Parkinson’s disease (PD) significantly increases the risk of falls due to its motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. These falls are not only more frequent but also more dangerous for people with PD compared to the general population. After a fall, individuals with Parkinson’s face a notably higher mortality risk, influenced by several interconnected factors related to the disease’s progression and complications.
First, the motor impairments in PD severely affect balance and coordination, making falls more likely. Studies show that about 45 to 68% of people with Parkinson’s experience falls, which is roughly three times the rate seen in healthy older adults. Half of these falls result in serious injuries such as fractures or head trauma. These injuries can lead to prolonged immobility, hospitalization, and complications that increase the risk of death.
Second, Parkinson’s disease often involves non-motor symptoms that worsen outcomes after a fall. For example, many patients develop orthostatic hypotension—a sudden drop in blood pressure when standing up—which causes dizziness and fainting, further increasing fall risk. Orthostatic hypotension also correlates with more severe disease progression and greater physical frailty, which impairs recovery after injury.
Third, cognitive decline and dementia, which affect about 30% of people with Parkinson’s, contribute to higher mortality after falls. Cognitive impairment reduces the ability to recognize hazards, follow safety precautions, or seek help promptly after a fall. Dementia in PD is associated with poorer quality of life, increased need for nursing care, and a higher likelihood of fatal complications.
Fourth, swallowing difficulties (dysphagia) are common in PD and worsen as the disease progresses. After a fall, immobility and hospitalization increase the risk of aspiration pneumonia—a lung infection caused by inhaling food or saliva into the lungs—which is a leading cause of death in Parkinson’s patients.
Moreover, the severity of Parkinson’s disease subtype influences mortality risk after falls. Those with more aggressive forms of PD, such as the diffuse malignant subtype, tend to have shorter survival times and more rapid progression of both motor and cognitive symptoms. This makes them more vulnerable to fatal outcomes following falls.
Falls in Parkinson’s patients also lead to a cascade of negative effects beyond immediate injury. They often result in loss of independence, social isolation, fear of falling again, and caregiver strain. These factors contribute to physical deconditioning, depression, and reduced overall health, all of which increase mortality risk over time.
In addition, multimorbidity—the presence of multiple chronic conditions—is common in older adults with Parkinson’s and complicates recovery after falls. Coexisting illnesses such as cardiovascular disease, diabetes, or osteoporosis can worsen outcomes and increase the likelihood of death following a fall-related injury.
Hospitalization after a fall can expose Parkinson’s patients to additional risks, including infections, delirium, and complications from immobility. The combination of PD-related frailty, cognitive impairment, and medical comorbidities makes recovery difficult and increases mortality risk.
In summary, Parkinson’s disease affects mortality risk after a fall through a complex interplay of motor dysfunction, autonomic instability, cognitive decline, swallowing problems, disease severity, and multimorbidity. Falls are more frequent and more likely to cause serious injury in PD, and the complications that follow—such as pneumonia, prolonged immobility, and hospitalization—significantly increase the chance of death. Preventing falls and managing the multifaceted symptoms of Parkinson’s are critical to reducing mortality risk in this vulnerable population.