scholarly journals Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jacek Wilczyński ◽  
Magdalena Ścipniak ◽  
Kacper Ścipniak ◽  
Kamil Margiel ◽  
Igor Wilczyński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Risk ◽  
Fear Of Falling ◽  
External Factors ◽  
Low Risk ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( χ 2 = 31.86 , p < 0.001 ), number of falls ( χ 2 = 37.92 , p < 0.001 ), independence of the subjects ( χ 2 = 19.28 , p < 0.001 ), type of injury suffered during the fall ( χ 2 = 36.93 , p < 0.001 ), external factors ( χ 2 = 33.36 , p < 0.001 ), and the level of fear of falling ( χ 2 = 8.88 , p < 0.001 ). A significant relationship also occurred between the number of falls and the fear of falling ( χ 2 = 33.49 , p < 0.001 ) and between the number of falls and disease severity ( χ 2 = 45.34 , p < 0.001 ). The applied physiotherapy did not reduce the risk of falls ( χ 2 = 3.18 , p = 0.17 ). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.

scholarly journals Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly

2019 ◽  
Vol 12 ◽  
pp. 117954411988493 ◽  
Author(s):  
Anneli Teder-Braschinsky ◽  
Aare Märtson ◽  
Marika Rosenthal ◽  
Pille Taba
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Knee Osteoarthritis ◽  
The Elderly ◽  
Control Group ◽  
Increased Risk ◽  
Symptomatic Knee ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.

scholarly journals Risk of Falls in Parkinson’s Disease: A Cross-Sectional Study of 160 Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Ana Contreras ◽  
Francisco Grandas
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Risk ◽  
Cross Sectional Study ◽  
Operating Characteristics ◽  
Balance Test ◽  
Cross Sectional ◽  
Risk Of Falls ◽  
Risk Factors For Falling

Falls are a major source of disability in Parkinson’s disease. Risk factors for falling in Parkinson’s disease remain unclear. To determine the relevant risk factors for falling in Parkinson’s disease, we screened 160 consecutive patients with Parkinson’s disease for falls and assessed 40 variables. A comparison between fallers and nonfallers was performed using statistical univariate analyses, followed by bivariate and multivariate logistic regression, receiver-operating characteristics analysis, and Kaplan-Meier curves. 38.8% of patients experienced falls since the onset of Parkinson’s disease (recurrent in 67%). Tinetti Balance score and Hoehn and Yahr staging were the best independent variables associated with falls. The Tinetti Balance test predicted falls with 71% sensitivity and 79% specificity and Hoehn and Yahr staging with 77% sensitivity and 71% specificity. The risk of falls increased exponentially with age, especially from 70 years onward. Patients aged >70 years at the onset of Parkinson’s disease experienced falls significantly earlier than younger patients.

Prospective Study of Falls and Risk Factors for Falls in Adults With Advanced Cancer

2012 ◽  
Vol 30 (17) ◽  
pp. 2128-2133 ◽  
Author(s):  
Carol A. Stone ◽  
Peter G. Lawlor ◽  
George M. Savva ◽  
Kathleen Bennett ◽  
Rose Anne Kenny
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Advanced Cancer ◽  
Proportional Hazards ◽  
Primary Brain Tumor ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Palliative Care Services ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Purpose Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients. Patients and Methods Patients admitted consecutively to community and inpatient palliative care services with metastatic or locoregionally advanced cancer who were mobile without assistance were recruited. Risk-factor assessment was conducted on initial encounter. Patients underwent follow-up via weekly telephone contact for 6 months or until time of fall or death. Relationship between covariates and time to fall was examined using hazard ratios (HRs) derived from univariate and multivariate Cox proportional hazards models. Results Of 185 participants (52.4% men; mean age 68 ± standard deviation of 12.6 years), 50.3% fell; 35 (53%) of 66 participants age < 65 years and 58 (48.7%) of 119 age ≥ 65 years fell; 61.3% of falls occurred in the community; 42% resulted in injury. Median time to fall was 96 days (95% CI, 64.66 to 127.34). Primary brain tumor or brain metastasis (HR 2.5; P = .002), number of falls in the preceding 3 months (HR, 1.27; P = .005), severity of depression (HR, 1.12; P = .012), benzodiazepine dose (HR, 1.05; P = .004), and cancer-related pain (HR, 1.96; P = .024) were independently associated with time to fall in multivariate analysis. Conclusion Fifty percent of adults with advanced cancer, regardless of age, will experience a fall associated with high risk of physical injury. There is a compelling need to assess the efficacy of assessment and management of modifiable fall risk factors in patients with advanced cancer.

scholarly journals Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

2021 ◽  
Author(s):  
Catarina Pereira ◽  
Hugo Rosado ◽  
Gabriela Almeida ◽  
Jorge Bravo
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
High Risk ◽  
Fall Prevention ◽  
Dynamic Performance ◽  
Community Dwelling ◽  
Low Risk ◽  
Falling Risk ◽  
Risk Factors For Falls ◽  
Community Dwelling Older Adults

Abstract Background: Several models and algorithms were designed to identify older adults at risk of falling supported on an intrinsically and extrinsically traditional approach. However, the dynamic interaction between multiple risk factors for falls must be considered. The present study aimed to design a dynamic performance-exposure algorithm for falling risk assessment and fall prevention in community-dwelling older adults.Methods: The study involved 1) a cross-sectional survey assessing retrospective falls, performance-related risk factors for falls (sociodemographic such as gender and age, cognitive, health conditions, body composition, physical fitness, and dual-task outcomes), exposure risk factors (environmental hazards and (in)physical activity), and performance-exposure risk factors (affordance perception), and 2) follow-up survey assessing prospective falls. Participants were Portuguese community dwellings (≥ 65 years). Data were reported based upon descriptive statistics, curve estimation regression, binary logistic regression, and ROC curve.Results: The selected and ordered outcomes included in the algorithm and respective cutoffs were: (1) falls in previous year (high risk: n>1, moderated: n=1, low risk: n=0); (2) health conditions (high risk: n >3, moderated: n=3, low risk: n<3); (3) multidimensional balance (high risk: score <32 points, moderated risk: 32 points ≤ score ≤33 points, low risk: score>33); (4) lower body strength (high risk: rep/30s< 11, moderated risk: 11≤ rep/30s ≤14, low risk: rep/30s >4); (5) perceiving action boundaries (high risk: overestimation bias, moderated risk: not applied, low risk: underestimation bias); (6) fat body mass (high risk: % fat >38, moderated risk: 37≤ % fat ≤38, low risk: % fat <7); (7) environmental hazards (high risk: n>5, moderated risk: n=5, low risk: n<5); (8) rest period (high risk: hours/day >4.5, moderated risk: 4≤ hours/day ≤4.5, low risk: hours/day <4); (9) physical activity metabolic expenditure (high risk: MET-min/week <2300 or >5200, moderated risk: 2300≤ MET-min/week <2800, low risk: 2800≤ MET-min/week ≤5200).Conclusions: Results demonstrated a dynamic relationship between older adults’ performance capacity and the exposure to falls opportunity, supporting the build algorithm’s conceptual framework. Fall prevention measures should consider the above factors that most contribute to the individual risk of falling, relative weights, and their distance from low-risk value, as proposed in the dynamic algorithm.

High risk factors for valvular heart disease from dopamine agonists in patients with Parkinson’s disease

2008 ◽  
Vol 116 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Tomoko Oeda ◽  
Motoko Masaki ◽  
Kenji Yamamoto ◽  
Eiji Mizuta ◽  
Naoyuki Kitagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Heart Disease ◽  
High Risk ◽  
Valvular Heart Disease ◽  
Dopamine Agonists ◽  
High Risk Factors

scholarly journals Risk factors for falls in patients with arterial hypertension

2019 ◽  
Vol 16 (4) ◽  
pp. 45-51
Author(s):  
Natalia O Khovasova ◽  
Anton V Naumov ◽  
Olga N Tkacheva ◽  
Victoriya I Moroz
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
High Risk ◽  
Arterial Hypertension ◽  
The Elderly ◽  
Elderly Persons ◽  
Target Values ◽  
Risk Of Falls ◽  
Common Risk Factors ◽  
Risk Factors For Falls

Falls are a serious multi-factorial problem faced by the elderly persons which is associated with serious complications, loss of functional autonomy, disability and death. One of the common comorbidities among the elderly persons is arterial hypertension (AH) which increases the risk of falls. Aim. To study the risk factors for falls among patients with AH. Materials and methods. Examined 155 patients of geriatric department with the presence of at least one fall in the last year: 133 (85.8%) women (75,29±8.31 years) and 22 (14.2%) men (79,14±4.64 years). Risk of falls and risk factors of falls were assessed in patients with AH. Results. 148 (95.5%) patients had AH. The most common risk factors for hypertension in the elderly were atherosclerosis and decreased physical activity. Target organ lesions of varying severity were observed in all patients. In 25.7% of cases, BP figures outside the target values were noted. 18 (12.2%) patients received hypotensive therapy irregularly. On avera-ge, at admission, patients received of 2.06±0.63 anti-hypertensive drug. The frequency of falls in patients with hypertension made up 2.59±2.2, two or more falls happened in 91 persons (61.5%). According to the self-assessment risk of falls scale 131 (88.5%) patients had a high risk of falls. A high risk of falling in hospital (on the Morse scale) was identified in 63 (42.6%) patients. The most common risk factors for falls in patients with AH were previous falls in anamnesis, sensory de-ficit, imbalance, osteoarthritis. The CGA results demonstrate that patients with hypertension with blood pressure below the target values in comparison with the target and even high numbers of blood pressure have a higher prevalence of frailty, worse indicators of functional status, higher incidence and high risk of falls on the Morse scale. Conclusion. The most common risk factors for falls among patients with AH are previous falls in anamnesis, sensory deficit, imbalance, osteoarthritis. For patients with hypertension, low blood pressure is a predictor of high risk of falls and a worse prognosis. When blood pressure is below the target, there is a higher prevalence of frailty and worse indicators of functional status, which is a poor prognostic sign for the elderly.

scholarly journals Perception of elderly related to the risk of falls and their associated factors

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Bruna Soares Vasques Blaz ◽  
Rosemeiry Capriata de Souza Azevedo ◽  
Daniela Luzia Zagoto Agulhó ◽  
Annelita Almeida Oliveira Reiners ◽  
Neuber José Segri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Perception ◽  
Low Income ◽  
Social Group ◽  
Significant Proportion ◽  
The Elderly ◽  
Low Risk ◽  
Mato Grosso ◽  
Risk Of Falls ◽  
Risk Factors For Falls

ABSTRACT Objective: To analyze the association of the perception of the elderly on the risk factors for falls. Methods: An Analytical cross-sectional study with 190 elderly from the Healthy Longevity Program of a public university in Mato Grosso, from May to August 2016. The collection wasdone through a structured interview and vignettes. Performed descriptive and bivariate analyzes - Pearson chi-square test (x2) significance level of 5%. The crude and adjusted prevalence ratios (PR), with confidence intervals (95%), were also estimated, followed by Poisson multiple regression. Results: Of the participants, 64.2% had a satisfactory perception about the risk factors for falls. The prevalence of unsatisfactory risk perception was 105% higher in those with income from 1 to 3 minimum wages, 75% higher in those with low risk of falls and 46% higher in those who did not attend another social group. Conclusion and implications for the practice: A significant proportion of the elderly have an unsatisfactory risk perception for the risk factors for falls associated with low income, not attending another social group and the low risk of falls. Knowledge about the risk perception of falls in the elderly helps nurses to plan and implement fall prevention programs for this population.

scholarly journals The Effect of Parkinson’s Disease on the Step Response to a Backwards Pull

2008 ◽  
Author(s):  
Molly A. McVey ◽  
Antonis P. Stylianou ◽  
Carl W. Luchies ◽  
Kelly E. Lyons ◽  
Rajesh Pahwa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Economic Impacts ◽  
Postural Instability ◽  
Step Response ◽  
Risk Of Falling ◽  
Effective Interventions ◽  
Increased Risk

Postural instability is one of the most disabling symptoms of Parkinson’s disease (PD) and often leads to falls. Falls can have severe physical, psychological, and economic impacts including fractures, fear of falling, and loss of independence [1]. Effective interventions to reduce fall risk exist [2, 3] and would be most effective if they could be implemented prior to a fall occurring. Unfortunately, the current methods to evaluate postural instability in PD are not sensitive enough to predict those who are at an increased risk of falling so it is difficult to identify the best time to begin fall interventions.

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