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Recurrent Falls in Parkinson’s Disease: A Systematic Review

DOI: 10.1155/2013/906274

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Abstract:

Most people with Parkinson’s disease (PD) fall and many experience recurrent falls. The aim of this review was to examine the scope of recurrent falls and to identify factors associated with recurrent fallers. A database search for journal articles which reported prospectively collected information concerning recurrent falls in people with PD identified 22 studies. In these studies, 60.5% (range 35 to 90%) of participants reported at least one fall, with 39% (range 18 to 65%) reporting recurrent falls. Recurrent fallers reported an average of 4.7 to 67.6 falls per person per year (overall average 20.8 falls). Factors associated with recurrent falls include: a positive fall history, increased disease severity and duration, increased motor impairment, treatment with dopamine agonists, increased levodopa dosage, cognitive impairment, fear of falling, freezing of gait, impaired mobility and reduced physical activity. The wide range in the frequency of recurrent falls experienced by people with PD suggests that it would be beneficial to classify recurrent fallers into sub-groups based on fall frequency. Given that there are several factors particularly associated with recurrent falls, fall management and prevention strategies specifically targeting recurrent fallers require urgent evaluation in order to inform clinical practice. 1. Introduction Falls are a debilitating and costly problem for many people with Parkinson’s disease (PD), with people with PD twice as likely to fall as people with other neurological conditions [1]. The consequences of these falls are significant and far reaching, often resulting in injury [2, 3] and contributing to fear of falling [4], reduced activity levels [2], poor quality of life [2, 5], and care giver stress [6, 7]. Given that the prevalence of PD in developed countries is expected to double from 2005 to 2030 [8], PD-related falls can be expected to have a major impact on health care systems in the coming decades. While it is well known that recurrent falls are a problem for people with PD, the extent and severity of this problem are not well understood. In the general older population, recurrent falls are said to have occurred when an individual falls more than once in a given time period (usually 12 months). Using this definition, around 15% of people in the general older population are classified as recurrent fallers [9]. However, recurrent falls are frequent amongst people with PD, with one study reporting that over 50% of participants fell recurrently [10]. Furthermore, in a survey of 100 people with PD, 13% reported

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