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Falls in ambulatory non-demented patients with Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Original Article
  • Published:
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Abstract

This study aimed at determining the prevalence of falling in PD patients, to assess generic and disease-specific clinical and pharmacological factors, relationship with health-related quality of life (HR-QoL) and changes in falls from OFF to ON in patients with motor fluctuations. Six-hundred and eighty-three PD patients of the COPARK survey were evaluated (11 had missing data and were excluded from the analysis). Patients with falls were identified as those with a UPDRS Item 13 ≥ 1 in the ON condition. All patients were assessed in a standardized manner [demographics, treatments, Unified PD Rating Scale (UPDRS), Hospital Anxiety and Depression Scale, Pittsburg questionnaire and HR-QoL scales (SF36, PDQ39)]. Falling was reported by 108/672 (16 %) PD patients during the ON state and prevalence increased according to PD severity, from 5 % in Hoehn and Yahr stage 1–60 % in stage 4. Falling was significantly related to lower HR-QoL. Falling correlated with (1) generic factors such as female gender, age at the end of academic studies and diuretics consumption, (2) motor PD-specific factors including disease severity, frozen gait, difficulties when arising from a chair, dyskinesia and higher levodopa daily equivalent dose and (3) non-motor PD-specific factors such as orthostatic hypotension and hallucinations. Falling was more frequent in OFF than in ON in 48/74 (64 %) patients with motor fluctuations and remained unchanged in 27 patients (36 %). In summary, falling affected a significant proportion of PD patients, especially in advanced stages. It was associated with a variety of generic and PD-specific factors and was related to reduced HR-QoL.

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Acknowledgments

The authors thank the patients who agreed to participate in this study and the Association France-Parkinson for its support. The project was co-funded by unrestricted and unconditional grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé. The project was sponsored and co-financed by LN PHARMA, which participated into the design and conduct of the study; collection, management, and interpretation of the data; and preparation and review of the manuscript.

Conflict of interest

Olivier Rascol reports no disclosures, Santiago Perez-Lloret reports no disclosures, Philippe Damier reports no disclosures, Arnaud Delval reports no disclosures, Pascal Derkinderen reports no disclosures, Alain Destée reports no disclosures, Wassilios Meissner reports that a grant was received by the Bordeaux University Hospital for the project. Francois Tison reports no disclosures, Laurence Negre-Pages reports grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé for funding this project and that she owns stock options from LN PHARMA, which was one of the sponsors of this study.

Author information

Authors and Affiliations

  1. Department of Clinical Pharmacology and Neurosciences, University of Toulouse 3, 37 Allées Jules Guesde, 31000, Toulouse, France

    Olivier Rascol & Santiago Perez-Lloret

  2. INSERM CIC1436 and UMR825, Toulouse, France

    Olivier Rascol

  3. NS-Park Network, INSERM, Toulouse, France

    Olivier Rascol, Philippe Damier, Alain Destée, Francois Tison & Laurence Negre-Pages

  4. Department of Neurology, Hôpital Laënnec, CHU Nantes, Nantes, France

    Philippe Damier & Pascal Derkinderen

  5. Department of Neurology, CHU Lille, Lille, France

    Arnaud Delval & Alain Destée

  6. INSERM U 837 Eq6, Lille, France

    Alain Destée

  7. Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux, Bordeaux, France

    Wassilios G. Meissner & Francois Tison

  8. Institut des Maladies Neurodégénératives, UMR 5293, CNRS, Bordeaux, France

    Wassilios G. Meissner & Francois Tison

  9. Service de Neurologie, CHU de Bordeaux, Bordeaux, France

    Wassilios G. Meissner & Francois Tison

  10. LN Pharma, Toulouse, France

    Laurence Negre-Pages

  11. Laboratory of Epidemiology and Experimental Pharmacology, Institute for Biomedical Research (BIOMED-CONICET), Faculty of Medical Sciences, Pontifical Catholic University of Argentina (UCA), Buenos Aires, Argentina

    Santiago Perez-Lloret

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  1. Olivier Rascol
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  2. Santiago Perez-Lloret
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  3. Philippe Damier
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  4. Arnaud Delval
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  6. Alain Destée
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  7. Wassilios G. Meissner
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  8. Francois Tison
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Corresponding author

Correspondence to Olivier Rascol.

Appendix: List of the French neurologists who participated into the patients’ selection and data collection

Appendix: List of the French neurologists who participated into the patients’ selection and data collection

Author

Degree

Affiliation

F. Tison

MD

University Hospital Bordeaux

W. G. Meissner

MD

University Hospital Bordeaux

U. Spampinato

MD

University Hospital Bordeaux

P. Damier

MD

University Hospital Nantes

P. Derkinderen

MD

University Hospital Nantes

O. Rascol

MD

University Hospital Toulouse

V. Rey-Zermati

MD

General Hospital Narbonne

X. Soulages

MD

General hospital Rodez

C. Azais-Vuillemin

MD

Clinique du Parc, Toulouse

N. Stambouli

MD

General Hospital, Cahors

J. R. Rouane

MD

Clinique Pasteur, Toulouse

A. M. Salandini

MD

Clinique Pasteur, Toulouse

J. M. Boulesteix

MD

General Hospital, Cahors

M. Barreda

MD

Clinique Toulouse Lautrec, Castres

D. Castan

MD

General Hospital Castres

A. Ojero-Senard

MD

University Hospital Toulouse

S. Perez-Lloret

MD

University Hospital Toulouse

G. Angibaud

MD

Clinique pont-de-Chaume, Montauban

J. P. Balague

MD

Clinique pont-de-Chaume, Montauban

A. Danielli

MD

Hopital General, Montauban

N. Attane

MD

Hopital Général, Carcasonne

J. M. Faucheux

MD

Hopital Général, Castres

P. Henry

MD

Clinique Ambroise Paré, Toulouse

M.H Rougie

MD

Private Office Toulouse

B. Jardillier

MD

General hospital Figeac

F Azais

MD

Private Office, Toulouse

L Damase

MD

Private Office, Toulouse

A. Destee

MD

University Hospital Lille

P. Lejeune

MD

Hopital Départemental La- Roche-sur-Yon

JM Delabrousse-Mayoux

MD

Private Office, Bergerac

S. Bonenfant

BSc

University Hospital Toulouse

R. Darmanaden

MD

Hopital Général, Villefranche de Rouergue

A. Robinson

MD

Hopital Général, Carcasonne

E. Gaujard

MD

Private Office, Bordeaux

E. Puymirat

MD

Clinique saint-Augustin, Bordeaux

C. E. Goumard

MD

Private Office, Bordeaux

M. H. Godin

MD

Private Office, Bordeaux

C. Latxague

PhD

University of Bordeaux

C. Deligny

MD

Private practice, Nantes

T. Lebouvier

MD

University Hospital Nantes

C. Lanctin-Garcia

MD

Private practice, Nantes

M. Roy

BSc

University Hospital Nantes

V. Verbist-Talmant

MD

University Hospital Nantes

P. Bertout

MD

Private practice, Saint Nazaire

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Rascol, O., Perez-Lloret, S., Damier, P. et al. Falls in ambulatory non-demented patients with Parkinson’s disease. J Neural Transm 122, 1447–1455 (2015). https://doi.org/10.1007/s00702-015-1396-2

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  • DOI: https://doi.org/10.1007/s00702-015-1396-2

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