Frequency and Risk Factors Association of Fall Among the Idiopathic Parkinson’s Patients in Jashore, Bangladesh
American Journal of Internal Medicine
Volume 7, Issue 2, March 2019, Pages: 36-40
Received: Mar. 28, 2019;
Accepted: May 5, 2019;
Published: May 30, 2019
Views 442 Downloads 87
Goutam Kumar Acherjya, Upazila Health Complex, Bagherpara, Jashore, Bangladesh
Mohammad Ali, Department of Hematology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
Mostofa Kamal, Department of Medicine, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh
Rajashish Chakkraborty, Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Md Anwar Shahadat, Zakia Wahid Hossain Medical Care, Jamaica, New York, United States of America
AV Srinivashan, Institute of Neurology, Madras Medical College and Research Institute, Chennai, Tamil Nadu, India
Parkinson’s disease is the second most common neuro degenerative disease worldwide. Fall is common scenario in our day to day clinical practice among the older people but it is more common among the Parkinson’s people. The study was conducted to assess the frequency of fall and to ascertain the risk association among the idiopathic Parkinson’s patients. This observational study was conducted from July to December, 2018 in the district of Jashore, Bangladesh. Both the male and female clinically diagnosed as idiopathic Parkinson’s disease without taking antiparkinsonian medication were recruited in the study. Those having Parkinson’s disease due to stroke or secondary causes, orthostatic hypotension, taking anti parkinsonian drugs and the drugs may mimicking Parkinson’s disease were excluded from the study. A total 111 patients were analyzed of which 69.4% (N=77) male and 30.6% (N=34) female with the mean age of our participants was 66±10 years. The event of fall among the idiopathic Parkinson’s patients was 36.9% in the last one year where single, two and three or more episodes of fall were 20.7%, 3.6% and 12.6% respectively. No significant difference observed between faller and non-fallers among different demographic characteristics including age (p: 0.091) sex (p: 0.058) educational level (p: 0.235), occupational status (p: 0.220) and residency (p: 0.547). Experience of fall found more in high BMI (p: 0.037), hypertensive (p: 0.018), diabetic (p: 0.009) and in patients receiving multiple medications (p: 0.011). But duration of Parkinsonism (p: 0.835) does not increase fall. Based on this study, we have found that there is high frequency of fall among the idiopathic Parkinson’s patients. So, earlier identification and potential strategies to remove the risk factors may prevent falls and falls related events, thus finally reducing the morbidity and mortality in the Parkinson’s patients.
Goutam Kumar Acherjya,
Md Anwar Shahadat,
Frequency and Risk Factors Association of Fall Among the Idiopathic Parkinson’s Patients in Jashore, Bangladesh, American Journal of Internal Medicine.
Vol. 7, No. 2,
2019, pp. 36-40.
Tinetti ME, Williams CS. Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home. The New England Journal of Medicine. 1997; 337: 1279–1284.
Thurman DJ, Stevens JA, Rao JK. Practice Parameter: Assessing patients in a neurology practice for risk of falls: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008; 70: 473–479.
Farombi TH, Owolabi MO, Ogunniyi A. Falls and Their Associated Risks in Parkinson’s disease Patients in Nigeria. Journal of Movement Disorders. 2016; 9 (3): 160-165.
Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson's disease: a systematic review. Parkinsons Dis. 2013; 2013: 906274.
Torsney KM, Noyce AJ, Doherty KM, Bestwick JP, Dobson R, Lees AJ. Bone health in Parkinson's disease: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2014; 85: 1159–1166.
van der Marck MA, Klok MP, Okun MS, Giladi N, Munneke M, Bloem BR, Falls Task Force NPF. Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s disease. Parkinsonism Relat Disord. 2014; 20 (4): 360–369.
Huang Y-F, Cherng Y-G, Hsu SPC, et al. Risk and adverse outcomes of fractures in patients with Parkinson's disease: two nationwide studies. Osteoporos Int. 2015; 26: 1723–1732.
Melton LJ, III, Leibson CL, Achenbach SJ, et al. Fracture risk after the diagnosis of Parkinson’s disease: influence of concomitant dementia. Movement Disorders. 2006; 21 (9): 1361–1367.
Hughes AJ, Ben-Shlomo Y, Daniel SE, Lees AJ. What features improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study. Neurology. 1992; 42 (6): 1142–1146.
World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. The New England Journal of Medicine. 1988; 319 (26): 1701–1707.
Voss TS, Elm JJ, Wielinski CL, et al. Fall Frequency and Risk Assessment in Early Parkinson’s Disease. Parkinsonism & related disorders. 2012; 18 (7): 837-841.
Hu G, Jousilathi P, Bidel S, Antikainen R, Toumilehto J. Type 2 Diabetes and the Risk of Parkinson’s Disease. Diabetes Care. 2007; 30 (4): 842- 847.
Cereda E, Barichelle M, Pedrolli C, et al. Diabetes and Risk of Parkinson’s Disease. Diabetes Care. 2011; 34(12): 2614-2623.
Sandyk R, Awerbuch GI. The association of Diabetes Mellitus with Dementia in Parkinson’s disease. International Journal of Neuroscience. 1992; 64: 1-4, 209-212.
Parashos SA, Wielinski CL, Giladi N, Gurevich T. National Parkinsons Foundation Quality Improvement Initiative Investigators. Falls in Parkinson disease: analysis of a large cross-sectional cohort. J Parkinsons Dis. 2013; 3: 515-522.
Lai sw, Su LT, Lin CH, Tsai CH, Sung FC, Hsieh PH. Polypharmacy increases the risk of Parkinson’s disease in older people in Taiwan: A population-based study. Phychogeriatrics. 2011; 11: 150-156.
Ejaz AA, Sekhon IS, Munjal S. Characteristic findings on 24-h ambulatory blood pressure monitoring in a series of patients with Parkinson's disease. Eur. J. Inter. Med. 2006; 17: 417–420.
Gross M, Bannister R, Godwin-Austen R. Orthostatic hypotension in Parkinson's disease. Lancet. 1972; 1: 174–176.
Sharabi Y, Goldstein DS. Mechanisms of orthostatic hypotension and supine hypertension in Parkinson disease. J. Neurol. Sci. 2011; 310: 123–128.
Bezza A, Ouzzif Z, Naji H, et al. Prevalence and risk factors of osteoporosis in patients with Parkinson's disease. Rheumatol Int. 2008; 28: 1205–1209.
Balash Y, Peretz C, Leibovich G, Herman T, Hausdorff JM, Giladi N. Falls in outpatients with Parkinson's disease: frequency, impact and identifying factors. J Neurol. 2005; 252: 1310–1315.