Interventions to prevent falls in people with Parkinson disease

Overall, the results indicate that in people with PD, exercise interventions probably reduce the rate of falls and probably slightly reduce the number of people falling (moderate‐certainty evidence). Further, fully supervised exercise may be more effective for reducing the number of falls than partially supervised exercise.

Notably, this evidence applies to people with mild to moderate PD. The effect of exercise on falls in people with more advanced disease is unclear. Safety, supervision and monitoring are important considerations when prescribing any exercise intervention for PD.

Cholinesterase inhibitors may reduce the rate of falls in people with PD who are at risk of falls, including those with impaired cognition. However, there was very-low‐certainty evidence that this medication makes little or no difference to the number of people falling. Any benefits of a cholinesterase inhibitor need to be balanced against the potential for non-fall‐related adverse events.