title: Fall frequency and risk assessment in early Parkinson's disease.
abstract: BACKGROUND
  We sought to define the frequency of falls in early PD and assess potential risk factors for falls in this population.
  
  
  METHODS
  We analyzed the data from two randomized, placebo controlled trials (NET-PD FS1 and FS-TOO) of 413 individuals with early PD over 18 months of follow-up in FS1 and 12 months in FS-TOO. Falls were defined as any report of falls on the UPDRS or the adverse event log. We assessed the frequency of falls overall and by age. The relationship between prespecified fall risk markers and the probability of falling was assessed using logistic and multiple logistic regression. A hurdle Poisson model was used to jointly model the probability of remaining fall-free and the number of falls.
  
  
  RESULTS
  During the follow-up period, 23% of participants fell, and 11% were habitual fallers. In a multiple logistic regression model, age, baseline UPDRS Falling score, and baseline PDQ-39 scores were associated with subsequent fall risk (p < 0.001). Similarly, in a hurdle Poisson regression model, age, baseline UPDRS falling item, and baseline PDQ-39 were all significantly related to the probability of falling, but only UPDRS falling >0 was associated with the number of falls.
  
  
  CONCLUSIONS
  Falls are frequent and are associated with impaired quality of life, even in early PD. Current standard rating scales do not sufficiently explain future fall risk in the absence of a prior fall history. New assessment methods for falls and postural instability are required to better evaluate this important problem in clinical trials and clinical practice.
authors.affiliation: Department of Neurology, University of Virginia, PO Box 800394, Charlottesville, VA 22908, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Voss
authors.forename: J J
authors.initials: JJ
authors.lastname: Elm
authors.forename: C L
authors.initials: CL
authors.lastname: Wielinski
authors.forename: M J
authors.initials: MJ
authors.lastname: Aminoff
authors.forename: D
authors.initials: D
authors.lastname: Bandyopadhyay
authors.forename: K L
authors.initials: KL
authors.lastname: Chou
authors.forename: L R
authors.initials: LR
authors.lastname: Sudarsky
authors.forename: B C
authors.initials: BC
authors.lastname: Tilley
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires