Fall frequency and risk factors in patients with Parkinson's disease in Belgrade, Serbia: a cross-sectional study.
OBJECTIVE
The aim of the present study was to estimate fall frequency as well as demographic and clinical factors related to falling in a cohort of Serbian patients with Parkinson's disease (PD).


METHODS
The cross-sectional study comprised 300 consecutive patients recruited at the Neurology Clinic in Belgrade, Serbia, from August 2011 to December 2012. Data were acquired though detailed interviews, while a history of falling referred to the period of 6 months before testing. After a interview related to the circumstances of the last fall sustained by PD patients, the participants were evaluated with the Mini-Mental State Examination, the Unified Parkinson's Disease Rating Scale, the Hoehn and Yahr scale, the Falls Efficacy Scale and the Self-Assessment Disability Scale, New Freezing of Gait questionnaire for frequency and impact of freezing, and the Hamilton Depression and the Hamilton Anxiety Rating Scale.


RESULTS
A total of 60% of individuals reported a fall in the 6-month period before testing. Multivariate regression showed that patients with PD who had a Self-Assessment Disability Scale score of ≥56 and Unified Parkinson's Disease Rating Scale total score of ≥69 were 2.04 and 3.32 times more likely to fall, respectively (95% CI 1.10-3.79, P = 0.023 for Self-Assessment Disability Scale and 95% CI 1.83-6.00, P = 0.001 for Unified Parkinson's Disease Rating Scale). In contrast, a decrease of risk for falling by 57% was observed among those who practiced regular physical activity before the onset of PD (95% CI 0.23-0.80, P = 0.008).


CONCLUSIONS
There is a strong relationship between falling and self-perceived disability, whereas previous physical exercise had a protective effect.
Institute of Epidemiology, University of Belgrade, Belgrade, Serbia.
Tatjana
T
Gazibara
Tatjana
T
Pekmezovic
Darija
D
Kisic Tepavcevic
Aleksandra
A
Tomic
Iva
I
Stankovic
Vladimir S
VS
Kostic
Marina
M
Svetel
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012307:Risk Factors; D012647:Self-Assessment; D055771:Serbia; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Parkinson's disease; falls; frequency; risk factors