Predicting future fallers in Parkinson's disease using kinematic data over a period of 5 years.

Parkinson's disease (PD) increases fall risk, leading to injuries and reduced quality of life. Accurate fall risk assessment is crucial for effective care planning. Traditional assessments are subjective and time-consuming, while recent assessment methods based on wearable sensors have been limited to 1-year follow-ups. This study investigated whether a short sensor-based assessment could predict falls over up to 5 years. Data from 104 people with PD without prior falls were collected using six wearable sensors during a 2-min walk and a 30-s postural sway task. Five machine learning classifiers analysed the data. The Random Forest classifier performed best, achieving 78% accuracy (AUC = 0.85) at 60 months. Most models showed excellent performance at 24 months (AUC > 0.90, accuracy 84-92%). Walking and postural variability measures were key predictors. Adding clinicodemographic data, particularly age, improved model performance. Wearable sensors combined with machine learning can effectively predict fall risk, enhancing PD management and prevention strategies.