Falls in different types of Parkinson's disease.
OBJECTIVE
Intrinsic factors are the main cause of falls in Parkinson's disease (PD). The relation between different symptoms or type of PD and frequency of falls has been unclear so far. The aim of the study was to assess the frequency and causes of falls in postural instability and gait difficulty dominant PD (PIGD) and tremor dominant PD (TD).


METHODS
The study was performed in 106 patients (51% were women; mean age: 67.7+/-9.8 years; mean disease duration: 6.3+/-3.5 years). The type of the disease was defined according to subscore of UPDRS concerning postural instability, gait difficulty and tremor assessment. The two groups were compared in regard to number and causes of falls, gender, age, disease duration, age at the onset of the disease, UPDRS score, Hoehn and Yahr stage, Schwab and England score, the occurrence of dyskinesia, fluctuations, mental function (MMSE) and depressive mood.


RESULTS
There were 76 patients (71.6%) in the PIGD group and 21 (19.8%) in the TD group. There were no significant differences between PIGD and TD regarding age, gender, disease duration, age at the onset of the disease, UPDRS score, Hoehn and Yahr stage, Schwab and England score, mental status and depression. Dyskinesia, fluctuations and gait disorders occurred more often in PIGD. Falls were significantly more common in PIGD-PD (57.9%) than in TD-PD (23.8%) (p=0.03). The number of falls in PIGD- -PD was significantly higher than in TD-PD (mean number of falls in PIGD-PD 3.6+/-6.0 and in T-PD 0.6+/-1.8, p=0.02). Sudden falls were the main cause of falls in both groups.


CONCLUSIONS
PIGD patients are significantly more predisposed to falls.
Rudzińska
Monika
M
Klinika Neurologii CM UJ, ul. Botaniczna 3, 31-503 Kraków, Poland. rudzinsk@neuro.cm-uj.krakow.pl
Marona
Monika
M
Bukowczan
Sylwia
S
Banaszkiewicz
Krzysztof
K
Mirek
Elzbieta
E
Szczudlik
Andrzej
A
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D004856:Postural Balance; D012720:Severity of Illness Index; D014202:Tremor / Q000209:etiology*