Impaired attention predicts falling in Parkinson's disease

• Published in: Parkinsonism & related disorders Vol. 15; no. 2; pp. 110 - 115
• Main Authors: Allcock, L.M, Rowan, E.N, Steen, I.N, Wesnes, K, Kenny, R.A, Burn, D.J
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2009
• Subjects: Accidental Falls; Aged; Antiparkinson Agents - therapeutic use; Attention; Attention Deficit Disorder with Hyperactivity - etiology; Cohort Studies; Falls; Female; Humans; Male; Neurology; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson's disease; Predictive Value of Tests; Reaction Time - drug effects; Reaction Time - physiology; Falls; Parkinson's disease; Attention
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2008.03.010

Abstract Background Cognitive deficits, in particular deficits of attention and executive function, may affect postural sway and balance in Parkinson's disease (PD). Our objective was to determine whether measures of attention were associated with falls in a large cohort of subjects with PD studied prospectively. Methods Patients meeting UK PD Society Brain Bank Criteria were included. Assessment included UPDRS III and the Cognitive Drug Research computerised assessment battery (CDR) from which Power of Attention, Continuity of Attention, cognitive reaction time and reaction time variability were derived. Falls were assessed prospectively using monthly fall diaries returned over a year following baseline assessment. Results One hundred and sixty four subjects completed fall diary datasets. One hundred and three (63%) fell one or more times during the 12 month period. Regression analysis revealed an association of fall frequency with poorer Power of Attention and increased reaction time variability, which was retained after correcting for UPDRS scores. Conclusions Reduced power of attention and increased reaction time variability are associated with increased fall frequency in PD. This has implications for the identification of those most at risk of falling, and for the management and prevention of falls in this patient group.