title: Circumstances of falls and fall-related injuries among patients with Parkinson's disease in an outpatient setting.
abstract: Falls represent continuing, disabling and costly problem in Parkinson's disease (PD). The study was carried out at the Neurology Clinic in Belgrade from August 2011 to December 2012. As many as 180 community dwelling persons with PD aged 22-83 years who sustained a fall in past 6 months were included. Characteristics of the most recent fall were obtained through detailed interviews. Inclusion criteria were: Mini Mental State Examination (MMSE)≥24, ability to walk independently for at least 10 m and ability to statically stand for at least 90 s. Exclusion criteria were: presence of other neurologic as well as psychiatric, visual, audio-vestibular and orthopedic impairments. Falls more frequently took place outside (57.2%) and in the morning (53.9%). As much as 38.9% of persons with PD sustained an injury. Soft-tissue contusion was the most common injury (71.8%) both after indoor and outdoor falls. Fractures accounted for 5% of all fall-related injuries. All the fractures were either arm, clavicle or rib fractures. Tripping was identified as risk factor for outdoor falls (OR=7.90; 95% confidence interval [95% CI] 3.21-19.39; p=0.001). In contrast, lower extremity weakness (OR=0.20; 95% CI 0.05-0.72; p=0.015) and internal sense of sudden loss of balance (OR=0.19; 95% CI 0.05-0.73; p=0.015) were risk factors for indoor falls. To accomplish long-term results, development of particular prevention programs for persons with PD who fall at home vs. outdoors is recommended.
authors.affiliation: Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Gazibara
authors.affiliation: Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
authors.affiliation: Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Darija Kisic
authors.initials: DK
authors.lastname: Tepavcevic
authors.affiliation: Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Tomic
authors.affiliation: Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia.
authors.forename: Iva
authors.initials: I
authors.lastname: Stankovic
authors.affiliation: Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia.
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostic
authors.affiliation: Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia. Electronic address: marinasvetel@gmail.com.
authors.forename: Marina
authors.initials: M
authors.lastname: Svetel
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010300:Parkinson Disease / Q000503:physiopathology*; D055815:Young Adult
keywords: Falls; Outcomes; Parkinson's disease