Falls and Their Associated Risks in Parkinson's Disease Patients in Nigeria

Temitope Hannah Farombi, Mayowa O Owolabi, Adesola Ogunniyi, Temitope Hannah Farombi, Mayowa O Owolabi, Adesola Ogunniyi

Abstract

Objective: Falls are a devastating consequence of Parkinson's disease (PD) and are due to motor imbalance. However, the frequency of falls and their risk factors among Nigerians with PD is not known despite the significant increase in PD cases in the country. To assess fall risk factors and frequency in Nigerian PD patients.

Methods: Using an analytical design to compare falling versus non-falling patients, 81 PD patients were assessed for clinical factors, frequency of falls, and candidate risk factors for falls according to the Tinetti Balance and Gait, Unified Parkinson's Disease Rating Scale subsection 1, and Timed Up and Go Tests. Descriptive, bivariate, and multivariate analyses were performed at the 95% confidence level.

Results: The mean age of participants was 65.6 ± 9.7 years. Falls were about three times (p < 0.001) more common in PD patients. Of the falling patients, 67.7% sustained injuries, 67.7% had recurrent falls and 44.9% admitted to having a fear of falling. The independent statistical predictors of fall were fear of falling [odds ratio (OR): 3.86], disease severity (OR: 1.09) and disease duration (OR: 1.01).

Conclusion: The frequency of falls in PD patients was significantly higher when compared with the healthy adult population, and the modifiable predictor was fear of falling with a potential to significantly reduce falls when strategically addressed.

Keywords: Nigeria; Parkinson’s disease; Sub-Saharan Africa; falls; risk factors.

Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1.
Figure 1.
Risk of fall among fallers and non-fallers using Tinneti scale.

References

    1. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002;72:721–725.
    1. Snijders AH, Nonnekes J, Bloem BR. Recent advances in the assessment and treatment of falls in Parkinson’s disease. F1000 Med Rep. 2010;2:76.
    1. Mak MK, Pang MY. Parkinsonian single fallers versus recurrent fallers: different fall characteristics and clinical features. J Neurol. 2010;257:1543–1551.
    1. Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson’s disease: characteristics of fallers and non-fallers. Age Ageing. 2001;30:47–52.
    1. Pickering RM, Grimbergen YA, Rigney U, Ashburn A, Mazibrada G, Wood B, et al. A meta-analysis of six prospective studies of falling in Parkinson’s disease. Mov Disord. 2007;22:1892–1900.
    1. Gray P, Hildebrand K. Fall risk factors in Parkinson’s disease. J Neurosci Nurs. 2000;32:222–228.
    1. Rudzińska M, Bukowczan S, Stożek J, Zajdel K, Mirek E, Chwała W, et al. Causes and consequences of falls in Parkinson disease patients in a prospective study. Neurol Neurochir Pol. 2013;47:423–430.
    1. Grimbergen YA, Schrag A, Mazibrada G, Borm GF, Bloem BR. Impact of falls and fear of falling on health-related quality of life in patients with Parkinson’s disease. J Parkinsons Dis. 2013;3:409–413.
    1. Contreras A, Grandas F. Risk of falls in Parkinson’s disease: a cross-sectional study of 160 patients. Parkinsons Dis. 2012;2012:362572.
    1. Koller WC, Glatt S, Vetere-Overfield B, Hassanein R. Falls and Parkinson’s disease. Clin Neuropharmacol. 1989;12:98–105.
    1. Ashburn A, Stack E, Pickering RM, Ward CD. Predicting fallers in a community-based sample of people with Parkinson’s disease. Gerontology. 2001;47:277–281.
    1. Schaafsma JD, Giladi N, Balash Y, Bartels AL, Gurevich T, Hausdorff JM. Gait dynamics in Parkinson’s disease: relationship to Parkinsonian features, falls and response to levodopa. J Neurol Sci. 2003;212:47–53.
    1. Balash Y, Peretz C, Leibovich G, Herman T, Hausdorff JM, Giladi N. Falls in outpatients with Parkinson’s disease: frequency, impact and identifying factors. J Neurol. 2005;252:1310–1315.
    1. Matinolli M, Korpelainen JT, Korpelainen R, Sotaniemi KA, Virranniemi M, Myllylä VV. Postural sway and falls in Parkinson’s disease: a regression approach. Mov Disord. 2007;22:1927–1935.
    1. Foreman KB, Addison O, Kim HS, Dibble LE. Testing balance and fall risk in persons with Parkinson disease, an argument for ecologically valid testing. Parkinsonism Relat Disord. 2011;17:166–171.
    1. Landers MR, Backlund A, Davenport J, Fortune J, Schuerman S, Altenburger P. Postural instability in idiopathic Parkinson’s disease: discriminating fallers from nonfallers based on standardized clinical measures. J Neurol Phys Ther. 2008;32:56–61.
    1. Robinson K, Dennison A, Roalf D, Noorigian J, Cianci H, Bunting-Perry L, et al. Falling risk factors in Parkinson’s disease. NeuroRehabilitation. 2005;20:169–182.
    1. Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zwinderman AH. Prospective assessment of falls in Parkinson’s disease. J Neurol. 2001;248:950–958.
    1. Kerr GK, Worringham CJ, Cole MH, Lacherez PF, Wood JM, Silburn PA. Predictors of future falls in Parkinson disease. Neurology. 2010;75:116–124.
    1. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79:368–376.
    1. World Health Organization . Falls (WHO Fact Sheet No. 344) Geneva: World Health Organization; 2012. [cited 2015 Jul 23] Available from: .
    1. Akinyemi RO, Okubadejo NN, Akinyemi JO, Owolabi MO, Owolabi LF, Ogunniyi A. Cognitive dysfunction in Nigerians with Parkinson’s disease. Mov Disord. 2008;23:1378–1383.
    1. Dibble LE, Lange M. Predicting falls in individuals with Parkinson disease: a reconsideration of clinical balance measures. J Neurol Phys Ther. 2006;30:60–67.
    1. Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331:821–827.
    1. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–126.
    1. Verghese J, Holtzer R, Lipton RB, Wang C. Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci. 2009;64:896–901.
    1. Horak FB, Dimitrova D, Nutt JG. Direction-specific postural instability in subjects with Parkinson’s disease. Exp Neurol. 2005;193:504–521.
    1. Allcock LM, Rowan EN, Steen IN, Wesnes K, Kenny RA, Burn DJ. Impaired attention predicts falling in Parkinson’s disease. Parkinsonism Relat Disord. 2009;15:110–115.
    1. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007;297:77–86.
    1. Okubadejo NU, Bower JH, Rocca WA, Maraganore DM. Parkinson’s disease in Africa: a systematic review of epidemiologic and genetic studies. Mov Disord. 2006;21:2150–2156.
    1. Femi OL, Ibrahim A, Aliyu S. Clinical profile of parkinsonian disorders in the tropics: experience at Kano, north-western Nigeria. J Neurosci Rural Pract. 2012;3:237–241.
    1. Moreno Catalá M, Woitalla D, Arampatzis A. Recovery performance and factors that classify young fallers and non-fallers in Parkinson’s disease. Hum Mov Sci. 2015;41:136–146.
    1. Cole MH, Silburn PA, Wood JM, Worringham CJ, Kerr GK. Falls in Parkinson’s disease: kinematic evidence for impaired head and trunk control. Mov Disord. 2010;25:2369–2378.
    1. Adkin AL, Frank JS, Jog MS. Fear of falling and postural control in Parkinson’s disease. Mov Disord. 2003;18:496–502.
    1. Williams DR, Watt HC, Lees AJ. Predictors of falls and fractures in bradykinetic rigid syndromes: a retrospective study. J Neurol Neurosurg Psychiatry. 2006;77:468–473.

Source: PubMed

3
Se inscrever