Article

Parkinsonian signs are common, non-specific findings in older adults
and associated with increased rates of dementia and mortality. It is important to
understand which motor outcomes are associated with parkinsonian signs.
OBJECTIVES: To determine the role of parkinsonian signs on fall rates among older
adults. METHODS: We conducted a longitudinal study of primary care patients from
the University of Pennsylvania Health System. Adults over 55 years were assessed
at baseline through surveys and a neurological examination. We recorded falls
over the following 2 years. Parkinsonian signs were defined as the presence of 2
of 4 cardinal signs. Incident falls were compared between subjects with and
without parkinsonian signs, and modified Poisson regression used to adjust for
potential confounders in the relationship between parkinsonian signs and falls.
RESULTS: 982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of
participants fell and 12% exhibited parkinsonian signs at baseline. The
unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95%
CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary
incontinence, depression, diabetes, stroke and arthritis, individuals with
parkinsonian signs were still 38% more likely to fall than those without
parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with
parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04).
CONCLUSIONS: Parkinsonian signs are a significant, independent risk factor for
falls. Early detection of this clinical state is important in order to implement
fall prevention programs among primary care patients.
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