title: Long-term risk of falls in an incident Parkinson's disease cohort: the Norwegian ParkWest study.
abstract: The objective of this study is to examine the frequency, development, concomitants, and risk factors of falls in a population-based incident Parkinson's disease (PD) cohort. One hundred eighty-one drug-naïve patients with incident PD and 173 normal controls recruited from the Norwegian ParkWest study were prospectively monitored over 7 years. Information on falls was obtained biannually from patients, and at baseline and after 1, 3, 5, and 7 years of follow-up in control subjects. Generalized estimating equation models for correlated data were applied to investigate concomitant features of falls and risk factors for incident falls during 7 years of follow-up in PD. Overall, 64.1% of patients reported falling during the study period. The 7-year cumulative incidence of falls in non-falling patients at baseline (n = 153) was 57.5%, with a relative risk to controls of at least 3.1 (95% confidence interval 1.5-6.3; p < 0.002). Significant concomitants of falls in patients during the study period were higher age, Unified PD Rating Scale motor score, postural instability and gait difficulties (PIGD) phenotype, dementia, and follow-up time. Higher age at baseline, PIGD phenotype at 1-year visit, and follow-up time were independent risk factors for incident falls during follow-up. Nearly two-thirds of patients in the general PD population experience falls within 7 years of diagnosis, representing a more than threefold increased risk compared to age- and gender-matched controls. Patients with higher age at baseline and early PIGD have the greatest risk of falling and may, therefore, be the prime target of specialized assessment and treatment interventions.
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway. ylvahi@sus.no.|Department of Physical Medicine and Rehabilitation, Stavanger University Hospital, Stavanger, Norway. ylvahi@sus.no.
authors.forename: Ylva Hivand
authors.initials: YH
authors.lastname: Hiorth
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.|Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Guido
authors.initials: G
authors.lastname: Alves
authors.affiliation: Network for Medical Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Jan Petter
authors.initials: JP
authors.lastname: Larsen
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.|Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway.
authors.forename: Jörn
authors.initials: J
authors.lastname: Schulz
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ole-Bjørn
authors.initials: OB
authors.lastname: Tysnes
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.|Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Kenn Freddy
authors.initials: KF
authors.lastname: Pedersen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D009664:Norway / Q000453:epidemiology; D010300:Parkinson Disease / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Cohort study; Epidemiology; Falls; Follow-up study; Parkinson’s disease; Risk factors