Fear of falling in patients with Parkinson’s disease

Objective. To assess the relationship between the fear of falling in patients with Parkinson’s disease (PD) and clinical factors, the amount of physical activity, the risk of a complicated fall, and the quality of life. Material and methods. The study included 39 female patients with Hoehn and Yahr stage 2—3 PD (66.64±6.79 years) and 27 females without PD (67.76±6.48 years). PD patients were assessed for disease duration, motor function (MDS UPDRS-Part III), and quality of life (PDQ-39). All study participants were assessed for fear of falling according to the ABC (confidence level) and the Falls Efficacy Scale-International (FES-I), the severity of depression (Beck Depression Inventory (BDI)), cognitive status (Montreal Cognitive Assessment (MoCA)), quality of life (EQ-5D-3L), the performance of the necessary physical activity for endurance, strength, and balance; in addition, hand strength was measured, and the probability of fractures (using FRAX tool) was calculated. Results. The sum of FES-I points was greater in patients with PD and was correlated with age, duration of PD, and the points for MDS UPDRS-Part III, BDI, PDQ-39, and EQ-5D-3L. The sum of points for the ABC scale in PD patients did not differ from those in subjects without PD and was correlated with age and the points for MDS UPDRS-Part III, BDI, PDQ-39, EQ-5D-3L, proximal hip fracture risk, and right and left hand strength. Fourteen (38%) PD patients performed the required amount of power load and had a sum of ABC points more than patients who failed this test. Conclusion. Among the elderly, the fear of falling is more pronounced in the presence of PD and is associated with age, duration of PD, motor disorders, and depression. Increased confidence reduces the risk of falls complicated by proximal hip fracture and improves quality of life. In PD patients, the fear of falling is reduced by regularly performing the required amount of physical activity.