TY - JOUR PY - 2014// TI - Impaired executive function can predict recurrent falls in Parkinson's disease JO - Archives of physical medicine and rehabilitation A1 - Mak, Margaret Ky A1 - Wong, Adrian A1 - Pang, Marco Yc SP - 2390 EP - 2395 VL - 95 IS - 12 N2 - 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

LA - en SN - 0003-9993 UR - http://dx.doi.org/10.1016/j.apmr.2014.08.006 ID - ref1 ER -