On the nature of fear of falling in Parkinson's disease

Article type: Research Article

Authors: Rahman, S. | Griffin, H.J.^; | Quinn, N.P. | Jahanshahi, M.

Affiliations: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, University College London, Queen Square, WC1N 3BG, London | Cognitive, Perceptual and Brain Sciences, University College London, 26 Bedford Way, WC1H 0AP, London

Note: [] Corresponding author. Tel.: +44 20 3108 0033; Fax: +44 20 7419 1860; E-mail: m.jahanshahi@ion.ucl.ac.uk

Abstract: In the elderly, fear of falling (FoF) can lead to activity restriction and affect quality of life (QoL). Our aim was to identify the characteristics of FoF in Parkinson's disease and assess its impact on QoL. We assessed FoF in 130 patients with Parkinson's disease (PD) on scales measuring perceived self-efficacy in performing a range of activities (FES), perceived consequences of falling (CoF), and activity avoidance (SAFFE). A significant difference was found in FoF between PD patients who had previously fallen and those who had not and between frequent and infrequent fallers. Patient-rated disability significantly influenced FoF. Difficulty in rising from a chair, difficulty turning, start hesitation, festination, loss of balance, and shuffling were the specific mobility problems which were associated with greater FoF in PD. Disability was the main predictor of FoF, additionally depression predicted perceived consequences of falling, while anxiety predicted activity avoidance. The FoF measures explained 65% of the variance of QoL in PD, highlighting the clinical importance of FoF. These results have implications for the clinical management of FoF in PD.

Keywords: Fear of falling, Parkinson's disease, mobility, quality of life, falls

DOI: 10.3233/BEN-2011-0330

Journal: Behavioural Neurology, vol. 24, no. 3, pp. 219-228, 2011