Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.
Philips Research, Department Personal Health, Eindhoven, the Netherlands.
Mov Disord. 2020 Jan;35(1):109-115. doi: 10.1002/mds.27830. Epub 2019 Aug 26.
Falling is among the most serious clinical problems in Parkinson's disease (PD). We used body-worn sensors (falls detector worn as a necklace) to quantify the hazard ratio of falls in PD patients in real life.
We matched all 2063 elderly individuals with self-reported PD to 2063 elderly individuals without PD based on age, gender, comorbidity, and living conditions. We analyzed fall events collected at home via a wearable sensor. Fall events were collected either automatically using the wearable falls detector or were registered by a button push on the same device. We extracted fall events from a 2.5-year window, with an average follow-up of 1.1 years. All falls included were confirmed immediately by a subsequent telephone call. The outcomes evaluated were (1) incidence rate of any fall, (2) incidence rate of a new fall after enrollment (ie, hazard ratio), and (3) 1-year cumulative incidence of falling.
The incidence rate of any fall was higher among self-reported PD patients than controls (2.1 vs. 0.7 falls/person, respectively; P < .0001). The incidence rate of a new fall after enrollment (ie, hazard ratio) was 1.8 times higher for self-reported PD patients than controls (95% confidence interval, 1.6-2.0).
Having PD nearly doubles the incidence of falling in real life. These findings highlight PD as a prime "falling disease." The results also point to the feasibility of using body-worn sensors to monitor falls in daily life. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
跌倒在帕金森病（PD）中是最严重的临床问题之一。我们使用可穿戴传感器（作为项链佩戴的跌倒探测器）来量化 PD 患者在现实生活中的跌倒风险比。
我们根据年龄、性别、合并症和生活条件，将所有 2063 名自述 PD 患者与 2063 名无 PD 患者进行匹配。我们分析了通过可穿戴传感器在家中收集的跌倒事件。跌倒事件通过可穿戴跌倒探测器自动收集，或者通过同一设备上的按钮按下来登记。我们从 2.5 年的窗口中提取跌倒事件，平均随访 1.1 年。所有包括的跌倒事件都通过随后的电话立即确认。评估的结果是（1）任何跌倒的发生率，（2）登记后新发跌倒的发生率（即危险比），以及（3）1 年跌倒累积发生率。
自述 PD 患者的任何跌倒发生率均高于对照组（分别为 2.1 和 0.7 次/人；P <.0001）。登记后新发跌倒的发生率（即危险比）自述 PD 患者是对照组的 1.8 倍（95%置信区间，1.6-2.0）。
患有 PD 使现实生活中跌倒的发生率几乎增加了一倍。这些发现突出了 PD 作为一种主要的“跌倒疾病”。结果还表明使用可穿戴传感器监测日常生活中的跌倒是可行的。© 2019 作者。运动障碍由 Wiley 期刊出版公司代表国际帕金森病和运动障碍协会出版。
