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Escola Anna Nery

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RESEARCH • Esc. Anna. Nery 26 • 2022 • https://doi.org/10.1590/2177-9465-EAN-2021-0131 copy

Assessment of risk of falls in people with Parkinson’s disease^a a Article extracted from the conclusion monograph Undergraduate Nursing Program entitled in Portuguese language “Risco e quedas entre as pessoas com a doença de Parkinson cadastradas na Associação Parkinson Santa Catarina”, authored by Franciny da Silva, supervised by Angela Maria Alvarez. Undergraduate Nursing Program at the Universidade Federal de Santa Catarina, in 2019.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to identify the factors associated with risk of falls among people with Parkinson’s disease registered at the Parkinson Santa Catarina Association.

Method

this is a cross-sectional exploratory descriptive study with a quantitative approach, carried out with 53 people registered at the Parkinson Santa Catarina Association, in the city of Florianópolis, Brazil, from June to September 2019. Sociodemographic questionnaire, Hoehn and Yahr scale, Mini Mental State Examination and Simple Screening Test for Risk of Falls in the Elderly were applied. The data were tabulated and analyzed using the SEstatNet^® Statistics Teaching-Learning Online System.

Results

risk factors were identified, such as sex, increased age, reduced muscle strength, postural instability and decreased gait speed. Regarding the stages of the disease, it was found that in all of them there was a worsening of gait speed and the fear of falling is constant, increasing with the worsening of the disease and diagnosis time.

Conclusion and implications for practice

by deepening the study of the topic, nurses are able to understand the motor impairments that lead to frailty and fall in people with Parkinson’s disease, developing strategies to prevent them.

Keywords:
Accidental Falls; Chronic Disease; Parkinson’s Disease; Nursing; Aging

Variables	Total		Fall risk groups score				Score Q22P
	Total		> = 6.5		<6.5		Score Q22P	P
	n (%) 53 (100)		n (%) 50 (94.3)		n (%) 3 (5.7)		P50 [P25; P75]
Age
<60 years	17 (32.1)		17 (34)		0 (0)		10 [9; 12]	0.367¹
60 \|-- 70 years	18 (34)		15 (30)		3 (100)		11.5 [8; 13]
> = 70 years	18 (34)		18 (36)		0 (0)		12.5 [9; 14]
P50 [P25; P75]	67 [57; 72]		67 [55; 72]		65 [65; 68]
Sex
Female	21 (39.6)		21 (42)		0 (0)		11 [9; 13]	0.293²
Male	32 (60.4)		29 (58)		3 (100)		10 [8; 13]
Education
Elementary school	18 (34)		17 (34)		1 (33.3)		11.5 [10; 15]	0.173¹
High school	12 (22.6)		12 (24)		0 (0)		10.5 [8.5; 13]
Higher education	18 (34)		17 (34)		1 (33.3)		10.5 [8; 13]
Graduate degree	5 (9.4)		4 (8)		1 (33.3)		9 [9; 10]
Marital status
With a partner	36 (67.9)		33 (66)		3 (100)		11 [9; 13]	0.788²
Without a partner	17 (32.1)		17 (34)		0 (0)		10 [8; 13]
Diagnosis time
0 - 4 years	19 (35.8)		17 (34)		2 (66.7)		9a [8; 13]	0.048 ¹
5 - 9 years	22 (41.5)		21 (42)		1 (33.3)		11b [10; 14]
10 or more	12 (22.6)		12 (24)		0 (0)		11.5b [10.5; 14]
P50 [P25; P75]	6 [3; 9]		6 [4; 9]		2.5 [0.6; 7]
Comorbidity
Yes	34 (64.2)		32 (64)		2 (66.7)		11 [9; 13]	0.765²
No	19 (35.8)		18 (36)		1 (33.3)		10 [8; 14]
Medication
<5 medications (n = 28)	28 (52.8)		25 (50)		3 (100)		9.5a [8; 11.5]	0.007 ²
> = 5 medications (n = 25)	25 (47.2)		25 (50)		0 (0)		12b [11; 14]
Hoehn and Yahr
Mild	38 (71.7)		35 (70)		3 (100)		10 [8; 13]	0.177²
Moderate/Severe	15 (28.3)		15 (30)		0 (0)		11 [10; 14]

	Total		Hoehn and Yahr
Variables	Total		Mild		Moderate/Severe		P
	n (%) 50 (100)		n (%) 35 (70.0)		n (%) 15 (30.0)
Age²
<60 years	17 (32.1)		13 (34.2)		4 (26.7)		0.811
60 \|-- 70 years	18 (34.0)		13 (34.2)		5 (33.3)
> = 70 years	18 (34.0)		12 (31.6)		6 (40.0)
Age¹ - P50 [P25; P75]	67 [55; 72]		66 [55; 72]		67 [57; 76]		0.273
Sex²
Female	21 (42.0)		15 (42.9)		6 (40.0)		>0.999
Male	29 (58.0)		20 (57.1)		9 (60.0)
Education²
Elementary school	17 (34.0)		12 (34.3)		5 (33.3)		0.972
High school	12 (24.0)		9 (25.7)		3 (20.0)
Higher education	17 (34.0)		11 (31.4)		6 (40.0)
Graduate degree	4 (8.0)		3 (8.6)		1 (6.7)
Marital status²
With a partner	33 (66.0)		21 (60)		12 (80.0)		0.333
Without a partner	17 (34.0)		14 (40)		3 (20.0)
Diagnosis time²
0 - 4 years	17 (34.0)		14 (40)		3 (20.0)		0.028
5 - 9 years	21 (42.0)		16 (45.7)		5 (33.3)
10 or more	12 (24.0)		5 (14.3)		7 (46.7)
Diagnosis time¹ - P50 [P25; P75]	6 [4; 9]		5.5 [3; 8]		9 [6; 11]		0.027
Comorbidity²
Yes	32 (64.0)		22 (62.9)		10 (66.7)		>0.999
No	18 (36.0)		13 (37.1)		5 (33.3)
Medications²
<5 medications	25 (50.0)		16 (45.7)		9 (60.0)		0.725
> = 5 medications	25 (50.0)		19 (54.3)		6 (40.0)

	Fall risk groups score
Questions	< = 6.5 points (n=50)				>6.5 points (n= 3)				Total (n=53)
	No n (%)		Yes n (%)		No n (%)		Yes n (%)		No n (%)		Yes n (%)
Q1	21 (42)		29 (58)		2 (66.7)		1 (33.3)		23 (43.4)		30 (56.6)
Q2	12 (24)		38 (76)		2 (66.7)		1 (33.3)		14 (26.4)		39 (73.6)
Q3	8 (16)		42 (84)		0 (0)		3 (100)		8 (15.1)		45 (84.9)
Q4	4 (8)		46 (92)		1 (33.3)		2 (66.7)		5 (9.4)		48 (90.6)
Q5	3 (6)		47 (94)		0 (0)		3 (100)		3 (5.7)		50 (94.3)
Q6	11 (22)		39 (78)		0 (0)		3 (100)		11 (20.8)		42 (79.2)
Q7	24 (48)		26 (52)		1 (33.3)		2 (66.7)		25 (47.2)		28 (52.8)
Q8	37 (74)		13 (26)		3 (100)		0 (0)		40 (75.5)		13 (24.5)
Q9	34 (68)		16 (32)		0 (0)		3 (100)		34 (64.2)		19 (35.8)
Q10	19 (38)		31 (62)		2 (66.7)		1 (33.3)		21 (39.6)		32 (60.4)
Q11	7 (14)		43 (86)		1 (33.3)		2 (66.7)		8 (15.1)		45 (84.9)
Q12	24 (48)		26 (52)		3 (100)		0 (0)		27 (50.9)		26 (49.1)
Q13	4 (8)		46 (92)		1 (33.3)		2 (66.7)		5 (9.4)		48 (90.6)
Q14	28 (56)		22 (44)		3 (100)		0 (0)		31 (58.5)		22 (41.5)
Q15	9 (18)		41 (82)		2 (66.7)		1 (33.3)		11 (20.8)		42 (79.2)
Q16	22 (44)		28 (56)		3 (100)		0 (0)		25 (47.2)		28 (52.8)
Q17	30 (60)		20 (40)		3 (100)		0 (0)		33 (62.3)		20 (37.7)
Q18	42 (84)		8 (16)		3 (100)		0 (0)		45 (84.9)		8 (15.1)
Q19	25 (50)		25 (50)		2 (66.7)		1 (33.3)		27 (50.9)		26 (49.1)
Q20	25 (50)		25 (50)		2 (66.7)		1 (33.3)		27 (50.9)		26 (49.1)
Q21	19 (38)		31 (62)		2 (66.7)		1 (33.3)		21 (39.6)		32 (60.4)
Q22	32 (64)		18 (36)		2 (66.7)		1 (33.3)		34 (64.2)		19 (35.8)

	Correlation
Hoehn and Yahr Severity Score	0,38 (p = 0,025)
Patient age	0.236 (p = 0.089)
Diagnosis time (years)	0.347 (p = 0.011)

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E-mail: annaneryrevista@gmail.com

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