Fall risk factors in Parkinson’s disease

Objective(s): To determine the risk factors of accidental falls in individuals diagnosed with Parkinson’s Disease.

Data Sources: A comprehensive search conducted on PubMed between August 2021 and January 2022. Searches were based on key phrases including: Parkinson’s Disease (PD), accidental falls, postural balance. Searches limited to full free text availability, human subjects, and English language.

Study Selection: A total of 315 articles were selected and further refined using inclusion and exclusion criteria, Six studies were selected detailing factors that had an impact on falls in patients with PD. Inclusion criteria: discussed one or more risk factors for falls in PD, published within the last 10 years, patients diagnosed with PD from a medical doctor or based on UK Brain Bank Criteria. This criteria was applied via multiple reviewers.

Data Extraction: Independent extraction and assessment of the validity of the data was conducted by the authors of this review. Data surrounding risk factors of falling including: Weakness, Impaired Balance, Freezing Gait, Disease duration, Pharmacologic Influences, Fear of Falling, Perceived Disability, Cognitive Impairments, and others (depression, anxiety, comorbidities) was extracted.

Data Synthesis: It appears that impaired postural stability and delayed balance reactions are the most common risk factor for accidental falls in individuals with PD who experienced falls. Weakness, especially of the lower extremity extensors i.e. the quadriceps, further limited participants’ abilities to perform functional mobility leading to future falls. The use of prescription drugs, disease duration, fear of falling, cognitive impairments, perceived disability, and/or other comorbidities such as CVD, depression, or anxiety each played a role in individual studies but were less consistent across the literature.

Conclusions: This review indicates that balance deficits and weakness are two of the largest risk factors for future or recurrent falls in PD. Future research should focus on approaches that benefit postural stability in standing and strength during functional activities in individuals with PD to decrease risk of future falls.

Author(s) Disclosures: there are no conflict of interest associated with this study for any of the authors