title: Concerns About Falling in Parkinson's Disease: Associations with Disabilities and Personal and Environmental Factors.
abstract: BACKGROUND
  Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related self-efficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors.
  
  
  OBJECTIVE
  To identify explanatory factors of concerns about falling in people with PD by focusing on personal and environmental factors as well as PD-related disabilities.
  
  
  METHODS
  Data were collected from 241 persons with PD (39% women, median age 70 years, PD duration 8 years). Concerns about falling (assessed with the Falls Efficacy Scale-International, FES-I; categorized into low, moderate, or high concerns) were used as the dependent variable in a multivariate ordinal regression analysis. Personal factors, environmental factors and PD-related disabilities constituted independent variables.
  
  
  RESULTS
  Low, moderate and high concerns about falling were reported by 29% , 24% and 47% of the participants, respectively. Walking difficulties, orthostatism, motor symptoms, age, and fatigue (presented in order of importance) were significant (p <  0.05) explanatory factors of concerns about falling.
  
  
  CONCLUSIONS
  Several factors significantly explained concerns about falling in people with PD. Walking difficulties was by far the strongest explanatory factor. This suggests that minimizing walking difficulties should be a primary target when aiming at reducing concerns about falling in people with PD.
authors: Department of Health Sciences, Lund University, Lund, Sweden.|Department of Neurology and Rehabilitation, Skåne University Hospital, Lund, Sweden.
authors: Stina B
authors: SB
authors: Jonasson
authors: R & D Centre, Skåne University Hospital, Lund, Sweden.
authors: Susann
authors: S
authors: Ullén
authors: Department of Health Sciences, Lund University, Lund, Sweden.
authors: Susanne
authors: S
authors: Iwarsson
authors: Department of Health Sciences, Lund University, Lund, Sweden.|Department of Neurology and Rehabilitation, Skåne University Hospital, Lund, Sweden.
authors: Jan
authors: J
authors: Lexell
authors: Department of Health Sciences, Lund University, Lund, Sweden.|Memory Clinic, Skåne University Hospital, Malmö, Sweden.
authors: Maria H
authors: MH
authors: Nilsson
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D004777:Environment; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D020377:Self Efficacy
keywords: Accidental falls; Parkinson disease; fear; multivariate analysis; regression analysis; self efficacy