@article{ref1,
title="Disability is an independent predictor of falls and recurrent falls in people with Parkinson's disease without a history of falls: a one-year prospective study",
journal="Journal of Parkinson's disease",
year="2015",
author="Almeida, Lorena R. S. and Sherrington, Catherine and Allen, Natalie E. and Paul, Serene S. and Valença, Guilherme T. and Oliveira-Filho, Jamary and Canning, Colleen G.",
volume="5",
number="4",
pages="855-864",
abstract="BACKGROUND: Predictors of falls in people with Parkinson's disease (PD) who have not previously fallen are yet to be identified. <br><br>OBJECTIVES: We aimed to identify predictors of all falls and recurrent falls in people with PD who had not fallen in the previous year and to explore the timing of falls in a 12-month follow-up period. <br><br>METHODS: Participants with PD (n = 130) were assessed by disease-specific, self-report and balance measures. Falls were recorded prospectively for 12 months. Univariate and multivariate analyses were performed. Kaplan-Meier survival analysis was used to investigate time to falling. <br><br>RESULTS: Forty participants (31%) had ≥1 fall during follow-up and 21 (16%) had ≥2 falls. Disability, reduced balance confidence and greater concern about falling were associated with ≥1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with ≥2 falls (p <  0.05). Disability (Schwab and England scale, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39-0.80; p = 0.002) was associated with ≥1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55-0.76; p = 0.005). Disability (Unified Parkinson's Disease Rating Scale activities of daily living, OR = 1.20; 95% CI 1.07-1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95-1.30; p = 0.19) were associated with ≥2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60-0.84, p = 0.001).Recurrent fallers experienced their first fall earlier than single fallers (p <  0.05). <br><br>CONCLUSIONS: Self-reported disability was the strongest single predictor of all falls and recurrent falls.<p /> <p>Language: en</p>",
language="en",
issn="1877-7171",
doi="10.3233/JPD-150651",
url="http://dx.doi.org/10.3233/JPD-150651"
}