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Change in fear of falling in Parkinson's disease: a two-year prospective cohort study

Published online by Cambridge University Press:  17 November 2017

Tatjana Gazibara ,
Darija Kisic Tepavcevic ,
Marina Svetel ,
Aleksandra Tomic ,
Iva Stankovic ,
Vladimir S. Kostic  and
Tatjana Pekmezovic
Tatjana Gazibara
Affiliation:
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Darija Kisic Tepavcevic
Affiliation:
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Marina Svetel
Affiliation:
Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Aleksandra Tomic
Affiliation:
Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Iva Stankovic
Affiliation:
Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vladimir S. Kostic
Affiliation:
Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Tatjana Pekmezovic*
Affiliation:
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
*
Correspondence should be addressed to: Professor Tatjana Pekmezovic, MD, PhD, Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, Belgrade 11000, Serbia. Phone/Fax: +381 11 3607062. Email: pekmezovic@sezampro.rs.
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Abstract

Background:

Fear of falling in Parkinson's disease (PD) has been suggested as predictor of future falling. The purpose of this study was to compare fear of falling score after two years of follow-up with those observed at baseline and to assess factors associated with change in fear of falling over time.

Methods:

A total of 120 consecutive persons with PD were recruited and followed for two years. Fear of falling was assessed by using the 10-item Falls Efficacy Scale (FES). Occurrence of falling was registered during the first year of follow-up.

Results:

After two years, the average FES score statistically significantly changed (p = 0.003) from 30.5 to 37.5 out of 100 (increase of 22.9%). We observed that median scores of all FES items, except for “Preparing a meal, not requiring carrying of heavy or hot objects” and “Personal grooming,” significantly increased after two-year follow-up. After accounting for age, gender, PD duration, levodopa dosage, Hoehn and Yayhr stage, Unified Parkinson's Disease Rating Scale score three, depression, anxiety, and falling, we observed that sustaining greater number of falls in the first year of follow-up was associated with higher increase in FES score after two years (odds ratio 3.08, 95% confidence interval 1.30–4.87).

Conclusion:

After two years of follow-up, we observed a decrease in confidence at performing nearly all basic daily activities. Fall prevention programs should be prioritized in management of PD.

Keywords

Parkinson's diseasefallsfear of fallingchangefollow-up
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 1: Issue Theme: Parkinson's Disease , January 2019 , pp. 13 - 20
Copyright
Copyright © International Psychogeriatric Association 2017 

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