Fall risk in lewy body dementia: Clinical correlates using the Morse Fall Scale and falls
Ozlem Totuk1
, Ozge Gonul Oner2
1Department of Neurology, University of Health Sciences, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye
2Department of Neurology, İstanbul Province Health Directorate Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
Keywords: Autonomic dysfunction, dementia with Lewy bodies, falls, Morse Fall Scale, urinary incontinence.
Abstract
Background: In this study, clinical fall risk in patients diagnosed with dementia with Lewy bodies (DLB) was assessed using the Morse Fall Scale (MFS), and its relationships with cognitive performance, mood status, motor severity, and autonomic dysfunction were examined.
Materials and Methods: Between May 2018 and January 2026, 44 patients (21 males, 23 females; mean age: 77.97±7.38 years; range 61 to 95 years) with probable LBD were included in this retrospective, single-center cross sectional study. Participants were categorized into low (n = 5), moderate (n = 10), and high (n = 29) fall risk groups based on MFS scores. Continuous variables were presented as median (interquartile range), and nonparametric tests were used for group comparisons. Multivariable logistic regression analysis was performed to explore factors associated with falls.
Results: Among the 44 patients, 65.9% were classified as high risk according to MFS. No significant differences were observed between MFS risk groups in terms of age, education, cognitive performance, or autonomic dysfunction (p > 0.05). In the subgroup with available fall data (n = 31), urinary incontinence was significantly associated with falls (p = 0.023). In univariate analyses, patients who experienced falls had higher education levels and higher Addenbrooke’s cognitive examination-III (ACE-III) scores.
Conclusion: Most patients with LBD exhibit a high clinical risk of falls. However, falls cannot be explained solely by advanced cognitive or motor impairment. Urinary incontinence was significantly associated with actual falls, which, alongside preserved mobility, likely heightens fall susceptibility. Conversely, the higher education and ACE-III scores observed among fallers may suggest a greater exposure to risk due to their relatively preserved functional capacity. These findings support a multidimensional clinical approach to fall risk assessment in LBD.
Cite this article as: Totuk O, Oner OG. Fall risk in lewy body dementia: Clinical correlates using the Morse Fall Scale and falls. Parkinson Hast Harek Boz Derg 2026;29(1):1-9. doi: 10.5606/phhb.dergisi.2026.69.