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Title: Fear of falling can independently predict future falls in people with Parkinson's disease
Authors: Mak, MKY 
Pang, MYC 
Issue Date: 2009
Publisher: John Wiley & Sons
Source: Movement disorder, 2009, v. 24, suppl. 1, Tu-193, p. s267-s268 (Poster) (Abstracts) How to cite?
Journal: Movement disorders 
Abstract: Objective: To examine whether fear of falling could independently predict recurrent falls in people with Parkinson’s disease (PD).
Background: Recurrent falls is common in PD patients and can lead to devastating problems such as fractures and/or head injuries, functional incapacity and higher incidence of institutionalization and mortality rate. Therefore, early identification of potential fallers is needed. Although previous studies have reported that history of fall is a significant fall predictor, it is not a modifiable factor. Identification of modifiable risk factors is essential so that early interventions can be implemented to the needy patients.
Methods: Seventy patients with PD subjects completed the study. Thirty-two patients had at least one fall in the previous 12 months. Most of patients with PD had moderate disease severity (Hoehn and Yahr stage III). Fear of falling was assessed by the activities-specific balance confidence (ABC) scale. PD-specific motor and balance impairment was determined by Unified PD rating scale (UPDRS). Functional mobility was measured by timed-up-and-go (TUG) test. All patients were followed for 12 months by phone interview to register monthly fall incidence.
Results: Fifteen patients reported more than one fall within one year (i.e. recurrent fallers). PD recurrent fallers had significantly higher HY staging score (p50.031), higher UPDRS motor score (p50.003), and lower ABC score (p<0.001) than non-recurrent fallers. Results of stepwise discriminant analysis showed that after adjusting for the fall history (F532.57, P<0.001) and UPDRS motor score (F525.23, P<0.001), ABC score (F518.84, P<0.001) remained as a significant predictor of recurrent falls. We further established a cut-off ABC score of 69 (i.e. 0-100, 0 indicates no confidence and 100 indicates full confidence) had the best sensitivity (93%) in predicting future falls in PD patients.
Conclusions: The results indicate that those with an ABC score <69 at baseline had significantly higher risk of sustaining recurrent falls in the next 12 months. Findings of the present study highlight the importance of considering fear of falling during fall risk assessment in patients with PD.
Description: Thirteenth International Congress of Parkinson's Disease and Movement Disorders, Paris, France, 7-11 June 2009
ISSN: 0743-4618 (print)
1477-3848 (online)
DOI: 10.1002/mds.22628
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