Ask HRC: Falls Related to Parkinson's Disease

​​​​A member recently asked for information related to falls and Parkinson's disease (PD). Falls in patients with PD are the result of a complex interplay of multiple factors. Several factors specifically related to PD include axial rigidity: postural abnormalities and instability; dyskinesia (impairment of voluntary movement); slow and shuffled gait; freezing of gait and festination; urinary incontinence; neurosurgery to include subthalamic nucleus deep brain stimulation; and medications, such as higher total doses of levodopa, use of dopamine agonists, and anticholinergics.

The Parkinson's Foundation also identifies nonmotor related symptoms that increase the risk of falling. These include lightheadedness from low blood pressure when arising from sitting or lying down (orthostatic hypotension), constipation, fatigue and exhaustion, stress and emotional reactions, and fears of falling. Cognitive impairment is also an independent predictor of falling—an important consideration because dementia is a common problem in PD that requires tailored fall interventions. The above risk factors do not include additional age-related risks and...