Age and Ageing 2017; 46: ii19 doi: 10.1093/ageing/afx109.53
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Scientific Research – Parkinson’s Disease 53
MOTOR IMPAIRMENTS ARE ASSOCIATED WITH FEAR OF FALLING IN PEOPLE WITH PARKINSON’S DISEASE
J Nell1, S Stuart1, B Galna1,2, L Alcock1, L Rochester1 Institute of Neuroscience/ Newcastle University Institute for Ageing, Newcastle University, NE4 5PL, UK 2 School of Biomedical Sciences, Newcastle University, NE2 4HH, UK
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Introduction: Parkinson’s disease (PD) is a common, clinically heterogeneous, neurodegenerative disease, which is characterised by motor symptoms such as gait deficit. Motor and non-motor (e.g. visual and cognitive) dysfunctions are common in PD and lead to increased falls risk. Fear of falling (FoF) has been associated with increased falls prevalence in PD, and likely relates to motor and non-motor dysfunction. Understanding the features that underpin FoF will improve therapeutic management. The objective of this study was to quantify and interpret important contributors to FoF in PD.
Methods: 70 participants with mild-to-moderate PD (Hoehn and Yahr Stage I:17, II:43, III:10) recruited from Movement Disorder Clinics in Newcastle upon Tyne were assessed for FoF using the Falls Efficacy Scale International (FES-I). Falls history was gained retrospectively over the 12-months prior to assessment. A range of demographic, clinical, visual, cognitive and gait outcomes were also obtained. The associations between FES-I and secondary outcomes were assessed using Spearman correlations, with variables demonstrating significance entered into multivariate regression models and Receiver Operating Characteristic (ROC) curves to determine significant predictors of FoF. Results: Motor symptoms of reduced gait speed (beta = -0.239, p = 0.007), greater UPDRS II score (self-evaluation of motor experiences of Activities of Daily Living (ADL)) (beta = 0.611, p < 0.001), and a history of previous falls (beta = 0.278, p = 0.016) predicted FoF in PD. Notably, non-motor visual and cognitive deficits did not directly predict FoF in PD (F = 0.692, p = 0.678). Conclusions: Impaired gait speed, impaired ADL function and a history of falls are associated with FoF in people with mild-to-moderate PD. The complex causal interaction between FoF, motor symptoms and falls remains unclear. Speculatively, interventions that target motor symptoms may help reduce FoF.
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