Objective:

To investigate the relationship between various neurological exam findings and number of falls in patients with Parkinson’s Disease 

Background:

Parkinson’s Disease (PD) has significant effect on patient ability to ambulate. Difficulty in ambulating is often associated with patient falls. Findings of various studies estimate that 38 to 87% of patients with PD experience falls. A history of previous falls, disease duration, and dementia have been identified as independent predictors of falling in PD patients. As patient falls can result in detrimental consequences, such as fractures or head trauma, identifying patients at increased risk of falls is essential. This study sought to examine if components of the neurological exam were associated with an increased number of patient falls. 

Design/Methods:

Data regarding neurological exam findings and reported number of patient falls were extracted from the most-recent visit of 242 patients charts at a single treatment center. All neurological exams were completed by one movement disorder specialist. Statistics were calculated using SPSS.

Results:

A higher UPDRS gait score was associated with an increased number of falls (beta=.62, p=.005). A gait score of 0 predicted 2.32 falls/month. A gait score of 4 predicted 8.16 falls/month. A higher UPDRS postural instability score was also associated with a higher number of falls (beta=0.42, p=.003). A instability score of 0 predicted 1.33 falls/month. An instability score of 4 predicted 8.42 falls/month. Utilizing the revised neuropathy disability score, PD patients with a clinical diagnosis of neuropathy did not have more falls than patients without neuropathy (p=0.537). 

Conclusions:

Various components of the UPDRS neurological exam can be utilized to discuss fall risk with patients and guide actions to decrease fall risk. Although neuropathy on its own is a predictor of fall risk, it did not result in an additional need to address fall risk in our PD patient population.