dr n. med. Magdalena Wójcik-Pędziwiatr, Department of Neurology, Jagiellonian University Medical College, 3 Botaniczna St, 31-503 Krakow, Poland, e-mail:
Neurol Neurochir Pol. 2013 Sep-Oct;47(5):431-7. doi: 10.5114/ninp.2013.38223.
BACKGROUND AND PURPOSE: Although Parkinson disease (PD) patients suffer falls more frequently than other old people, only a few studies have focused on identifying the specific risk factors for falls in PD patients. The aim of this study was to assess the incidence and risk factors of falls in a prospective study in comparison to a control group. MATERIAL AND METHODS: One hundred patients with PD were recruited to the study along with 55 gender- and age-matched healthy controls. Both groups were examined twice; the second examination took place one year after the first one. Examination of the PD group included: medical history including falls, neurological examination, assessment of the severity of parkinsonism [Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scale (S and E), Hoehn and Yahr scale (H and Y), Mini-Mental State Examination (MMSE)], Hamilton scale and quality of life scales (SF-36, EQ-5D) and Freezing of Gait Questionnaire (FOG-Q). In both groups falls were recorded over the 12 months. Frequent fallers are defined as having more than 3 falls a year. RESULTS: Over the year falls occurred in 54% of PD patients and 18% of controls. In a prospective study 28% of PD patients fell more frequently than in retrospective analysis. Frequent fallers were found in 20% of patients and in 7% of controls. Fallers showed higher scores in UPDRS, H and Y, S and E, MMSE, and Hamilton scale than non-fallers. Independent risk factors for falls were: age, previously reported falls and higher score in the FOG-Q. CONCLUSIONS: Falls in PD patients occurred three times more frequently than in controls. Independent risk factors for falls were: high score in FOG-Q, older age and presence of falls in medical history.
背景与目的:尽管帕金森病(PD)患者比其他老年人更容易跌倒,但只有少数研究关注 PD 患者跌倒的具体危险因素。本研究旨在通过前瞻性研究评估 PD 患者跌倒的发生率和危险因素,并与对照组进行比较。
材料与方法:本研究共纳入 100 例 PD 患者和 55 名性别和年龄匹配的健康对照者。两组均接受两次检查;第二次检查在第一次检查后一年进行。PD 组的检查包括:病史,包括跌倒史、神经系统检查、帕金森病严重程度评估[统一帕金森病评定量表(UPDRS)、斯瓦伯和英格兰量表(S 和 E)、Hoehn 和 Yahr 量表(H 和 Y)、简易精神状态检查(MMSE)]、汉密尔顿量表和生活质量量表(SF-36、EQ-5D)和冻结步态问卷(FOG-Q)。在两组中,记录了 12 个月内的跌倒情况。频繁跌倒者定义为每年跌倒超过 3 次。
结果:在一年中,54%的 PD 患者和 18%的对照组发生跌倒。在前瞻性研究中,28%的 PD 患者跌倒次数多于回顾性分析。20%的患者和 7%的对照组为频繁跌倒者。跌倒者在 UPDRS、H 和 Y、S 和 E、MMSE 和汉密尔顿量表中的得分均高于非跌倒者。跌倒的独立危险因素为:年龄、既往跌倒史和 FOG-Q 评分较高。
结论:PD 患者跌倒的发生率是对照组的 3 倍。跌倒的独立危险因素为:FOG-Q 评分较高、年龄较大和既往有跌倒史。
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