Falls in ambulatory non-demented patients with Parkinson's disease

SANTIAGO P¨¦REZ LLORET; OLIVIER RASCOL

San Diego

Congreso; 19th International Congress of Parkinson¡¯s Disease and Movement; 2015

Objective: To determine the prevalence of falling in Parkinson's Disease (PD) patients, to assess generic anddisease-specific clinical and pharmacological factors, relationship with Health-related Quality of Life (HR-QoL), andchanges in falls from OFF to ON in patients with motor fluctuations.To determine the prevalence of falling in Parkinson's Disease (PD) patients, to assess generic anddisease-specific clinical and pharmacological factors, relationship with Health-related Quality of Life (HR-QoL), andchanges in falls from OFF to ON in patients with motor fluctuations.Background: Falls are a frequent feature of PD.Falls are a frequent feature of PD.Methods: 683 PD patients of the COPARK survey were evaluated (11 had missing data and were excluded from theanalysis). Patients with falls were identified as those with a UPDRS Item 13 ¡Ý1 in the ON condition. All patientswere assessed in a standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS), HospitalAnxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales (SF36, PDQ39)].Results: Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Conclusions: Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.683 PD patients of the COPARK survey were evaluated (11 had missing data and were excluded from theanalysis). Patients with falls were identified as those with a UPDRS Item 13 ¡Ý1 in the ON condition. All patientswere assessed in a standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS), HospitalAnxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales (SF36, PDQ39)].Results: Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Conclusions: Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.¡Ý1 in the ON condition. All patientswere assessed in a standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS), HospitalAnxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales (SF36, PDQ39)].Results: Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Falling was reported by 108/672 (16%) PD patients during the ON-state and prevalence increasedaccording to PD severity, from 5% in Hoehn & Yahr stage 1 to 60% in stage 4. Falling correlated with (1) genericfactors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specificfactors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopadaily equivalent dose and (3) non-motor PD specific factors like orthostatic hypotension and hallucinations. Fallingwas significantly related to lower HR-QoL. Falling was more frequent in OFF than ON in 48/74 (64%) patients withmotor fluctuations and remained unchanged in 27 patients (36%).Conclusions: Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.Falling affected a significant proportion of PD patients, especially in advanced stages. It was relatedto reduced HR-QoL and was associated to a variety of generic and PD-specific factors.