One systematic review of falls in patients with PD, including 22 studies, showed that falls are common in patients with PD, as shown on the slide.3 Furthermore, the rate of falls per recurrent faller was high, ranging from 4.7 to 67.6 falls per year – with one individual patient reporting falling more than 500 times in a 20-week period.3 Factors associated with greater risk of falling included previous falling, and PD severity.3. The authors highlight the need for the fear of falling to be assessed in patients with PD, given the inconsistent relationship that they found in the data between fear of falling and actual falling.3 Where these two risks are connected, strategies to reduce fear of falling might be considered.3
Fear of falling can be a consequence of falling in elderly individuals.7 In one study, fear of falling was associated with female sex, older age, balance and gait abnormalities, and poor self-assessed physical health, cognitive health, and economic resources.7 Indeed, a fear of falling might well be a rational response to an individual making an assessment about their personal risk of falling, particularly among frail, elderly women.7
References:
1. Ooi WL, Hossain M, Lipsitz LA. The association between orthostatic hypotension and recurrent falls in nursing home residents. Am J Med 2000; 108 (2): 106–111.
2. Merola A, Romagnolo A, Rosso M, et al. Orthostatic hypotension in Parkinson’s disease: does it matter if asymptomatic? Parkinsonism Relat Disord 2016; 33: 65–71.
3. Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson’s disease: a systematic review. Parkinsons Dis 2013; 2013: 906274.
4. Lubomski M, Rushworth RL, Tisch S. Hospitalisation and comorbidities in Parkinson’s disease: a large Australian retrospective study. J Neurol Neurosurg Psychiatry 2015; 86 (3): 324–330.
5. Goldstein DS, Sharabi Y. Neurogenic orthostatic hypotension: a pathophysiological approach. Circulation 2009; 119 (1): 139–146.
6. Pathak A, Lapeyre-Mestre M, Montastruc JL, Senard JM. Heat-related morbidity in patients with orthostatic hypotension and primary autonomic failure. Mov Disord 2005; 20 (9): 1213–1219.
7. Vellas BJ, Wayne SJ, Romero LJ, et al. Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997; 26 (3): 189–193.
8. Jonasson SB, Nilsson MH, Lexell J, Carlsson G. Experiences of fear of falling in persons with Parkinson’s disease – a qualitative study. BMC Geriatr 2018; 18 (1): 44.
