Clinical neurology and neurosurgery · 2024
Evaluating prognostic factors for falls in Parkinson's disease: A sex-based analysis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Murueta-Goyena Ane, Del Pino Rocío, Tijero Beatriz, Ortuzar Naiara, Ruiz-Lopez Marta, Fernández-Valle Tamara, Acera Marian, Ayo Naia, Carmona-Abellán Mar, Gabilondo Iñigo, Gómez-Esteban Juan Carlos
Аннотация
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.
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.