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A Meta-Analysis of Six Prospective Studies of Falling in Parkinson's Disease

Pickering, Ruth M., Grimbergen, Yvette A. M., Rigney, Una, Ashburn, Ann, Mazibrada, Gordon, Wood, Brian, Gray, Peggy, Kerr, Graham K., & Bloem, Bastiaan R. (2007) A Meta-Analysis of Six Prospective Studies of Falling in Parkinson's Disease. Movement Disorders, 22(13), pp. 1892-1900.

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Abstract

Recurrent falls are a disabling feature of Parkinson's disease (PD). We have estimated the incidence of falling over a prospective 3 month follow-up from a large sample size, identified predictors for falling for PD patients repeated this analysis for patients without prior falls, and examined the risk of falling with increasing disease severity. We pooled six prospective studies of falling in PD (n = 473), and examined the predictive power of variables that were common to most studies. The 3-month fall rate was 46% (95% confidence interval: 38-54%). Interestingly, even among subjects without prior falls, this fall rate was 21% (12-35%). The best predictor of falling was two or more falls in the previous year (sensitivity 68%; specificity 81%). The risk of falling rose as UPDRS increased, to about a 60% chance of falling for UPDRS values 25 to 35, but remained at this level thereafter with a tendency to taper off towards later disease stages. These results confirm the high frequency of falling in PD, as almost 50% of patients fell during a short period of only 3 months. The strongest predictor of falling was prior falls in the preceding year, but even subjects without any prior falls had a considerable risk of sustaining future falls. Disease severity was not a good predictor of falls, possibly due to the complex U-shaped relation with falls. Early identification of the very first fall therefore remains difficult, and new prediction methods must be developed.

Impact and interest:

155 citations in Scopus
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134 citations in Web of Science®

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ID Code: 14218
Item Type: Journal Article
Additional Information: For more information, please refer to the journal's website (see hypertext link) or contact the author.
Keywords: falling, prediction, sensitivity, specificity, Parkinson's disease, meta, analysis, UPDRS
DOI: 10.1002/mds.21598
ISSN: 0885-3185
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2007 John Wiley & Sons
Deposited On: 30 Jul 2008
Last Modified: 29 Feb 2012 23:38

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