Falls in progressive supranuclear palsy: Comparison with Parkinson disease

We investigated the frequency, time, circumstances, causes and consequences of falling in fourteen patients hospitalized with progressive supranuclear palsy (PSP) compared with eleven patients with Parkinson disease (PD) without dementia and Yahr stage over III for two months. The rate of falling patients was 50% in PSP, against 45% in PD. The mean frequency of falling per month in PSP tended to be more frequent than in PD (3.2 times per month in PSP, 0.7 in PD). More than 20% of PSP patients sustained external injuries as a result of falling. The site of the injuries was mainly the face and head. Furthermore, falling was observed even in the bedridden state in PSP. Thus, falling is a serious long-term problem in caregiving for PSP. It was suggested that the cause of falling in PSP was not only postural instability but also frontal lobe dementia. In practice, PSP patients sometimes showed sudden unexpected behaviour despite the medical caregiver's carefulness, so prevention of falling is very difficult. It is necessary to take measures for preventing and decreasing external injuries.