Factors associated with injurious from falls in people with early stage Parkinson's disease

TL;DR

This study identifies key factors associated with injurious falls in early Parkinson's disease patients using Bayesian logistic regression, highlighting potential preventive targets like balance, gait, and body mass index.

Contribution

It introduces a Bayesian two-stage logistic regression approach to distinguish factors linked to injurious falls specifically in early Parkinson's disease patients.

Findings

Fear, gait, and previous falls predict fall risk with 77% accuracy.

Injurious falls are associated with fall time, BMI, anxiety, balance, gait, and gender.

Females are more likely to sustain injuries from falls than males.

Abstract

Falls are common in people with Parkinson's disease (PD) and have detrimental effects which can lower the quality of life. While studies have been conducted to learn about falling in general, factors distinguishing injurious from non-injurious falls are less clear. We develop a two-stage Bayesian logistic regression model was used to model the association of falls and injurious falls with data measured on patients. The forward stepwise selection procedure was used to determine which patient measures were associated with falls and injurious falls, and Bayesian model averaging (BMA) was used to account for uncertainty in this variable selection procedure. Data on 99 patients for a 12-month time period were considered in this analysis. Fifty five percent of the patients experienced at least one fall, with a total of 335 falls cases; 25% of which were injurious falls. Fearful, Tinetti gait, and previous falls were the risk factors for fall/non-fall, with 77% accuracy, 76% sensitivity, and 76% specificity. Fall time, body mass index, anxiety, balance, gait, and gender were the risk factors associated with injurious falls. Thus, attaining normal body mass index, improving balance and gait could be seen as preventive efforts for injurious falls. There was no significant difference in the risk of falls between males and females, yet if falls occurred, females were more likely to get injured than males.