title: Falls in ambulatory non-demented patients with Parkinson's disease.
abstract: This study aimed at determining the prevalence of falling in PD patients, to assess generic and disease-specific clinical and pharmacological factors, relationship with health-related quality of life (HR-QoL) and changes in falls from OFF to ON in patients with motor fluctuations. Six-hundred and eighty-three PD patients of the COPARK survey were evaluated (11 had missing data and were excluded from the analysis). Patients with falls were identified as those with a UPDRS Item 13 ≥ 1 in the ON condition. All patients were assessed in a standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS), Hospital Anxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales (SF36, PDQ39)]. Falling was reported by 108/672 (16%) PD patients during the ON state and prevalence increased according to PD severity, from 5% in Hoehn and Yahr stage 1-60% in stage 4. Falling was significantly related to lower HR-QoL. Falling correlated with (1) generic factors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specific factors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopa daily equivalent dose and (3) non-motor PD-specific factors such as orthostatic hypotension and hallucinations. Falling was more frequent in OFF than in ON in 48/74 (64%) patients with motor fluctuations and remained unchanged in 27 patients (36%). In summary, falling affected a significant proportion of PD patients, especially in advanced stages. It was associated with a variety of generic and PD-specific factors and was related to reduced HR-QoL.
authors.affiliation: Department of Clinical Pharmacology and Neurosciences, University of Toulouse 3, 37 Allées Jules Guesde, 31000, Toulouse, France. olivier.rascol@univ-tlse3.fr.|INSERM CIC1436 and UMR825, Toulouse, France. olivier.rascol@univ-tlse3.fr.|NS-Park Network, INSERM, Toulouse, France. olivier.rascol@univ-tlse3.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
authors.affiliation: Department of Clinical Pharmacology and Neurosciences, University of Toulouse 3, 37 Allées Jules Guesde, 31000, Toulouse, France. splloret@gmail.com.|Laboratory of Epidemiology and Experimental Pharmacology, Institute for Biomedical Research (BIOMED-CONICET), Faculty of Medical Sciences, Pontifical Catholic University of Argentina (UCA), Buenos Aires, Argentina. splloret@gmail.com.
authors.forename: Santiago
authors.initials: S
authors.lastname: Perez-Lloret
authors.affiliation: NS-Park Network, INSERM, Toulouse, France. philippe.damier@chu-nantes.fr.|Department of Neurology, Hôpital Laënnec, CHU Nantes, Nantes, France. philippe.damier@chu-nantes.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Damier
authors.affiliation: Department of Neurology, CHU Lille, Lille, France. Arnaud.delval@chru-lille.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Delval
authors.affiliation: Department of Neurology, Hôpital Laënnec, CHU Nantes, Nantes, France. pascal.derkinderen@chu-nantes.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Derkinderen
authors.affiliation: NS-Park Network, INSERM, Toulouse, France. adestee@chru-lille.fr.|Department of Neurology, CHU Lille, Lille, France. adestee@chru-lille.fr.|INSERM U 837 Eq6, Lille, France. adestee@chru-lille.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Destée
authors.affiliation: Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux, Bordeaux, France. wassilios.meissner@chu-bordeaux.fr.|Institut des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France. wassilios.meissner@chu-bordeaux.fr.|Service de Neurologie, CHU de Bordeaux, Bordeaux, France. wassilios.meissner@chu-bordeaux.fr.
authors.forename: Wassilios G
authors.initials: WG
authors.lastname: Meissner
authors.affiliation: NS-Park Network, INSERM, Toulouse, France. Francois.Tison@chu-bordeaux.fr.|Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux, Bordeaux, France. Francois.Tison@chu-bordeaux.fr.|Institut des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France. Francois.Tison@chu-bordeaux.fr.|Service de Neurologie, CHU de Bordeaux, Bordeaux, France. Francois.Tison@chu-bordeaux.fr.
authors.forename: Francois
authors.initials: F
authors.lastname: Tison
authors.affiliation: NS-Park Network, INSERM, Toulouse, France. laurence.negre-pages@lnpharma.fr.|LN Pharma, Toulouse, France. laurence.negre-pages@lnpharma.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Negre-Pages
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D000978:Antiparkinson Agents
keywords: Falls; Gait disorders; Hallucinations; Orthostatic hypotension; Parkinson’s disease; Quality of life
references.citation: Mov Disord. 2007 Oct 15;22(13):1892-900
references.pmid: 17588236
references.citation: Parkinsonism Relat Disord. 2012 Jun;18(5):501-5
references.pmid: 22336566
references.citation: Mov Disord. 2009 Apr 15;24(5):745-51
references.pmid: 19133666
references.citation: J Neurol Neurosurg Psychiatry. 2002 Jun;72(6):721-5
references.pmid: 12023412
references.citation: Age Ageing. 1995 Nov;24(6):505-9
references.pmid: 8588541
references.citation: Front Neurol. 2013 Dec 13;4:202
references.pmid: 24379799
references.citation: Acta Neurol Scand. 2011 Mar;123(3):193-200
references.pmid: 20545629
references.citation: Funct Neurol. 2005 Oct-Dec;20(4):163-8
references.pmid: 16483454
references.citation: Injury. 2006 Oct;37(10):929-34
references.pmid: 16483578
references.citation: Parkinsons Dis. 2013;2013:906274
references.pmid: 23533953
references.citation: Med Care. 1992 Jun;30(6):473-83
references.pmid: 1593914
references.citation: Parkinsonism Relat Disord. 2012 Aug;18(7):837-41
references.pmid: 22542094
references.citation: Mov Disord. 2008 Nov 15;23(15):2129-70
references.pmid: 19025984
references.citation: Parkinsonism Relat Disord. 2014 Jan;20(1):88-92
references.pmid: 24134900
references.citation: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references.pmid: 6880820
references.citation: Mov Disord. 2004 Aug;19(8):871-84
references.pmid: 15300651
references.citation: Eur J Neurol. 2013 Jan;20(1):160-6
references.pmid: 22816560
references.citation: Mov Disord. 2010 Nov 15;25(15):2649-53
references.pmid: 21069833
references.citation: J Parkinsons Dis. 2014;4(2):255-60
references.pmid: 24577502
references.citation: Neurology. 2010 Jul 13;75(2):116-24
references.pmid: 20574039
references.citation: Parkinsonism Relat Disord. 2014 Apr;20(4):360-9
references.pmid: 24484618
references.citation: Neurol Neurochir Pol. 2013 Sep-Oct;47(5):431-7
references.pmid: 24166564
references.citation: Parkinsons Dis. 2013;2013:141720
references.pmid: 23841020
references.citation: JAMA Neurol. 2014 Jul 1;71(7):884-90
references.pmid: 24839938
references.citation: J Neurol. 2010 Sep;257(9):1524-32
references.pmid: 20411272
references.citation: Accid Anal Prev. 2012 Mar;45:99-106
references.pmid: 22269490