Falls in ambulatory non-demented patients with Parkinson’s disease
J Neural Transm. 2015-04-07; 122(10): 1447-1455
DOI: 10.1007/s00702-015-1396-2
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1. J Neural Transm (Vienna). 2015 Oct;122(10):1447-55. doi:
10.1007/s00702-015-1396-2. Epub 2015 Apr 7.
Falls in ambulatory non-demented patients with Parkinson’s disease.
Rascol O(1)(2)(3), Perez-Lloret S(4)(5), Damier P(6)(7), Delval A(8), Derkinderen
P(9), Destée A(10)(11)(12), Meissner WG(13)(14)(15), Tison F(16)(17)(18)(19),
Negre-Pages L(20)(21).
Author information:
(1)Department of Clinical Pharmacology and Neurosciences, University of Toulouse
3, 37 Allées Jules Guesde, 31000, Toulouse, France. .
(2)INSERM CIC1436 and UMR825, Toulouse, France. .
(3)NS-Park Network, INSERM, Toulouse, France. .
(4)Department of Clinical Pharmacology and Neurosciences, University of Toulouse
3, 37 Allées Jules Guesde, 31000, Toulouse, France. .
(5)Laboratory of Epidemiology and Experimental Pharmacology, Institute for
Biomedical Research (BIOMED-CONICET), Faculty of Medical Sciences, Pontifical
Catholic University of Argentina (UCA), Buenos Aires, Argentina.
.
(6)NS-Park Network, INSERM, Toulouse, France. .
(7)Department of Neurology, Hôpital Laënnec, CHU Nantes, Nantes, France.
.
(8)Department of Neurology, CHU Lille, Lille, France.
.
(9)Department of Neurology, Hôpital Laënnec, CHU Nantes, Nantes, France.
.
(10)NS-Park Network, INSERM, Toulouse, France. .
(11)Department of Neurology, CHU Lille, Lille, France. .
(12)INSERM U 837 Eq6, Lille, France. .
(13)Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux,
Bordeaux, France. .
(14)Institut des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France.
.
(15)Service de Neurologie, CHU de Bordeaux, Bordeaux, France.
.
(16)NS-Park Network, INSERM, Toulouse, France. .
(17)Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux,
Bordeaux, France. .
(18)Institut des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France.
.
(19)Service de Neurologie, CHU de Bordeaux, Bordeaux, France.
.
(20)NS-Park Network, INSERM, Toulouse, France. .
(21)LN Pharma, Toulouse, France. .
This study aimed at determining the prevalence of falling in PD patients, to
assess generic and disease-specific clinical and pharmacological factors,
relationship with health-related quality of life (HR-QoL) and changes in falls
from OFF to ON in patients with motor fluctuations. Six-hundred and eighty-three
PD patients of the COPARK survey were evaluated (11 had missing data and were
excluded from the analysis). Patients with falls were identified as those with a
UPDRS Item 13 ≥ 1 in the ON condition. All patients were assessed in a
standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS),
Hospital Anxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales
(SF36, PDQ39)]. Falling was reported by 108/672 (16%) PD patients during the ON
state and prevalence increased according to PD severity, from 5% in Hoehn and
Yahr stage 1-60% in stage 4. Falling was significantly related to lower HR-QoL.
Falling correlated with (1) generic factors such as female gender, age at the end
of academic studies and diuretics consumption, (2) motor PD-specific factors
including disease severity, frozen gait, difficulties when arising from a chair,
dyskinesia and higher levodopa daily equivalent dose and (3) non-motor
PD-specific factors such as orthostatic hypotension and hallucinations. Falling
was more frequent in OFF than in ON in 48/74 (64%) patients with motor
fluctuations and remained unchanged in 27 patients (36%). In summary, falling
affected a significant proportion of PD patients, especially in advanced stages.
It was associated with a variety of generic and PD-specific factors and was
related to reduced HR-QoL.
DOI: 10.1007/s00702-015-1396-2
PMID: 25845678 [Indexed for MEDLINE]