Assessment Of The Association Between Fear Of Falling And Dual-Task Performance In People With Parkinson’s Disease: A Cross-Sectional, Observational Study
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People with Parkinson’s Disease (PwP) report greater levels of fear of falling (FOF) and demonstrate poorer ability to complete two tasks at once (i.e. dual-tasking) than healthy age-matched controls.
Aims and Objectives:
Aim: to assess the association between FOF and dual-task performance in communitydwelling PwP. Objectives: a) to assess the level of FOF in PwP in Ireland, b) to investigate the association between FOF and both motor and cognitive dual-task performance.
Thirty-one PwP (54.8% male) participated (Hoehn and Yahr Stages I-IV) with a mean age and duration of disease of 69.5 (±8.4) and four (±five) years respectively. The Activities-specific Balance Confidence scale was used to estimate the level of FOF. Dual-task ability was assessed by adding concurrent tasks to the Timed Up and Go (TUG) test. The motor dual-task involved carrying a glass of water (TUG-Manual) and the cognitive dual-tasks were serial subtractions (TUG-Arithmetic) and reciting the days of the week backwards (TUG-Literacy).
Forty-five percent of participants reported high levels of FOF. Correlation testing and linear regression analysis demonstrated that FOF was strongly associated with the motor dual-task (p=0.01), explaining 25% of the variance in the TUG-Manual. Fear of falling was moderately associated with the TUG-Literacy when outliers were removed ii (p=0.045) but was weakly associated with the TUG-Arithmetic (p=0.13). Fear of falling explained 10.2% and 5.6% of the variance in the TUG-Literacy and the TUGArithmetic respectively.
There was a strong association between FOF and the motor dual-task and a weak to moderate association between FOF and the cognitive dual-tasks.
Implications of findings:
Dual-task difficulties and FOF are common in PwP. The association between FOF and dual-task performance depends on the type of dual-task. Future research could assess the impact of balance and dual-task training on reducing FOF and improving dual-task performance in PwP.