Article

OBJECTIVE: To examine whether impairment in executive function independently
predicts recurrent falls in people with Parkinson's disease (PD). DESIGN:
Prospective cohort study. SETTING: University motor control research laboratory.
PARTICIPANTS: A convenience sample of community-dwelling people with PD (N=144)
was recruited from a patient self-help group and movement disorders clinics.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Executive function was
assessed with the Mattis Dementia Rating Scale Initiation/Perseveration (MDRS-IP)
subtest, and fear of falling (FoF) with the Activities-specific Balance
Confidence (ABC) Scale. All participants were followed up for 12 months to record
the number of monthly fall events. RESULTS: Forty-two people with PD had at least
2 falls during the follow-up period and were classified as recurrent fallers.
After accounting for demographic variables and fall history (P=.001), multiple
logistic regression analysis showed that the ABC scores (P=.014) and MDRS-IP
scores (P=.006) were significantly associated with future recurrent falls among
people with PD. The overall accuracy of the prediction was 85.9%. With the use of
the significant predictors identified in multiple logistic regression analysis, a
prediction model determined by the logistic function was generated: Z = 1.544 +
.378 (fall history) - .045 (ABC) - .145 (MDRS-IP). CONCLUSIONS: Impaired
executive function is a significant predictor of future recurrent falls in people
with PD. Participants with executive dysfunction and greater FoF at baseline had
a significantly greater risk of sustaining a recurrent fall within the subsequent
12 months.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS