Evaluating prognostic factors for falls in Parkinson's disease: A sex-based analysis

Introduction Falls are a common and debilitating complication in Parkinson's disease (PD). Previous studies have primarily focused on cohorts with prevalent falls or advanced disease stages. This study assessed risk factors for falls in early-stage falls-naïve cohort stratified by sex. Methods...

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Detalles Bibliográficos
Autores: Murueta-Goyena Larrañaga, Ane, Del Pino Sáez, Rocío, Tijero Merino, Beatriz, Ortuzar Markes, Naiara, Ruiz López, Marta, Fernández Valle, Tamara, Acera Gil, María Ángeles, Ayo Mentxakatorre, Naia, Carmona Abellán, Mar, Gabilondo Cuellar, Iñigo, Gómez Esteban, Juan Carlos
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/72296
Acceso en línea:http://hdl.handle.net/10810/72296
Access Level:acceso abierto
Palabra clave:sex
falls
Parkinson’s disease
longitudinal
cohort study
Descripción
Sumario:Introduction Falls are a common and debilitating complication in Parkinson's disease (PD). Previous studies have primarily focused on cohorts with prevalent falls or advanced disease stages. This study assessed risk factors for falls in early-stage falls-naïve cohort stratified by sex. Methods A total of 172 PD patients (<5 years disease duration) were selected from a registry-based study that reported no falls at baseline. All patients were assessed with a standardized data extraction form and falls were defined according to UPDRS Item 13. Hazard Ratios were calculated with univariable and stepwise multivariable Cox Proportional Hazard regression models. Results Among the study sample, 61 (35.4 %) patients were female. At baseline, female and male PD groups were comparable in terms of age, disease duration, and UPDRS scores, although female PD patients had higher scores for UPDRS IV. Over a mean follow-up period of 3.9 (3.0) years, falls were reported in 13 female (21.3 %) and 18 male (16.2 %) PD patients. In female PD, motor fluctuations (HR [95 %] = 1.8 [1.3 – 2.6], p < 0.001) and postural stability (HR [95 %] = 4.2 [1.6 – 10.6], p = 0.003) emerged as significant predictors for falls, whereas in male PD, stepwise Cox regression selected freezing of gait (HR [95 %] = 2.0 [1.0 – 4.2], p = 0.053) and postural instability (HR [95 %] = 2.2 [0.89 – 5.4], p = 0.089) as the primary predictors for falls, although they were non-significant. Conclusion Our findings suggest that the risk factors for falls differ between female and male early-stage PD patients, which may have important implications for clinical management.