title: Influence of urinary urgency and other urinary disturbances on falls in Parkinson's disease.
abstract: BACKGROUND
  Falling is one of the most common and serious public health problems. It can cause injuries such as sprains and fractures, and hospitalization may be required for serious injuries. Patients with Parkinson's disease have a higher risk of falls, and urinary incontinence is a known risk factor for falls in the elderly. However, whether other urinary disturbances contribute to the risk of falling remains unclear. The purpose of this study was to identify the association between falls and urinary disturbances in Parkinson's disease.
  
  
  METHODS
  A prospective cohort study was conducted at a single institution with a 6-month observation period. Subjects were ambulatory patients with Parkinson's disease. Assessments included patient demographics, disease severity measured by the Hoehn and Yahr scale, and urinary disturbances measured using the overactive bladder symptom score (OABSS). Falls were reported using a self-documented fall record.
  
  
  RESULTS
  A total of 97 patients were included. Forty-four subjects experienced one or more falls during the observation period. The frequency of urination was not related to falling; however, mild urinary urgency, but not severe urinary urgency, increased the risk of falls by an odds ratio of 5.14 (95% confidence interval: 1.51-17.48). Mild urinary urgency was also associated with the time to the first fall and the frequency of falls. One third of falls occurred in the living room, and 13.8% of falls occurred on the way to/from the toilet.
  
  
  CONCLUSIONS
  Falls in patients with Parkinson's disease might be associated with urinary urgency, but not with the frequency of urination.
authors.affiliation: Department of Neurology, Hokkaido University Graduate School of Medicine, Japan. Electronic address: sakusima@med.hokudai.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Sakushima
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Yamazaki
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Japan; Center for Innovative Research for Community and Clinical Excellence, Fukushima Medical University, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Fukuma
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.affiliation: Department of Neurology, Hokkaido University Graduate School of Medicine, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yabe
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Japan; Center for Innovative Research for Community and Clinical Excellence, Fukushima Medical University, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
authors.affiliation: Department of Neurology, Hokkaido University Graduate School of Medicine, Japan.
authors.forename: Hidenao
authors.initials: H
authors.lastname: Sasaki
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D014555:Urination Disorders / Q000150:complications / Q000503:physiopathology*
keywords: Falls; Overactive bladder symptom score; Parkinson's disease; Urinary disturbance