Predictive Factors of Fall-Related Activity Avoidance in People With Parkinson Disease-A Longitudinal Study With a 3-Year Follow-up

Background and Purpose: Knowledge of predictive factors can foster the development of preventive approaches. This study examined how prevalence and severity of fall-related activity avoidance evolve over a 3-year period in people with Parkinson disease (PD). A specific aim was to identify predictive factors of fall-related activity avoidance (ie, modified Survey of Activities and Fear of Falling in the Elderly [mSAFFE] scores) after 3 years. Methods: The sample included 151 people with PD (mean [SD] age: 68 [8.8] years). The mSAFFE score was the dependent variable in multivariable linear regression analyses, with 17 potential predictors. On the basis of a collinearity check, 2 models studying various risk factors were developed. Model 1 included concerns about falling and model 2 walking difficulties. Results: After 3 years, more participants reported fall-related activity avoidance, that is, 34% versus 50% (P< 0.001). Regression model 1 explained 63% of the variance. The strongest predictive factor was concerns about falling (standardized regression coefficient, beta = 0.589), followed by pain (beta = 0.161), unsteadiness while turning (beta = 0.137), and age (beta = 0.136). These variables remained significant when adjusting for mSAFFE baseline scores. In model 2 (explained 50% of the variance), the strongest predictive factor was perceived walking difficulties (beta = 0.392), followed by age (beta = 0.238), unsteadiness while turning (beta = 0.198), and pain (beta = 0.184). Unlike the other factors, walking difficulties were not significant when adjusting for mSAFFE baseline scores. Discussion and Conclusions: Fall-related activity avoidance increased over time in people with PD. If fall-related activity avoidance is to be targeted, this study suggests that interventions should address concerns about falling, pain, unsteadiness while turning, and walking difficulties.