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Abstract
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OBJECTIVE: To examine whether impairment in executive function independently predicts recurrent falls in people with Parkinson's disease (PD).
DESIGN: Prospective cohort study. SETTING: University motor control research laboratory. PARTICIPANTS: A convenience sample of 144 community-dwelling people with PD was recruited from a patient self-help group and movement disorders clinics. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Executive function was assessed with the Mattis Dementia Rating Scale Initiation/Perseveration (MDRS-IP) subtest, and fear of falling (FoF) with the Activities-specific Balance Confidence (ABC) scale. All participants were followed up for 12 months to record the number of monthly fall events.
RESULTS: Forty-two people with PD had at least two falls during the follow-up period, and were classified as recurrent fallers. After accounting for demographic variables and fall history (p= 0.001), multiple logistic regression analysis showed that the ABC scores (p=0.014) and MDRS-IP scores (p=0.006) were significantly associated with future recurrent falls amongst people with PD. The overall accuracy of the prediction was 85.9%. Using the significant predictors identified in multiple logistic regression analysis, a prediction model determined by the logistic function was generated: Z = 1.544 + 0.378 (fall history) - 0.045 (ABC) - 0.145 (MDRS-IP).
CONCLUSION: Impaired executive function is a significant predictor of future recurrent falls in people with PD. Participants with executive dysfunction and greater FoF at baseline had significantly greater risk of sustaining a recurrent fall within the subsequent 12 months.
Language: en |