Parkinson's Disease and Falls
Falls are a common complication of Parkinson’s Disease (PD), with approximately 45-68% of people with PD falling at least once each year, and many experiencing multiple falls per year. The main concern with falls is the subsequent potential for major injury. Whilst a fall can result in a minor injury such as a small cut or a bruise, they can also result in something more serious such as a hip fracture. Additionally, falls in PD can lead to hospitalisation, reduced independence of living, and reduced self-confidence to perform activities due to concerns about falling again. Therefore, it is very important to minimise the risk of falling in PD as much as possible.
Why do falls occur in Parkinson's Disease?
There are a few factors that contribute to the increased risk of falls in PD. Some of the main factors include freezing, which is feeling like your feet are stuck to the ground, and postural instability, which occurs due to the degeneration of nerve cells in the brain and causes a loss of balance. Stooped or forward-leaning posture, and a shuffling gait, can often occur in PD, and these also increases the risk of falling. Reduced leg muscle strength is also associated with increased risk of falls in PD.
Low blood pressure is another factor that can contribute to falls. Some PD medications can cause low blood pressure when moving quickly from a lying or seated position to a standing position (also known as orthostatic or postural hypotension), since blood flow to the brain has not adjusted and can cause feelings of light-headedness. The prevalence of vision impairment, which is more common in people with PD, and fatigue due to disturbed sleep, are also factors that contribute to falls. Lastly, falls can also result from trips or slips due to physical obstacles or items in or outside of the house, such as clothes left on the floor, a rug, or an uneven pavement.
What can I do to prevent falls?
While there is no guaranteed way to prevent falls entirely, there are some tips that you can use to minimise the risk of a fall.
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Take your PD medications as prescribed. Speak to your GP regarding your medications if you have any concerns.
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Exercise has been shown to improve a lot of factors that contribute to falls, such as poor balance, muscle weakness, and walking ability. Contact an exercise specialist such as an Accredited Exercise Physiologist to help you commence an appropriate exercise program.
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Get up from a lying or seated position slowly. Take some time before standing.
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Keep your house free of obstacles as much as possible. Examples can include picking up cords, or making sure mats or rugs are anchored down.
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Ensure you have good lighting in the house. Consider a night light in the hallway or bathroom and turn on the lights if you need to get up at night.
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Before going to sleep, make sure the path to the bathroom is clear of obstacles.
Written by Mitch Abagi
References
European Parkinson’s Disease Association. (2022). Falls. Retrieved February 4, 2022, from https://www.epda.eu.com/about-parkinsons/symptoms/motor-symptoms/falls/
Pelicioni, P. H., Menant, J. C., Latt, M. D., & Lord, S. R. (2019). Falls in Parkinson’s disease subtypes: risk factors, locations and circumstances. International journal of environmental research and public health, 16(12), 2216.
Schrag, A., Choudhury, M., Kaski, D., & Gallagher, D. A. (2015). Why do patients with Parkinson’s disease fall? A cross-sectional analysis of possible causes of falls. npj Parkinson's Disease, 1(1), 1-6.