The prevalence of falls among neurological patients is unknown, although disturbances of gait and posture are common. Falls may lead to burdens for the patient, the caregivers and the health system. We designed a prospective study and investigated all patients for a history of falls admitted to a neurological hospital during a 100-day period. Clinical investigation was carried out and several disease specific rating scales were applied. A total of 548 patients were investigated. Of all patients 34% had fallen once or more often during the last twelve months. A disturbance of gait was blamed for the fall in 55%, epileptic seizures in 12%, syncope in 10 % and stroke in 7%. Intrinsic risk factors for falls were high age, disturbed gait, poor balance and a fear of falling. As extrinsic factors we identified the treatment with antidepressants, neuroleptics and different cardiovascular medications, adverse environmental factors in the patients' home and the use of walking aids. Within the diagnoses, falls were most frequent in Parkinson's disease (62 %), syncope (57%) and polyneuropathy (48 %). According to these findings falls in neurological in-patients are twice as frequent as in an age-matched population living in the community. Falls in neurological patients are particularly linked to medication and disorders affecting gait and balance.

The prevalence of gait disorders among neurological inpatients is unknown, although disturbed gait is a common symptom. Gait disorders often lead to loss of independence with restraints for the patients and caregivers and costs for the health system. We designed a prospective study and investigated all patients admitted to a neurological hospital during a 100-day period for the presence of a gait disorder. Clinical investigation and several disease-specific rating scales were carried out for 493 patients. In 60% of the patients, a disturbance of gait was diagnosed. Most frequent diagnoses were stroke (21%), Parkinson's disease (17%), and polyneuropathy (7%). Within these diagnoses, the rate of patients with disturbed gait was high in Parkinson's disease (93%), subcortical arteriosclerotic encephalopathy (85%), and motor neuron disease (83%). Advanced age, dementia, alcohol abuse, and treatment with antiepileptics, neuroleptics, benzodiazepines, and chemotherapeutics were identified as risk factors for a gait disorder. A decline of cognitive function was accompanied by a reduction of walking speed. According to these results, gait disorders are among the most frequent symptoms in neurology.