Abstract
Background and Purpose: Knowledge of predictive factors can foster the development of preventive approaches. This study examined how prevalence and severity of fall-related activity avoidance evolve over a 3-year period in people with Parkinson disease (PD). A specific aim was to identify predictive factors of fall-related activity avoidance (ie, modified Survey of Activities and Fear of Falling in the Elderly [mSAFFE] scores) after 3 years.
Methods: The sample included 151 people with PD (mean [SD] age: 68 [8.8] years). The mSAFFE score was the dependent variable in multivariable linear regression analyses, with 17 potential predictors. On the basis of a collinearity check, 2 models studying various risk factors were developed. Model 1 included concerns about falling and model 2 walking difficulties.
Results: After 3 years, more participants reported fall-related activity avoidance, that is, 34% versus 50% (P < 0.001). Regression model 1 explained 63% of the variance. The strongest predictive factor was concerns about falling (standardized regression coefficient, [beta] = 0.589), followed by pain ([beta] = 0.161), unsteadiness while turning ([beta] = 0.137), and age ([beta] = 0.136). These variables remained significant when adjusting for mSAFFE baseline scores.
In model 2 (explained 50% of the variance), the strongest predictive factor was perceived walking difficulties ([beta] = 0.392), followed by age ([beta] = 0.238), unsteadiness while turning ([beta] = 0.198), and pain ([beta] = 0.184). Unlike the other factors, walking difficulties were not significant when adjusting for mSAFFE baseline scores.
Discussion and Conclusions: Fall-related activity avoidance increased over time in people with PD. If fall-related activity avoidance is to be targeted, this study suggests that interventions should address concerns about falling, pain, unsteadiness while turning, and walking difficulties.
Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A310).