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Description
Abstract: This study examined awareness of the risk factors for falling among a group of community dwelling patients with Parkinson disease (PD) using the Falls Risk Awareness Questionnaire (FRAQ). A cross-sectional survey of 28 patients who attended a Movement Disorders Clinic for treatment of PD was used. FRAQ is a 28-item self-administered survey that assesses the knowledge and perception of risk factors for falling. Demographic, medical, and medication data were gathered from both the participants and clinic charts. Twenty-three (82%) of the participants reported falls in the past; seven (30%) had fallen within the past month. Nineteen (68%) of the participants felt they were at risk for further falls. When asked to list potential risk factors for falling, only 14% could identify medication as a risk factor. Persons with PD are at substantial risk of falling, yet many appear to be unaware of common risk factors, especially medication use.
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Falls in the elderly population constitute a significant risk for injury and death (Ashburn, Stack, Pickering, & Ward, 2001b; King & Tinetti, 1995). In turn, falls increase short- and long-term use of healthcare resources (Pressley et al., 2003; Rizzo, Baker, McAvay, & Tinetti, 1996; Wilkins, 1999). Although falls in Parkinson disease (PD) have not been extensively examined, falling is the most common complication of PD, with reported rates from 51% to 68% (Ashburn, Stack, Pickering, & Ward, 2001a; Bloem, Grimbergen, Cramer, Willemsen, & Zwinderman, 2001; Gray & Hildebrand, 2000; Wood, Bilclough, Bowron, & Walker, 2002). Koller, Glatt, Vetere-Overfield, and Hassanein (1989) found that 13% of patients with PD fell more than once a week. Gait impairment and postural instability greatly increase the risk of falls in this patient population (Ashburn et al., 2001a; King & Tinetti, 1995; Wood et al., 2002). Perhaps more noteworthy, polypharmacy and impaired mood are two additional risk factors strongly associated with falls in persons with PD (Ashburn et al., 2001a).
Falls by patients with PD can have devastating effects on their ability to live independently and can often lead to admission to a hospital or nursing home (Wood et al., 2002). Because persons with PD are twice as likely to fall as the general population or matched controls (Genever, Downes,& Medcalf, 2005; Teno, Kiel, & Mor, 1990), routine fall assessment in the clinical context is potentially valuable in this patient population.
An integral component of primary prevention of falls in this high-risk group is an evaluation of patient and caregiver awareness of the risk factors for falls. Patients and caregivers may not be aware of the increased risk for falls or predisposing factors (Gray & Hildebrand, 2000). Deficits in the knowledge of specific risk factors can be targeted as a preventive strategy for avoiding falls. Although recent studies have attempted to document the risks for falling in the general elderly population, and to a certain degree in the PD patient population, no investigations (to our knowledge) have examined patient awareness of the risks for falling in this high-risk group.
The objective of this study was twofold: (1) to examine the knowledge of the risk factors for falling within a group of community-dwelling participants with PD using the Falls Risk Awareness Questionnaire (FRAQ) and (2) to examine the associations between participant characteristics and awareness of the risk factors for falling.
Methods
The study was a cross-sectional survey of a consecutive sample of outpatients with PD who attended the Movement Disorders Clinic at the Glenrose Rehabilitation Hospital in Edmonton, Alberta, Canada, between January 29 and March 18, 2003. The Movement Disorders Clinic consists of three neurologists and allied health professionals. The clinic serves northern Alberta with a catchment area of approximately 1.5 million people. Patients attend the clinic on a biannual basis and represent a range of ages and disease severity.
Inclusion criteria for the current study were a diagnosis of PD and English literacy. All patients who were invited to participate agreed to complete the survey. Approval was obtained from the ethics committees of the university and health region.
The self-administered survey was given to participants when... |
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