Background
Parkinson's disease (PD) is a chronic and progressive neurological disease, with negative consequences on major aspects of health such as functional capacity, ability to perform activities and participation in life situations. About 75 % of people with PD have gait and balance problems, which are known to negatively influence their health–related quality of life. Still, the use and perceived unmet need as well as impact of mobility devices remain unclear. Moreover, people with PD have an increased risk of falling than others of the same age. They most commonly fall in the home environment and while walking. A fear of falling (FOF) is also more common and pronounced, and walking difficulties are the strongest contributing factor to FOF among people with PD. However, no PD–study has yet investigated activity avoidance due to the risk of falling out of a longitudinal perspective, which is a prerequisite for determining predictive factors. Such knowledge is highly needed for the development of potent interventions.
Aim
The overarching aim of this longitudinal PhD student project is to gain an increased knowledge regarding walking difficulties, FOF, fall–related activity avoidance and the use and perceived need of mobility devices in people ageing with PD.
Methods
This PhD student project rests upon an already initiated longitudinal cohort study targeting people with PD. All baseline assessments were completed in 2013 (n=255), and all participants will be invited to participate in an equivalent three–year follow–up (2016). Participants: Those with a PD diagnosis (G20.9, ICD–10) for at least one year were included. The exclusion criteria were difficulties in understanding or speaking Swedish and/or extensive cognitive difficulties/other reasons making the individual unable to give informed consent or take part in the majority of the data collection. The participants were recruited from three hospitals in Region Skåne (Hässleholm, Kristianstad, SUS Lund).
Design of studies: The first two studies will be cross–sectional, based on the baseline data available. Studies III –IV will have a longitudinal design, involving baseline data and data collected at the forthcoming three–year follow–up.
Data collection: Self–administered questionnaires are administered via mail in advance of a subsequent home visit, which includes clinical assessments, observations and interview–administered questionnaires.
Importance
The results will be of importance for the planning of health care, including preventive efforts, treatment and rehabilitation targeting people with PD.
Study I
Aim: To investigate how fall-related activity avoidance relates to a history of self-reported falls/near falls, fear of falling and disease severity in people ageing with PD