Scientists discover a way to diagnose types of fear of falling in Parkinson's patients

September 25, 2018 by Kelly Johnston, University of Calgary
Cumming School of Medicine researchers discover a way to diagnose subtypes of fear of falling, a common condition experienced by people who have Parkinson's disease. The findings indicate the current standard of treatment for fear of falling may not be effective for all patients. From left: Taylor Chomiak and Bin Hu. Credit: Riley Brandt, University of Calgary

Parkinson's disease, a progressive nervous system disorder that affects movement, causes one of the highest risks of falling among all neurological conditions. Due to this, many patients develop a fear of falling (FOF), even if they have never fallen. For some the fear can be excessive. Patients become prisoners in their own homes, scared to venture out despite the fact that they are physically able to do so. Others can develop a "fearlessness" putting themselves at high risk of falling.

Vivien Poon was diagnosed with Parkinson's 10 years ago. She walks with the use of a cane and says her fear of falling is something she has to deal with on a daily basis. "I'm pretty lucky. Although I've fallen many times, I've only broken a finger. For a lot of patients, falls lead to serious injury," says Poon.

Drs. Bin Hu, Ph.D., and Taylor Chomiak, Ph.D., with the Cumming School of Medicine (CSM) have developed a way to measure different types of FOF in hopes of improving treatment and quality of life for patients. Traditionally, FOF is considered to be a problem with motor function. Standard treatment focuses on improving a patient's gait, balance and muscle strength. However, in a recent multi-centre study, these researchers discovered that cognitive function plays an important role.

"The findings indicate the current standard treatment for fear of falling may not be effective for all patients. Many may benefit from treatments aimed at addressing their fear and improving their level of confidence to get up and be active," says Hu, professor in the departments of Clinical Neurosciences and Cell Biology and Anatomy and member of the Hotchkiss Brain Institute.

Vivien Poon, who was diagnosed with Parkinson's disease 10 years ago, demonstrates one of the mobility tests conducted in the research study. Participants underwent a six-minute walking test using an Ambulosono wearable sensor system (seen on Vivien's right leg). The demonstration occurred at the Clinical and Translational Exercise Physiology Laboratory, which investigates the role of exercise in the prevention and management of chronic diseases, including neurodegeneration conditions related to aging such as Parkinson's disease and Alzheimer disease. Credit: Riley Brandt, University of Calgary
"Some patients have developed an excessive fear of falling that's keeping them from participating in activities, but physically, they have no reason to be afraid," says Hu. "On the opposite end of the spectrum we discovered patients who are physically at a high-risk of falling, but cognitively don't recognize their weaknesses and aren't taking proper precautions."

The researchers incorporated machine learning to compare cognitive and mobility tests from 57 patients. This aspect of artificial intelligence allows computer systems to learn from the data and find hidden patterns. The algorithms produced visual maps that helped separate the patients with FOF into different categories: those with mobility issues, those with cognitive dysfunction with relatively mild motor impairment, and those with a combination of the two. The study is published in the Nature Partner Journals npj Parkinson's Disease.

"Up to now there has been no generally accepted scientific method that can be used to diagnose with different types of of falling," says Chomiak, an adjunct assistant professor in the Department of Clinical Neurosciences. "This is the first step toward the development of an effective diagnostic tool to identify types of FOF that combines conventional clinical assessments with mobile and computer technology."

Parkinson's disease is difficult to treat. The symptoms and progression of the disease are unique to each individual. People with the disease can have problems controlling their body; tremors and muscle weakness are common symptoms. They can also experience cognitive impairment, including loss of memory, anxiety and depression. There is no cure.

Explore further: Optimizing dopaminergic treatment improves non-motor symptoms

More information: Taylor Chomiak et al, Differentiating cognitive or motor dimensions associated with the perception of fall-related self-efficacy in Parkinson's disease, npj Parkinson's Disease (2018). DOI: 10.1038/s41531-018-0059-z

Related Stories

Optimizing dopaminergic treatment improves non-motor symptoms

September 24, 2018
Non-motor symptoms are common in late stage Parkinson's disease (PD) as the frequency and severity of most of these symptoms increase with advancing disease. Optimizing dopaminergic treatment in the most severe stages can ...

Increasing physical activity, function can decrease fall fears

August 18, 2017
(HealthDay)—Enhancing physical activity level and function can decrease the fear of falling among elderly patients, according to a study published online Aug. 9 in the Journal of Clinical Nursing.

Effects of deep brain stimulation in patients with Parkinson's disease

August 29, 2018
Researchers at Universitätsmedizin Berlin have studied motor and cognitive effects of deep brain stimulation in patients with Parkinson's disease. Their results show that the adverse cognitive effects of deep brain stimulation ...

Study identifies risks related to falling in patients with COPD

July 24, 2015
In a recent year-long study, 40% of patients with chronic obstructive pulmonary disease (COPD) experienced falls, with more than 75% of these falling multiple times.

Don't let fear of falling freeze you in your tracks

September 23, 2013
A Saint Louis University School of Nursing faculty member is going to mark the first day of fall with a simple warning to senior adults: Don't let fear of falling stand in the way of being active and engaged with the world ...

Finding a treatment for Parkinson's disease dementia

September 2, 2015
University of Adelaide neuroscientists are leading a world-first study into a form of dementia experienced by many Parkinson's disease suffers, which is expected to ultimately lead to a new therapy for the condition.

Recommended for you

New transgenic model of Parkinson's illuminates disease biology

October 11, 2018
Parkinson's disease (PD) is a neurodegenerative disorder that presents clinically with abnormal movement and tremors at rest. In the brain, PD is marked by the accumulation of the protein, α-synuclein (αS), into clumps ...

Early Parkinson's patients waiting too long to seek medical evaluation

September 27, 2018
The time between diagnosis and the institution of symptomatic treatment is critical in the effort to find a cure for Parkinson's Disease (PD). A paper published in Nature Partner Journal: Parkinson's Disease notes too many ...

Molecule capable of halting and reverting neurodegeneration caused by Parkinson's disease identified

September 25, 2018
The small SynuClean-D molecule interrupts the formation of the alpha-synuclein amyloid fibres responsible for the onset of Parkinson's disease, and reverts the neurodegeneration caused by the disease. The study, headed by ...

Genomic dark matter activity connects Parkinson's and psychiatric diseases

September 20, 2018
Dopamine neurons are located in the midbrain, but their tendril-like axons can branch far into the higher cortical areas, influencing how we move and how we feel. New genetic evidence has revealed that these specialized cells ...

Gene therapy shown to remove core component of Parkinson's disease

September 14, 2018
An international team led by Rush researcher Jeffrey Kordower, Ph.D., has moved a step closer to developing a treatment to clear brain cells of a protein that is an integral cause of Parkinson's disease. The team published ...

ADHD may increase risk of Parkinson's disease and similar disorders

September 12, 2018
While about 11 percent of children (4-17 years old) nationwide have been diagnosed with attention-deficit hyperactivity disorder (ADHD), the long-term health effects of having ADHD and of common ADHD medications remains understudied. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.