Vol. 16 nº 2 - Apr/May/Jun de 2022
Original Article Páginas: 153 a 161

Falls in Parkinson‚?Ts disease: the impact of disease progression, treatment, and motor complications

Authors Danielle Pessoa Lima1,2,3,4; Samuel Brito de-Almeida4; Janine de Carvalho Bonfadini1,2,4; Alexandre Henrique Silva Carneiro2; Jo√£o Rafael Gomes de Luna2; Madeleine Sales de Alencar2; Antonio Brazil Viana-J√ļnior4; Pedro Gustavo Barros Rodrigues4; Isabelle de Sousa Pereira4; Jarbas de S√° Roriz-Filho2; Manoel Alves Sobreira-Neto1,4,5; Pedro Braga-Neto1,4,6

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keywords: Accidental Falls; Parkinson Disease; Gait.

ABSTRACT:
The prevalence of Parkinson‚?Ts disease (PD) tends to increase worldwide in the coming decades. Thus, the incidence of falls is likely to increase, with a relevant burden on the health care system.
OBJECTIVE: The objective of this study was to evaluate clinical factors and drug use associated with falls in PD patients.
METHODS: We conducted a cross-sectional study at the Movement Disorders outpatient clinic of a tertiary hospital in Northeast Brazil. We performed structured interviews to collect sociodemographic and clinical data. Functional capacity was assessed using the Schwab and England Activities of Daily Living Scale and the modified Hoehn and Yahr Staging Scale. We divided the study sample into non-fallers (no falls) and fallers (≥1 fall), and non-recurrent (≤1¬†fall) and recurrent fallers (>1 fall).
RESULTS: The study population comprised 327 PD patients (48% women), with a mean age of 70¬†years. The mean disease duration was 9.9¬Ī6.9 years. The most prevalent comorbidities were depression (47.2%), hypertension (44.0%), and type 2 diabetes mellitus (21.5%). The logistic regression analysis revealed that hallucinations, amantadine, and catechol-O-methyltransferase inhibitors (entacapone) were independently associated with falls in PD patients. Also,¬†hallucinations, dyskinesia, and the use of amantadine were independently associated with recurrent falls.
CONCLUSIONS: Health care providers play an essential role in fall prevention in PD patients, particularly by identifying older adults experiencing dyskinesia and visual hallucinations. Prospective studies should investigate the use of amantadine as a risk factor for falls in PD patients.

 

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