title: Impaired executive function can predict recurrent falls in Parkinson's disease.
abstract: OBJECTIVE
  To examine whether impairment in executive function independently predicts recurrent falls in people with Parkinson's disease (PD).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University motor control research laboratory.
  
  
  METHODS
  A convenience sample of community-dwelling people with PD (N=144) was recruited from a patient self-help group and movement disorders clinics.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Executive function was assessed with the Mattis Dementia Rating Scale Initiation/Perseveration (MDRS-IP) subtest, and fear of falling (FoF) with the Activities-specific Balance Confidence (ABC) Scale. All participants were followed up for 12 months to record the number of monthly fall events.
  
  
  RESULTS
  Forty-two people with PD had at least 2 falls during the follow-up period and were classified as recurrent fallers. After accounting for demographic variables and fall history (P=.001), multiple logistic regression analysis showed that the ABC scores (P=.014) and MDRS-IP scores (P=.006) were significantly associated with future recurrent falls among people with PD. The overall accuracy of the prediction was 85.9%. With the use of the significant predictors identified in multiple logistic regression analysis, a prediction model determined by the logistic function was generated: Z = 1.544 + .378 (fall history) - .045 (ABC) - .145 (MDRS-IP).
  
  
  CONCLUSIONS
  Impaired executive function is a significant predictor of future recurrent falls in people with PD. Participants with executive dysfunction and greater FoF at baseline had a significantly greater risk of sustaining a recurrent fall within the subsequent 12 months.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China. Electronic address: Margaret.Mak@polyu.edu.hk.
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Mak
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
authors.forename: Marco Y
authors.initials: MY
authors.lastname: Pang
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D003072:Cognition Disorders / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011336:Probability; D011446:Prospective Studies; D012008:Recurrence
keywords: Accidental falls; Executive function; Parkinson disease; Prospective study; Rehabilitation