Use of Smartphone-Based Ecological Momentary Assessment to Characterize Fall Risk Factors in Parkinson’s Disease

Parkinson’s disease (PD) is a complex, progressive neurodegenerative disorder that significantly impacts both motor and non-motor functions, leading to an increased risk of falls. Approximately 60% of individuals with PD will fall every year and nearly 70% fall recurrently, many as often as several times a day or week. Falls occur from the complex interaction between personal, environmental, and behavioral factors; however, little focus has been given to understanding the environmental and behavioral circumstances of falls in PD. Knowledge of moment-to-moment changes in personal, environmental, and behavioral fall risk factors and subsequent falls may help identify key patterns in fall risk profiles and inform future tailored interventions to prevent falls in PD. Smartphone-based ecological momentary assessment (EMA) is an approach for moment-to-moment data collection that could be applied to understanding how interactions between PD symptoms and environmental and behavioral fall risk factors fluctuate throughout the day and across time. We will use smartphone-based EMA surveys to collect intensive longitudinal data on falls and fall risk factors among adults with PD. We will recruit 50 community-dwelling individuals with PD who have experienced at least two falls in the past year. EMA surveys will collect information about fall risk factors including gait and balance, fear of falling, bradykinesia, and environmental fall hazards. Surveys will be delivered three times per day for 14 days using REDCap mobile surveys. Participants will additionally report comprehensive circumstances of where, when, why, and how they fell each day for 6 weeks using a digital falls diary. Participants will also provide details of any injuries experienced. These findings will generate important knowledge on specific personal, environmental, and behavioral risk factors for falls in PD. This knowledge will enable PD scientists and clinicians to identify and deliver more precise, comprehensive interventions for preventing falls among adults living with PD.