A meta-analysis of six prospective studies of falling in Parkinson's disease.
Identifieur interne : 002614 ( PubMed/Curation ); précédent : 002613; suivant : 002615A meta-analysis of six prospective studies of falling in Parkinson's disease.
Auteurs : Ruth M. Pickering [Royaume-Uni] ; Yvette A M. Grimbergen ; Una Rigney ; Ann Ashburn ; Gordon Mazibrada ; Brian Wood ; Peggy Gray ; Graham Kerr ; Bastiaan R. BloemSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Accidental Falls (statistics & numerical data), Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Disease Progression, Female, Humans, Incidence, Male, Middle Aged, Neurologic Examination, Parkinson Disease (diagnosis), Parkinson Disease (epidemiology), Prospective Studies, Recurrence, Risk Assessment, Sensitivity and Specificity.
- MESH :
- diagnosis : Parkinson Disease.
- epidemiology : Parkinson Disease.
- statistics & numerical data : Accidental Falls.
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Disease Progression, Female, Humans, Incidence, Male, Middle Aged, Neurologic Examination, Prospective Studies, Recurrence, Risk Assessment, Sensitivity and Specificity.
Abstract
Recurrent falls are a disabling feature of Parkinson's disease (PD). We have estimated the incidence of falling over a prospective 3 month follow-up from a large sample size, identified predictors for falling for PD patients repeated this analysis for patients without prior falls, and examined the risk of falling with increasing disease severity. We pooled six prospective studies of falling in PD (n = 473), and examined the predictive power of variables that were common to most studies. The 3-month fall rate was 46% (95% confidence interval: 38-54%). Interestingly, even among subjects without prior falls, this fall rate was 21% (12-35%). The best predictor of falling was two or more falls in the previous year (sensitivity 68%; specificity 81%). The risk of falling rose as UPDRS increased, to about a 60% chance of falling for UPDRS values 25 to 35, but remained at this level thereafter with a tendency to taper off towards later disease stages. These results confirm the high frequency of falling in PD, as almost 50% of patients fell during a short period of only 3 months. The strongest predictor of falling was prior falls in the preceding year, but even subjects without any prior falls had a considerable risk of sustaining future falls. Disease severity was not a good predictor of falls, possibly due to the complex U-shaped relation with falls. Early identification of the very first fall therefore remains difficult, and new prediction methods must be developed.
DOI: 10.1002/mds.21598
PubMed: 17588236
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A meta-analysis of six prospective studies of falling in Parkinson's disease.</title><author><name sortKey="Pickering, Ruth M" sort="Pickering, Ruth M" uniqKey="Pickering R" first="Ruth M" last="Pickering">Ruth M. Pickering</name><affiliation wicri:level="1"><nlm:affiliation>Public Health Sciences and Medical Statistics, University of Southampton, Southampton, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Public Health Sciences and Medical Statistics, University of Southampton, Southampton</wicri:regionArea></affiliation></author><author><name sortKey="Grimbergen, Yvette A M" sort="Grimbergen, Yvette A M" uniqKey="Grimbergen Y" first="Yvette A M" last="Grimbergen">Yvette A M. Grimbergen</name></author><author><name sortKey="Rigney, Una" sort="Rigney, Una" uniqKey="Rigney U" first="Una" last="Rigney">Una Rigney</name></author><author><name sortKey="Ashburn, Ann" sort="Ashburn, Ann" uniqKey="Ashburn A" first="Ann" last="Ashburn">Ann Ashburn</name></author><author><name sortKey="Mazibrada, Gordon" sort="Mazibrada, Gordon" uniqKey="Mazibrada G" first="Gordon" last="Mazibrada">Gordon Mazibrada</name></author><author><name sortKey="Wood, Brian" sort="Wood, Brian" uniqKey="Wood B" first="Brian" last="Wood">Brian Wood</name></author><author><name sortKey="Gray, Peggy" sort="Gray, Peggy" uniqKey="Gray P" first="Peggy" last="Gray">Peggy Gray</name></author><author><name sortKey="Kerr, Graham" sort="Kerr, Graham" uniqKey="Kerr G" first="Graham" last="Kerr">Graham Kerr</name></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2007">2007</date><idno type="doi">10.1002/mds.21598</idno><idno type="RBID">pubmed:17588236</idno><idno type="pmid">17588236</idno><idno type="wicri:Area/PubMed/Corpus">002614</idno><idno type="wicri:Area/PubMed/Curation">002614</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A meta-analysis of six prospective studies of falling in Parkinson's disease.</title><author><name sortKey="Pickering, Ruth M" sort="Pickering, Ruth M" uniqKey="Pickering R" first="Ruth M" last="Pickering">Ruth M. Pickering</name><affiliation wicri:level="1"><nlm:affiliation>Public Health Sciences and Medical Statistics, University of Southampton, Southampton, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Public Health Sciences and Medical Statistics, University of Southampton, Southampton</wicri:regionArea></affiliation></author><author><name sortKey="Grimbergen, Yvette A M" sort="Grimbergen, Yvette A M" uniqKey="Grimbergen Y" first="Yvette A M" last="Grimbergen">Yvette A M. Grimbergen</name></author><author><name sortKey="Rigney, Una" sort="Rigney, Una" uniqKey="Rigney U" first="Una" last="Rigney">Una Rigney</name></author><author><name sortKey="Ashburn, Ann" sort="Ashburn, Ann" uniqKey="Ashburn A" first="Ann" last="Ashburn">Ann Ashburn</name></author><author><name sortKey="Mazibrada, Gordon" sort="Mazibrada, Gordon" uniqKey="Mazibrada G" first="Gordon" last="Mazibrada">Gordon Mazibrada</name></author><author><name sortKey="Wood, Brian" sort="Wood, Brian" uniqKey="Wood B" first="Brian" last="Wood">Brian Wood</name></author><author><name sortKey="Gray, Peggy" sort="Gray, Peggy" uniqKey="Gray P" first="Peggy" last="Gray">Peggy Gray</name></author><author><name sortKey="Kerr, Graham" sort="Kerr, Graham" uniqKey="Kerr G" first="Graham" last="Kerr">Graham Kerr</name></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007" type="published">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (statistics & numerical data)</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (epidemiology)</term><term>Prospective Studies</term><term>Recurrence</term><term>Risk Assessment</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Accidental Falls</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Prospective Studies</term><term>Recurrence</term><term>Risk Assessment</term><term>Sensitivity and Specificity</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Recurrent falls are a disabling feature of Parkinson's disease (PD). We have estimated the incidence of falling over a prospective 3 month follow-up from a large sample size, identified predictors for falling for PD patients repeated this analysis for patients without prior falls, and examined the risk of falling with increasing disease severity. We pooled six prospective studies of falling in PD (n = 473), and examined the predictive power of variables that were common to most studies. The 3-month fall rate was 46% (95% confidence interval: 38-54%). Interestingly, even among subjects without prior falls, this fall rate was 21% (12-35%). The best predictor of falling was two or more falls in the previous year (sensitivity 68%; specificity 81%). The risk of falling rose as UPDRS increased, to about a 60% chance of falling for UPDRS values 25 to 35, but remained at this level thereafter with a tendency to taper off towards later disease stages. These results confirm the high frequency of falling in PD, as almost 50% of patients fell during a short period of only 3 months. The strongest predictor of falling was prior falls in the preceding year, but even subjects without any prior falls had a considerable risk of sustaining future falls. Disease severity was not a good predictor of falls, possibly due to the complex U-shaped relation with falls. Early identification of the very first fall therefore remains difficult, and new prediction methods must be developed.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">17588236</PMID><DateCreated><Year>2007</Year><Month>11</Month><Day>05</Day></DateCreated><DateCompleted><Year>2008</Year><Month>03</Month><Day>21</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>22</Volume><Issue>13</Issue><PubDate><Year>2007</Year><Month>Oct</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>A meta-analysis of six prospective studies of falling in Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>1892-900</MedlinePgn></Pagination><Abstract><AbstractText>Recurrent falls are a disabling feature of Parkinson's disease (PD). We have estimated the incidence of falling over a prospective 3 month follow-up from a large sample size, identified predictors for falling for PD patients repeated this analysis for patients without prior falls, and examined the risk of falling with increasing disease severity. We pooled six prospective studies of falling in PD (n = 473), and examined the predictive power of variables that were common to most studies. The 3-month fall rate was 46% (95% confidence interval: 38-54%). Interestingly, even among subjects without prior falls, this fall rate was 21% (12-35%). The best predictor of falling was two or more falls in the previous year (sensitivity 68%; specificity 81%). The risk of falling rose as UPDRS increased, to about a 60% chance of falling for UPDRS values 25 to 35, but remained at this level thereafter with a tendency to taper off towards later disease stages. These results confirm the high frequency of falling in PD, as almost 50% of patients fell during a short period of only 3 months. The strongest predictor of falling was prior falls in the preceding year, but even subjects without any prior falls had a considerable risk of sustaining future falls. Disease severity was not a good predictor of falls, possibly due to the complex U-shaped relation with falls. Early identification of the very first fall therefore remains difficult, and new prediction methods must be developed.</AbstractText><CopyrightInformation>2007 Movement Disorder Society</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pickering</LastName><ForeName>Ruth M</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Public Health Sciences and Medical Statistics, University of Southampton, Southampton, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grimbergen</LastName><ForeName>Yvette A M</ForeName><Initials>YA</Initials></Author><Author ValidYN="Y"><LastName>Rigney</LastName><ForeName>Una</ForeName><Initials>U</Initials></Author><Author ValidYN="Y"><LastName>Ashburn</LastName><ForeName>Ann</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Mazibrada</LastName><ForeName>Gordon</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Wood</LastName><ForeName>Brian</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Gray</LastName><ForeName>Peggy</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Kerr</LastName><ForeName>Graham</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Bloem</LastName><ForeName>Bastiaan R</ForeName><Initials>BR</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000058">Accidental Falls</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000706">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000328">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003430">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018450">Disease Progression</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015994">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009460">Neurologic Examination</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000175">diagnosis</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000453">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011446">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012008">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018570">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012680">Sensitivity and Specificity</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2007</Year><Month>6</Month><Day>26</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>3</Month><Day>22</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2007</Year><Month>6</Month><Day>26</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.21598</ArticleId><ArticleId IdType="pubmed">17588236</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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