Online publication date: 25/01/2017

Acceptance date: 11/09/2017

Date deposited: 03/10/2017

ISSN (print): 0340-5354

ISSN (electronic): 1432-1459

Publisher: Springer

URL: https://doi.org/10.1007/s00415-017-8620-y

DOI: 10.1007/s00415-017-8620-y


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