Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Richard Camicioli*, Meg E. Morris, Frederico Pieruccini-Faria, Manuel Montero-Odasso, Surim Son, David Buzaglo, Jeffrey M. Hausdorff, Alice Nieuwboer

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: People living with Parkinson's disease (PD) have a high risk for falls. Objective: To examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults. Methods: A Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention. Results: A recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi-domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels. Conclusion: Effective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.

Original languageEnglish
Pages (from-to)1459-1469
Number of pages11
JournalMovement Disorders Clinical Practice
Volume10
Issue number10
DOIs
StatePublished - Oct 2023

Keywords

  • Parkinson's disease
  • accidental falls
  • exercise
  • falls
  • freezing
  • gait speed

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