1.1 Who falls with Parkinson’s?

Falls are a common and devastating complication of Parkinson’s. A meta-analysis of six independent, prospective studies that examined the incidence of falls in people with Parkinson’s demonstrated that 46% (95%CI 38-54%) fell over 3 months (Pickering et al, 2007). In patients who had not previously fallen, this rate was still high at 21% (95%CI 12-35%). In a prospective cohort study based in Sydney, 87% of the patients who remained alive at 20 years post diagnosis, had experienced a fall (Hely et al, 1999). A more recent meta-analysis has demonstrated that 60% of people with Parkinson’s fall annually and 39% fall recurrently (Allen et al, 2013). In recurrent fallers median survival is reduced to 6 years (Wenning et al, 1999).

The rate of falls increases as the condition progresses, reaching a peak at Hoehn and Yahr stage 3 (Balash et al, 2005). At this point, people with Parkinson’s are moderately impaired with reduced stability – but still mobile. Falls are more common in older people with Parkinson’s. Evidence from the ICICLE cohort which comprises people with newly diagnosed Parkinson’s, supports the fact a falls can occur early on in the course of disease, and that, once occurred, falls become recurrent (Hunter et al, (2018):