Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, University College London, Queen Square.
Behav Neurol. 2011;24(3):219-28. doi: 10.3233/BEN-2011-0330.
In the elderly, fear of falling (FoF) can lead to activity restriction and affect quality of life (QoL). Our aim was to identify the characteristics of FoF in Parkinson's disease and assess its impact on QoL. We assessed FoF in 130 patients with Parkinson's disease (PD) on scales measuring perceived self-efficacy in performing a range of activities (FES), perceived consequences of falling (CoF), and activity avoidance (SAFFE). A significant difference was found in FoF between PD patients who had previously fallen and those who had not and between frequent and infrequent fallers. Patient-rated disability significantly influenced FoF. Difficulty in rising from a chair, difficulty turning, start hesitation, festination, loss of balance, and shuffling were the specific mobility problems which were associated with greater FoF in PD. Disability was the main predictor of FoF, additionally depression predicted perceived consequences of falling, while anxiety predicted activity avoidance. The FoF measures explained 65% of the variance of QoL in PD, highlighting the clinical importance of FoF. These results have implications for the clinical management of FoF in PD.
在老年人中，对跌倒的恐惧（FoF）可能导致活动受限并影响生活质量（QoL）。我们的目的是确定帕金森病患者 FoF 的特征，并评估其对 QoL 的影响。我们使用一系列活动中自我效能感评估量表（FES）、跌倒后果感知量表（CoF）和活动回避量表（SAFFE）评估了 130 名帕金森病患者的 FoF。我们发现有跌倒史和无跌倒史的 PD 患者之间以及频繁跌倒者和不频繁跌倒者之间存在 FoF 显著差异。患者自评的残疾程度显著影响 FoF。从椅子上站起来困难、转身困难、启动犹豫、慌张步态、失去平衡和拖曳步态是与 PD 患者 FoF 相关的特定活动障碍。残疾是 FoF 的主要预测因素，此外抑郁预测跌倒后果感知，而焦虑预测活动回避。FoF 测量指标解释了 PD 患者 QoL 变异的 65%，突出了 FoF 的临床重要性。这些结果对 PD 中 FoF 的临床管理具有重要意义。
