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Falls are a debilitating problem for people with Parkinson's disease (PD).To compare clinical and functional characteristics of non-fallers, single and recurrent fallers (≥2 falls); to determine predictors of time to second fall; and to develop a predictive tool for identifying people with PD at different categories of falls risk.Participants (n = 229) were assessed by disease-specific, self-report and balance measures and followed up for 12 months. Area under the receiver operating characteristic curves (AUC), Kaplan-Meier curves and log-rank test were performed. Selected predictors with p 0.10 in univariate analysis were chosen to be entered into the Cox regression model.Eighty-four (37%) participants had ≥2 falls during the follow-up. Recurrent fallers significantly differed from single fallers. The final Cox model included history of ≥2 falls in the past year (Hazard Ratio [HR] = 3.94; 95% confidence interval [CI] 2.26-6.86), motor fluctuations (HR = 1.91; 95% CI 1.12-3.26), UPDRS activities of daily living (ADL) (HR = 1.10 per 1 point increase; 95% CI 1.06-1.14) and levodopa equivalent dose (LED) (HR = 1.09 per 100 mg increase; 95% CI 1.02-1.16). A 3-predictor tool included history of ≥2 falls in the past year, motor fluctuations and UPDRS ADL12 points (AUC = 0.84; 95% CI 0.78-0.90). By adding LED700 mg/day and Berg balance scale ≤49 points, a 5-predictor tool was developed (AUC = 0.86; 95% CI 0.81-0.92).Two predictive tools with moderate-to-high accuracy may identify people with PD at low, medium and high risk of falling recurrently within the next year. However, future studies to address external validation are required.

Background: Previous studies have described the association between dopamine replacement therapy in Parkinson’s disease and impulse control disorders. Methods: A caseecontrol study was performed to establish the prevalence of four of these behaviors in Brazilian patients with Parkinson’s disease on stable dopamine replacement therapy and the possible associated risk factors. We investigated 152 patients and 212 healthy controls for pathological gambling, compulsive sexual behavior and compulsive buying and eating. Results: Overall, patients had more impulsive control disorders than controls (18.4% vs. 4.2%, P < 0.001). Impulse control disorders were more common in younger patients (P ¼ 0.008) and in those taking dopamine agonist (P < 0.001) and levodopa (P ¼ 0.02). Higher Unified Parkinson’s Disease Rating Scale motor score (P ¼ 0.03) and past smoking (P ¼ 0.02) were also associated in the univariate analysis. Variables independently associated with impulse control disorders were history of smoking (odds ratio ¼ 1.059 for each year of smoking, P ¼ 0.010) and current use of pramipexole (odds ratio ¼ 2.551 for each increase in 1 mg, P < 0.001). Conclusions: Dopaminergic stimulation and previous exposure to smoking are independently associated with impulse control disorders in a dose-dependent manner.