Predicting falls in Parkinson disease
A step in the right direction
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Falls are only one of many disruptive manifestations of gait disturbance in Parkinson disease (PD); they can be common, and occur at an early stage of disease. Falls are themselves responsible for substantial morbidity; for example, due to injury and loss of confidence.
In this issue of Neurology®, Kerr et al.1 prospectively assessed how various measures predicted future falls in patients with early-stage PD. The results offer important pathophysiologic insights into what causes falls in this population. Over 6 months of follow-up, 48% of patients reported at least one fall (half of whom fell more than once), confirming that falls are common even in those with relatively modest motor impairment. It is notable that several instruments designed to predict falls in the general geriatric population, such as the Physiological Profile Assessment (PPA) and Functional Reach Test, were not suited to predicting falls in PD. Tests that captured the specific deficits of PD, such as the Unified Parkinson's Disease Rating Scale (UPDRS), Freezing of Gait (FOG) questionnaire, and extent …
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