Factors associated with falling in early, treated Parkinson's disease: The NET-PD LS1 cohort

NINDS NET-PD Investigators

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. Objective To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. Methods The LS-1 database included 1741 early treated PD subjects (median 4 year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. Results 728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. Conclusion Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.

Original languageEnglish (US)
Pages (from-to)137-143
Number of pages7
JournalJournal of the Neurological Sciences
Volume377
DOIs
StatePublished - Jun 15 2017

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Accidental Falls
Parkinson Disease
Activities of Daily Living
Logistic Models
National Institute of Neurological Disorders and Stroke
Dopamine Agonists
Statistical Models
Databases

Keywords

  • Falls
  • NET-PD
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Factors associated with falling in early, treated Parkinson's disease : The NET-PD LS1 cohort. / NINDS NET-PD Investigators.

In: Journal of the Neurological Sciences, Vol. 377, 15.06.2017, p. 137-143.

Research output: Contribution to journalArticle

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title = "Factors associated with falling in early, treated Parkinson's disease: The NET-PD LS1 cohort",
abstract = "Background Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. Objective To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. Methods The LS-1 database included 1741 early treated PD subjects (median 4 year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. Results 728 subjects (42{\%}) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. Conclusion Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.",
keywords = "Falls, NET-PD, Parkinson's disease",
author = "{NINDS NET-PD Investigators} and Chou, {Kelvin L.} and Elm, {Jordan J.} and Wielinski, {Catherine L.} and Simon, {David K.} and Aminoff, {Michael J.} and Christine, {Chadwick W.} and Liang, {Grace S.} and Hauser, {Robert A.} and Lewis Sudarsky and Umeh, {Chizoba C.} and Tiffini Voss and Jorge Juncos and Fang, {John Y.} and Boyd, {James T.} and Ivan Bodis-Wollner and Zoltan Mari and Morgan, {John Christopher} and Wills, {Anne Marie} and Lee, {Stephen L.} and Parashos, {Sotirios A.}",
year = "2017",
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T1 - Factors associated with falling in early, treated Parkinson's disease

T2 - The NET-PD LS1 cohort

AU - NINDS NET-PD Investigators

AU - Chou, Kelvin L.

AU - Elm, Jordan J.

AU - Wielinski, Catherine L.

AU - Simon, David K.

AU - Aminoff, Michael J.

AU - Christine, Chadwick W.

AU - Liang, Grace S.

AU - Hauser, Robert A.

AU - Sudarsky, Lewis

AU - Umeh, Chizoba C.

AU - Voss, Tiffini

AU - Juncos, Jorge

AU - Fang, John Y.

AU - Boyd, James T.

AU - Bodis-Wollner, Ivan

AU - Mari, Zoltan

AU - Morgan, John Christopher

AU - Wills, Anne Marie

AU - Lee, Stephen L.

AU - Parashos, Sotirios A.

PY - 2017/6/15

Y1 - 2017/6/15

N2 - Background Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. Objective To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. Methods The LS-1 database included 1741 early treated PD subjects (median 4 year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. Results 728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. Conclusion Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.

AB - Background Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. Objective To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. Methods The LS-1 database included 1741 early treated PD subjects (median 4 year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. Results 728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. Conclusion Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD.

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KW - NET-PD

KW - Parkinson's disease

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