Research Article Recurrent Falls in People with Parkinson’s Disease without Cognitive Impairment: Focusing on Modifiable Risk Factors Lorena R. S. Almeida, 1,2 Guilherme T. Valença, 1,2 Nádja N. Negreiros, 1 Elen B. Pinto, 2 and Jamary Oliveira-Filho 2 1 Movement Disorders Clinic, Bahia State Health Attention Center for the Elderly, Avenida ACM, s/n, Ed. Jos´ e Maria de Magalh˜ aes Netto, Iguatemi, 41820-000 Salvador, BA, Brazil 2 Post-Graduate Program in Health Sciences, Federal University of Bahia, Largo do Terreiro de Jesus, s/n, Centro Hist´ orico, 40025-010 Salvador, BA, Brazil Correspondence should be addressed to Lorena R. S. Almeida; lorenasantos@gmail.com Received 6 July 2014; Revised 21 October 2014; Accepted 4 November 2014; Published 23 November 2014 Academic Editor: Francisco Grandas Copyright © 2014 Lorena R. S. Almeida et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Falls can be considered a disabling feature in Parkinson’s disease. We aimed to identify risk factors for falling, testing simultaneously the ability of disease-speciic and balance-related measures. We evaluated 171 patients, collecting demographic and clinical data, including standardized assessments with the Uniied Parkinson’s Disease Rating Scale (UPDRS), activities of daily living (ADL) and motor sections, modiied Hoehn and Yahr Scale, Schwab and England, eight-item Parkinson’s Disease Questionnaire, Activities- speciic Balance Conidence Scale, Falls Eicacy Scale-International (FES-I), Berg Balance Scale, Dynamic Gait Index, Functional Reach, and Timed Up and Go. ROC curves were constructed to determine the cutof scores for all measures. Variables with < 0.1 entered a logistic regression model. he prevalence of recurrent falls was 30% (95% CI 24%–38%). In multivariate analysis, independent risk factors for recurrent falls were ( < 0.05) levodopa equivalent dose (OR = 1.283 per 100 mg increase; 95% CI = 1.092–1.507), UPDRS-ADL > 16 points (OR = 10.0; 95% CI = 3.6–28.3), FES-I > 30 points (OR = 6.0; 95% CI = 1.6–22.6), and Berg ≤ 48 points (OR = 3.9; 95% CI = 1.2–12.7).We encourage the utilization of these modiiable risk factors in the screening of fall risk. 1. Introduction Parkinson’s disease (PD) is a common neurodegenerative disorder in older adults and postural instability is well known to occur in these individuals, increasing the risk for falling [1– 4]. Falls are one of the most disabling features of PD and the incidence of falls is high, with reported rates varying from 35 to 68% for one or more falls [5–12] and from 24 to 43% for two or more falls [5, 7, 10, 12, 13], in a 3- to 12-month follow- up period. he consequences of falls are numerous and can afect not only fallers, but also their family and community. Falls can result in injuries such as head trauma and hip fractures and may also contribute to increased fear of falling, reduced level of activity, and functional impairment, leading to decreased quality of life in these individuals [14–16]. he inancial cost of a fall is high, for patients and the health system, as the fall- related injuries, especially the fractures, are a common reason of hospitalization [17]. Several risk factors of falls have been proposed, although we can note that some of them have limited use in the general clinical practice, such as longer disease duration and demen- tia [8]; abnormal posture, freezing of gait (FOG), and frontal impairment [9]; and female gender, older age, and symmetri- cal onset [18]. Previous authors have found poor balance con- idence and longer Timed Up and Go Test (TUG) as factors related with falls [19], relecting the role of balance-related measures in fall risk assessment. Some functional activities have been described as common situations of falls in people with PD, such as transfers, bending or reaching for an object, turning, and walking [14], and these tasks are addressed by some balance scales [20–25]. Hindawi Publishing Corporation Parkinson’s Disease Volume 2014, Article ID 432924, 8 pages http://dx.doi.org/10.1155/2014/432924