Factors Predicting Falls in Parkinson's Disease: Investigation of Motor, Non-motor Findings and Different Dual Task Activities

Abstract

Objective: The purpose of this study was to identify the predictors of future falls in mild-to-moderate stage Parkinson's disease (PD) without cognitive impairment. We evaluated motor findings, non-motor findings, and different cognitive dual tasks such as memory, attention, and executive functions added to the 10-meter walk test (10MWT), which has been used to measure walking speed in PD. Materials and Methods: A total of 62 subjects were evaluated in terms of eligibility for the study. Thirty-six patients with PD who met the inclusion criteria were included in the study. Demographic characteristics were identified and clinical findings were examined. Motor and non-motor findings were evaluated using the Turkish version of the Movement Disorder Society-Unified PD Rating scale (MDS-UPDRS). Walking speed was measured with the 10MWT as single task and with different cognitive domains added to the 10MWT as cognitive dual task activities. After the initial evaluation, falls within six months were recorded. Results: The previous history of falls, high scores of MDS-UPDRS 1.A, MDS-UPDRS 1.B, and MDS-UPDRS 2, walking speed under a single task (10MWT) and different cognitive (memory, digit span-forwards, digit span-backwards, and serial 7s) dual tasks were significantly different in terms of the future falls within six months (p<0.05). According to the results of multiple logistic regression analysis using these variables, it was observed that the increase in 10MWT speed decreased the risk of future falls by 0.76 times, and an increase in MDS-UPDS 1.B score increased the risk of future falls by 2.06 times. Conclusion: In our study, in which the known risk factors associated with falls in PD were examined together, the risk of falls in patients with mild-to-moderate stage PD without cognitive impairment was found to be predicted by gait speed and the MDS-UPDRS 1.B score, which evaluated non-motor findings such as sleep disorder, sensory problems, and autonomic dysfunction.