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. 2024 Apr;124(2):395-406.
doi: 10.1007/s13760-023-02428-2. Epub 2023 Nov 28.

Prognostic factors for falls in Parkinson's disease: a systematic review

Ane Murueta-Goyena  1   2 , Oier Muiño  3 , Juan Carlos Gómez-Esteban  4   5   6
Affiliations

Prognostic factors for falls in Parkinson's disease: a systematic review

Ane Murueta-Goyena et al. Acta Neurol Belg. 2024 Apr.

Abstract

Background: Falls represent a critical concern in Parkinson's disease (PD), contributing to increased morbidity and reduced quality of life.

Purpose: We conducted a systematic review to assess the prognostic factors associated with falls in PD, aiming to provide a comprehensive overview of relevant demographic and clinical parameters, and aid neurologists in identifying subsets of PD patients most susceptible to falls and associated injuries.

Methods: PubMed and Web of Science databases were searched for prospective studies assessing factors associated with falls in ambulatory PD patients across different settings, from inception to August 2023. Data extraction was conducted using CHARMS-PF checklist and risk of bias was assessed with QUIPS tool. PRISMA guidelines were followed.

Results: The initial search yielded 155 references. Thirty-four studies, involving a total of 3454 PD patients, were included in the final analysis. The mean pooled age was 67.6 years, and 45.1% were women. PD patients presented mild motor impairment (UPDRS III score 27.8) with mean pooled disease duration of 5.7 years. Gait and balance disorders and history of prior falls emerged as the most consistent predictors of falls across studies. Disease duration, disease severity, dysautonomic symptoms, freezing of gait, frontal cognitive functions, and PD medication dosages yielded inconsistent findings. Conversely, dyskinesias, age, sex, and depression were unrelated to future falls in PD. Logistic regression models were most commonly employed to identify factors significantly associated with falls in PD. Substantial heterogeneity prevailed in the inclusion of confounding factors.

Conclusion: The evidence suggests that previous history of falls, gait disorders, and poor balance are robust prognostic markers for falls in PD.

Keywords: Balance; Falls; Freezing of gait; Gait; Parkinson’s disease; Prognostic factors.

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Conflict of interest statement

The authors have not received any funding from any institution, including personal relationships, interests, grants, employment, affiliations, patents, inventions, honoraria, consultancies, royalties, stock options/ownership, or expert testimony for the last 12 months.

Figures

Fig. 1
Fig. 1
PRISMA flowchart for the study selection
Fig. 2
Fig. 2
Number of prognostic factors included in the studies from this systematic review
Fig. 3
Fig. 3
Risk of bias assessment with QUIPS tool
See this image and copyright information in PMC

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