title: Causes and consequences of falls in Parkinson disease patients in a prospective study.
abstract: OBJECTIVE
  Falls are common events in Parkinson disease (PD) but only a few prospective studies have focused on causes and consequences of falls in PD patients. The aim of the study was prospective analysis of direct causes and consequences of falls in PD patients in comparison to the control group.
  
  
  METHODS
  One hundred PD patients and 55 age-matched controls were enrolled in the study. The diagnostic workup in all patients included neurological examination, Unified Parkinson's Disease Rating Scale, magnetic resonance imaging, electroencephalography, ultrasonography, otolaryngological, ophthalmological and autonomic function examination. During 12 months of follow-up, falls were registered in both groups, direct causes were classified according to the St. Louis and Olanow classification, and consequences were established.
  
  
  RESULTS
  Falls occurred in 54% of PD patients and in 18% of control subjects. Analysis of direct causes of falls revealed that sudden falls were the most common (31%), followed by episodes of freezing and festination (19.6%), neurological and sensory disturbances (mostly vertigo) (12%), environmental factors (12%), postural instability (11%), orthostatic hypotension (4%), and severe dyskinesia (3.6%); 6.19% of falls were unclassified; 22% of patients had the same etiology of subsequent falls. In PD patients, intrinsic factors were dominant, whereas in the control group intrinsic and extrinsic factors occurred with the same frequency. Every third fall intensified fear of walking. 34% of falls caused injuries; among them bruises of body parts other than the head were most frequent.
  
  
  CONCLUSIONS
  Intrinsic factors are the most common causes of falls in PD. Every third fall intensifies fear of walking and causes injuries.
authors.affiliation: dr n. med. Magdalena Wójcik-Pędziwiatr, Department of Neurology, Jagiellonian University Medical College, 3 Botaniczna St, 31-503 Krakow, Poland, e-mail: stokrotka283@tlen.pl.
authors.forename: M
authors.initials: M
authors.lastname: Rudzińska
authors.forename: S
authors.initials: S
authors.lastname: Bukowczan
authors.forename: J
authors.initials: J
authors.lastname: Stożek
authors.forename: K
authors.initials: K
authors.lastname: Zajdel
authors.forename: E
authors.initials: E
authors.lastname: Mirek
authors.forename: W
authors.initials: W
authors.lastname: Chwała
authors.forename: M
authors.initials: M
authors.lastname: Wójcik-Pędziwiatr
authors.forename: K
authors.initials: K
authors.lastname: Banaszkiewicz
authors.forename: A
authors.initials: A
authors.lastname: Szczudlik
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness; D010300:Parkinson Disease / Q000150:complications*; D011044:Poland; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index