Objective: To quantify falls related to Freezing of Gait (FoG) versus unrelated to FoG as Parkinson’s disease progresses.

Background: FoG is a debilitating symptom of PD and is associated with an increased risk of falls [1]. FoG manifests as brief episodes where patients are unable to initiate or maintain walking [2]. We sought to explore the frequency of falls related to FoG as PD progresses over time and characterize its impact on injury risk and quality of life.

Method: We conducted a retrospective study of PD patients from the Parkinson’s Progression Markers Initiative (PPMI). The dataset includes two variables extracted from the Determination of Freezing and Falls questionnaire. Freezing of Gait in the Past 12 Months (FRZGT12M), measures the severity of FoG experienced in the past 12 months. Falls Not Related to Freezing in the Past 12 Months (FLNFR12M), assesses the frequency of falls in the past 12 months not caused by FoG. We compared the frequency of FoG in the past 12 months and Falls unrelated to FoG in the past 12 months and the mean severity of the question items between a disease duration 1 +/- 1 year versus 10 +/- 1 year using a t-test.

Results: 255 patients were included in our analysis. The mean (SEM) of Freezing of gait in the past 12 months from 0 to 2 years was 0.125 (0.069) at baseline. This increased to 0.608 (0.065) after 10 years. This represented a statistically significant increase from baseline (p = 0.0177). Similarly, the mean (SEM) of Falls not related to freezing in the past 12 months was 0.208 (0.084) at baseline. This increased to 0.511 (0.047) after 10 years. This was a statistically significant increase from baseline (p = 0.0447).

Conclusion: We demonstrate in a larger international cohort that FoG increases over time as PD disease progresses. We will look to characterize how this impacts motor outcomes and quality of life.

Mean and standard error for FRZGT12M and FLNFR12M

References: [1] Herman, T., Barer, Y., Bitan, M. et al. A meta-analysis identifies factors predicting the future development of freezing of gait in Parkinson’s disease. npj Parkinsons Dis. 9, 158 (2023). https://doi.org/10.1038/s41531-023-00600-2

[2] Nutt, J. G., Bloem, B. R., Giladi, N., Hallett, M., Horak, F. B., & Nieuwboer, A. (2011). Freezing of gait: moving forward on a mysterious clinical phenomenon. The Lancet. Neurology, 10(8), 734–744. https://doi.org/10.1016/S1474-4422(11)70143-0

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-freezing-of-gait-on-falls-over-time-in-parkinsons-disease/