Falls in ambulatory non-demented patients with Parkinson’s disease
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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.
KeywordsFalls Parkinson’s disease Gait disorders Quality of life Orthostatic hypotension Hallucinations
The authors thank the patients who agreed to participate in this study and the Association France-Parkinson for its support. The project was co-funded by unrestricted and unconditional grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé. The project was sponsored and co-financed by LN PHARMA, which participated into the design and conduct of the study; collection, management, and interpretation of the data; and preparation and review of the manuscript.
Conflict of interest
Olivier Rascol reports no disclosures, Santiago Perez-Lloret reports no disclosures, Philippe Damier reports no disclosures, Arnaud Delval reports no disclosures, Pascal Derkinderen reports no disclosures, Alain Destée reports no disclosures, Wassilios Meissner reports that a grant was received by the Bordeaux University Hospital for the project. Francois Tison reports no disclosures, Laurence Negre-Pages reports grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé for funding this project and that she owns stock options from LN PHARMA, which was one of the sponsors of this study.
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