People living with Parkinson’s disease (PD) are at a higher risk for falls due to the motor symptoms, including stiff muscles, freezing (temporary inability to move), and balance impairment. Research estimates that people with PD are at twice the risk of falling as often as their peers. Falls can be mild, causing only bumps and bruises, or they can result in significant damage, causing increased disability and a reduced quality of life. The fear of falling in people living with PD is real and impacts both the patient and their caregiver or care partner.1
Factors that increase the risk of falling
To understand how to reduce the risk of falling, researchers have studied people with PD to determine the causes of their falls. By knowing why people fall, strategies can be developed to reduce the risk. Increased falls among people with PD are not associated with age or gender. People with PD who seem to be at an increased risk of falling include:
- Those with longer disease duration
- Those taking higher levodopa doses
- Those with stooped posture, balance problems, impaired gait, and freezing episodes
- Those experiencing greater “on” time with dyskinesia (involuntary, uncontrolled movements when medication is working and symptoms from PD are minimal)
- Those taking antidepressants or antipsychotic medications, due to their sedating effects
- Those who have cognitive (thinking) impairment, such as difficulty with multitasking, switching tasks, or solving problems
- Those who experience sleep disturbances, particularly REM sleep disorder (a condition in which the person acts out their dreams in physical ways while sleeping)
- Those with vision impairments, such as blurry vision or the inability to recognize changes in depth perception1,2
Ways to reduce the risk of falling
There are several steps people living with PD can take to reduce their risk of falling, including:
- Talk to your doctor about your risks. Your doctor can assess your personal risk and can help you manage your medications and any side effects. Medications may need to be adjusted or switched up.
- Exercising regularly helps maintain strength, improve stamina, improve balance, and reduce the risk of falls. Exercises that challenge your balance are especially beneficial, and research has shown that exercise that requires your attention, concentration and focus on activity and movement may also be neuroprotective – protecting the nerve cells from damage and possibly slowing the progression of PD.
- Make modifications to your home. There are several adaptations that can be made in your home to make falls less likely, such as removing throw rugs, ensuring wide pathways through furniture, and adding non-skid mats and grab bars to showers and bathtubs.
- Use a walking aid. Canes or four-wheeled walkers offer stability for people with PD.
- Learn ways to overcome freezing episodes, such as walking in beat to music or a metronome. Some people also find it helpful to move from side to side before stepping forward.
- Work with a physical therapist or occupational therapist. Physical and occupational therapists can provide exercises to help keep you mobile. Occupational therapists also can suggest adaptations and modifications to the person’s environment.1,3-5