Fear of falling and dual-task performance in people with Parkinson's disease

People with Parkinson's disease (PwP) report greater fear of falling (FOF) and demonstrate poorer dual-task performance than healthy age-matched controls. The aim of this study was to assess the association between FOF and dual-task performance in PwP. 31 PwP participated (17 male, 14 female) with mild to severe disease severity (Hoehn and Yahr Stages I: 8, II: 4, III: 13 and IV: 6) and mean age of 69.5 (+/- 8.4) years. FOF was assessed using the Activities-specific Balance Confidence scale. Dual-tasks performed with the Timed Up and Go (TUG) were TUG-Manual: carrying a glass of water, TUG-Arithmetic: serial subtractions and TUG-Literacy: reciting the days of the week backwards. 45% (n = 14) reported high levels of FOF. FOF had a strong significant inverse association with the motor dual-task (r = -0.504, p = 0.01) and a weak to moderate non-significant association with the cognitive dual-tasks (TUG-Literacy r = -0.343, p = 0.06; TUG-Arithmetic r = -0.282, p = 0.13). Cognitive dysfunction (Mini-Mental State Examination score) was significantly inversely associated with the cognitive dual-tasks (TUG-Literacy: r = -0.48, p = 0.01) (TUG-Arithmetic: r = -0.532, p < 0.001) but not with the motor dual-task (r = -0.16, p = 0.44). The association between FOF and dual-task performance is dependent on task type and complexity. Future research should determine the cause and effect nature of this relationship in a longitudinal cohort study.