Citation

Silva de Lima AL, Borm C, Vries NM, Bloem BR. Arq. Neuropsiquiatr. 2019; 77(11): 759-760.

Affiliation

Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Center of Expertise for Parkinson & Movement Disorders; Department of Neurology, Nijmegen, The Netherlands.

Copyright

(Copyright © 2019, Associacao Arquivos De Neuro-Psiquitria)

DOI

10.1590/0004-282X20190164

PMID

31826130

Abstract

Falling is common among people with Parkinson's disease (PD). Because of a common amnesia for falls, capturing falls in real-life is challenging. Despite this challenge, we estimate that about 70% of PD patients experience at least one fall per year, which - according to objective measurements using wearable falls detectors - is about 1.8 times more often than age matched controls. Established risk factors for falling in PD include particularly motor features, such as freezing of gait or balance impairment. The contribution of non-motor symptoms, such as autonomic failure, ophthalmological problems or depression, can be suspected, but is to date much less clear.

In this current edition, Alvarado-Bolaños and colleagues report on the association between non-motor symptoms and fall risk in people with PD. Using a cross-sectional design, they collected retrospective data from a convenience sample of 179 people with PD attending a Movement Disorders clinic in Mexico City. Thirty of these were self-reported fallers (16 of whom were recurrent fallers), and their profile was fairly representative (19 men; mean age 66.7 years), although 13 were surprisingly mildly affected (Hoehn & Yahr stage 1 or 2). Baseline data included presence and severity of motor symptoms (Movement Disorder Society – Unified Parkinson's Disease Rating Scale - MDS-UPDRS) and non-motor symptoms (non-motor symptoms scale - NMSS; and relevant sections of the UPDRS). Bivariate analyses showed that fallers had more non-motor symptoms (mainly in the urinary and miscellaneous domains of the NMSS) compared to non-fallers. However, in a multivariate analysis, non-motor symptoms were no longer predictive of falling; only disease duration and the Postural Imbalance and Gait Disorder (PIGD) type of PD persisted as predictors of falls ...

Language: en