Examining the Association between Recurrent Falls and Comprehensive Parkinson's Disease Subtypes

At least 60% of people with Parkinson’s disease (PD) will fall every year and nearly 70% fall recurrently, many as often as several times a day or week. Identifying those most at risk for recurrent falls is key to improving tailored fall prevention interventions for people with PD. This study investigated the relationship between recurrent falls, clinical characteristics, and PD subtypes using a novel PD subtyping scheme. Participants from the WashU Movement Disorders Research Group with idiopathic PD, at least one complete fall report, and a Clinical Dementia Rating < 1 at baseline were included. Baseline clinical characteristics were used to classify participants into three subtypes: 1) motor only (M); 2) psychiatric & motor (PM); or 3) cognitive & motor (CM). Recurrent falls were defined as two or more reported falls within the past six months. A longitudinal logistic regression was performed to evaluate the relationship between recurrent fall status, PD subtype, and PD duration. A total of 103 participants (M age=69 years) completed 332 fall reports; 126 (38%) reports reported two or more falls, with 206 (62%) reporting one or fewer. A total of 49 participants were classified as M subtype, 12 were PM subtype, and 42 were CM subtype. Participants with the PM or CM subtypes had 6.29 [1.33-29.66; P<0.05] & 3.86 [1.40-10.68; P<0.01] greater odds of experiencing recurrent falls compared to the M subtype, respectively. These findings underscore the importance of examining non-motor contributors to falls in PD, including cognitive and psychiatric factors, to identify those at increased risk of recurrent falls. Furthermore, this knowledge can provide key insights into the stratification of fall risk among people with PD and enable more targeted fall prevention strategies for people with PD at risk for falling.