Risk of Falls and Need of Walking Aid in Parkinson's Disease: Incidence and Impact of Comorbidities

BACKGROUND: Predicting falls in patients with Parkinson's disease (PD) is challenging despite their significant frequency and consequences. OBJECTIVES: To determine incidences of first fall, walking aid requirement, and identify risk factors of subsequent risk, including factors unrelated to PD. METHODS: Study in 415 PD patients (DIGPD prospective cohort). Cumulative incidence curves were calculated and Generalized Linear Mixed Models investigated influencing factors. RESULTS: Five years after diagnosis, 26.1% of patients experienced falls while only 2.1% required walking aids; after 10 years, it rose to 66.5% and 17%, respectively. Median time to first fall was 7.9 years. Risk factors of falls were cognitive decline, freezing, comorbidities such as diabetes and depression, history of falls particularly in male, or low Body Mass Index (BMIs). Walking aids risk factors were older age, freezing, lower walking speed, higher BMIs, history of walking aid. CONCLUSIONS: Treatable comorbidities (depression, diabetes, weight regulation) should be addressed in daily care to avoid falls in PD patients.