Latest research shows that people suffering from Parkinson’s disease (PD) are at a greater risk of falls leading to injuries such as hip fractures. What’s even more shocking is that this risk exists years before these individuals are actually diagnosed with the disease. This has led scientists to believe that such patients might begin to develop clinically relevant neurodegenerative impairment long before their actual diagnosis, and this risk could be used as a potential indicator for singling out at-risk individuals early on.

Early Symptoms Of Parkinson’s: Collecting And Deciphering Data

As reported in the PLOS Medicine, researchers evaluated 24,412 individuals diagnosed with PD in Sweden between 1988 and 2012. Each patient was matched with 10 control subjects of the same gender and year of birth, making a comparison group of 243,363 people without Parkinson’s. The researchers then considered the rate of falls in both groups that could lead to injuries requiring medical care or hospitalization.

It was observed that 18 percent of the patients had experienced at least one fall that had led to a serious injury, that too 20 years before being diagnosed with Parkinson’s. In contrast, only 11.5 percent of individuals from the control group had suffered such an accident. After controlling for risk factors, PD was seen to be significantly associated with an increased risk of falls leading to injury – a 19 percent higher risk as compared to the subjects in the control group – for as much as 10 years before diagnosis.

Association Of Injurious Falls With PD

Considering the risk of hip fractures in particular, results showed that people with Parkinson’s had a 36 percent higher chance of such an injury about 15 years before their diagnosis as compared to controls.

“The risk of injurious falls, especially those resulting in hip fracture, was increased decades before the diagnosis of Parkinson’s disease”, said the researchers, led by Helena Nyström, of Umeå University in Sweden.

In a separate analysis comprising of 622,333 individuals who had been prescribed emergency care after a fall in Sweden between 1988 and 2012 revealed that 0.7 percent were subsequently diagnosed with PD during follow-up, as compared to the 0.5 percent matched controls.

“The increased risk of falling and hip fractures prior being diagnosed with Parkinson’s disease might suggest the occurrence of clinically relevant neurodegenerative impairment decades before the actual symptomatic diagnosis of the disease”, concluded the researchers.

Muscle Strength Could Be Possible Factor

Scientists also observed low muscle strength in older adults who were eventually diagnosed with PD about 30 years later. This highlights the possibility of decreased muscle strength being an indicator of increased risk of falling and fractures prior to being diagnosed with PD.

Despite the vital limitation that the study obtains data solely from registers with no clinical confirmations, all the results point towards a potential link between PD and clinically relevant neurodegenerative impairment decades before an individual is diagnosed with having Parkinson’s.

Conclusions And Recommendations

The diagnosis and subsequent treatment of PD generally occurs when the condition has progressed to a fairly advanced stage where motor impairment is quite evident and significant neurophysiological damage has occurred. The larger percentage of non-motor symptoms is usually seen much earlier, such as the increased risk of falling and injury, and may be used as an early indication to promptly begin treatment and therapeutic interventions.

Various studies and clinical trials are now pointing towards the critical advantages associated with early diagnosis and treatment of PD. They have listed many medical and other benefits, such as:

  • reduction in symptoms, particularly dyskinesia (movement disorders characterized by involuntary muscle movements such as tics)
  • delay in the use of levodopa (L-Dopa)
  • possible delay in progression of the disease, although conclusive evidence is lacking
  • significant decrease in symptoms to improve quality of life
  • monetary benefits – early-treatment strategies that diminish symptoms have the potential to slow disease progression and meaningfully impact PD expenditures
  • taking advantage of more convenient and adherence-friendly drug formulations could further improve outcomes and lower treatment costs

Diagnosing Parkinson’s can be challenging, since there are no biomarkers or neuroimaging or clinical tests to confirm the diagnosis. Currently, PD is diagnosed based on the presence or absence of clinical features, which is not 100 percent reliable since these symptoms may be present in other movement disorders as well. Hence, in light of the above mentioned studies and suggestions, the risk of falling could be used as a potentially significant and very early indicator of identifying individuals at risk of developing PD, so that they may be given relevant interventions right away.