Article

Falls in frequent neurological disease. Prevalence, risk factors and aetiology

Christian-Albrechts-Universität zu Kiel, Kiel, Schleswig-Holstein, Germany
Journal of Neurology (Impact Factor: 3.38). 02/2004; 251(1):79-84. DOI: 10.1007/s00415-004-0276-8
Source: PubMed

ABSTRACT

The prevalence of falls among neurological patients is unknown, although disturbances of gait and posture are common. Falls may lead to burdens for the patient, the caregivers and the health system. We designed a prospective study and investigated all patients for a history of falls admitted to a neurological hospital during a 100-day period. Clinical investigation was carried out and several disease specific rating scales were applied. A total of 548 patients were investigated. Of all patients 34% had fallen once or more often during the last twelve months. A disturbance of gait was blamed for the fall in 55%, epileptic seizures in 12%, syncope in 10 % and stroke in 7%. Intrinsic risk factors for falls were high age, disturbed gait, poor balance and a fear of falling. As extrinsic factors we identified the treatment with antidepressants, neuroleptics and different cardiovascular medications, adverse environmental factors in the patients' home and the use of walking aids. Within the diagnoses, falls were most frequent in Parkinson's disease (62 %), syncope (57%) and polyneuropathy (48 %). According to these findings falls in neurological in-patients are twice as frequent as in an age-matched population living in the community. Falls in neurological patients are particularly linked to medication and disorders affecting gait and balance.

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    • "individuals with AD [3, 7–9]. Additionally, stumbling is common during obstacle avoidance during walking [10], and stumbling is one of the major causes of falls (29%) [11], particularly in individuals with AD. Studies of obstacle avoidance, which requires a high level of attention, have been useful for understanding the mechanisms underlying dynamic motor control [12] [13] [14]. "
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