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A Real-world Assessment of Hospitalizations Due to Falls among Patients with and without OFF episodes in Parkinson’s Disease

K. Rajagopalan, A. Lee, J. Barton, J. Pike (Marlborough, MA, USA)

Meeting: 2018 International Congress

Abstract Number: 115

Keywords: Parkinsonism, Wearing-off fluctuations

Session Information

Date: Saturday, October 6, 2018

Session Title: Education in Movement Disorders

Session Time: 1:45pm-3:15pm

Location: Hall 3FG

Objective: To investigate the association between “OFF” episodes and hospitalizations due to falls among patients with Parkinson’s disease (PD) in a real-world setting.

Background: Quantitative evidence about incidence of hospitalizations due to falls among patients with PD experiencing “OFF” episodes (i.e. breakthrough motor symptoms) is lacking.

Methods: Data were drawn from the Adelphi Parkinson’s Disease Specific Programme, a cross-sectional study of 109 neurologists and their consulting patients with PD in the USA. Study measures included for analysis were annual rates of neurologist-reported (i) presence/absence of OFF-episodes and average OFF-time hours/day, and (ii) hospitalizations due to falls as reason for admission. Multiple negative binomial regressions, adjusted for age, sex, BMI, and comorbidities, modelled the relationship between those with and without OFF episodes, OFF-time hours/day, and hospitalizations due to falls. Incidence rate ratios (IRR) were derived.

Results: Of the 1409 PD patients, 27.5% experienced OFF episodes and had higher mean age (70.3 ± 11.3 years) compared to patients “without OFF”, (66.3 ± 10.8years). They had also been diagnosed with PD longer (5.1 ± 6.9 years) than those “without OFF” (2.5 ± 3.3 years). Among patients “with OFF”, 50.8% reported 2–3 OFF hours/day and 28.9% had 4+ OFF-hours/day. Patients “with OFF” had higher rates of hospitalization due to falls (IRR 3.96, p<0.001) compared to patients “without OFF”. Increasing OFF-hours were significantly associated with greater hospitalizations due to falls (IRR 1.29, p=0.002).

Conclusions: This real-world, cross-sectional survey of PD patients demonstrated that patients who experience “OFF” episodes may be more severe since they have been diagnosed longer, have almost four times higher number of hospitalizations due to falls compared to those without “OFF” episodes. Each incremental OFF-hour/day may also result in 29% greater rate of hospitalization due to falls.

To cite this abstract in AMA style:

K. Rajagopalan, A. Lee, J. Barton, J. Pike. A Real-world Assessment of Hospitalizations Due to Falls among Patients with and without OFF episodes in Parkinson’s Disease [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/a-real-world-assessment-of-hospitalizations-due-to-falls-among-patients-with-and-without-off-episodes-in-parkinsons-disease/. Accessed May 13, 2025.
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