Parkinsonian signs are a risk factor for falls

Abstract

Background Parkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs. Objectives To determine the role of parkinsonian signs on fall rates among older adults. Methods We conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls. Results 982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05–1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04–1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04). Conclusions Parkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients.

Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations

“…Arthritis and orthopedic conditions have been shown to associate with MPS. 14,60,69,70 In the Canadian Longitudinal Study of Aging (CLSA), 14 spondylosis or arthritis were associated with higher MDS-UPDRS scores (mean, 1.8 points). In a casecontrol study, 70 a group with orthopedic but no neurological complaints had nearly identical UPDRS-III scores (mean, 5.3; 95% confidence interval [CI], 4.6-5.9) to individuals with MPS (mean, 5.8; 95% CI, 4.6-7.0).…”

Analysis of the fall‐related risk of pharmacotherapy in Czech hospitals: A case control study

“…The patient's health condition is one of the internal risk factors that can be regarded as a signal of fall‐related risk. There are several published studies assessing the fall‐related risk of selected diseases, also discussing preventability in the given cases …”

Vitamin B12 deficiency can be a cause of acute reversible parkinsonism and cognitive impairment in older adults

“…1 In contrast, parkinsonian signs are common among older adults, with prevalence estimates that range from 15% to 40%. 2 Although both vitamin B 12 deficiency and parkinsonism increase with age, the coexistence of them is exceedingly rare in elderly patients. In this report, it is presented that acute parkinsonism related to vitamin B 12 deficiency in an older adult was improved completely with vitamin B 12 supplements.…”

“…Parkinsonism, whose underlying causes are numerous, is a clinical syndrome characterized by tremor, bradykinesia, rigidity and postural instability. 2 Parkinson's disease (PD) is the most common, but a broad range of other causes including some toxins, drugs and metabolic diseases might lead to similar motor symptoms. 2 Parkinsonism secondary to vitamin B 12 deficiency is extremely rare, and the pathophysiology of extrapyramidal signs in patients with a vitamin B 12 deficiency is unclear.…”

“…2 Parkinson's disease (PD) is the most common, but a broad range of other causes including some toxins, drugs and metabolic diseases might lead to similar motor symptoms. 2 Parkinsonism secondary to vitamin B 12 deficiency is extremely rare, and the pathophysiology of extrapyramidal signs in patients with a vitamin B 12 deficiency is unclear. The relationship between the two could be explained by several hypotheses.…”