Abstract
BackgroundFalls are frequent and severe in older adults, especially among those with cognitive impairments due to altered motor control. Which brain areas are affected among fallers remains yet not elucidated. The objective of this cross-sectional analysis was to determine whether the history of falls correlated with focal brain volume reductions in older adults.MethodsParticipants from the MERE study (n = 208; mean, 71.9 ± 5.9 years; 43% female; 38% cognitively healthy, 41% with mild cognitive impairment and 21% with dementia) were asked about their history of falls over the preceding year and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, use of psychoactive drugs, cognitive status, and total intracranial volume were used as covariates.ResultsFifty-eight participants (28%) reported history of falls. Fallers were older (P = 0.001), used more often psychoactive drugs (P = 0.008) and had more often dementia (P = 0.004) compared to non-fallers. After adjustment, we found correlations between the history of falls and brain subvolumes; fallers exhibiting larger gray matter subvolumes in striatum, principally in bilateral caudate nucleus, than non-fallers. By stratifying on cognitive status, these neuroanatomical correlates were retrieved only in participants with MCI or dementia. There were no correlations with the subvolumes of white matter.ConclusionOlder fallers had larger subvolumes in bilateral striatum than non-fallers, principally within the caudate nucleus. This suggests a possible brain adaptative mechanism of falls in people with neurocognitive decline.
Highlights
Falls in older adults are frequent, with a prevalence reaching 35% after the age of 65 and 50% after 80, and severe as they lead to adverse consequences including fractures, hospitalization, loss of independence, institutionalization and death; with significant health care costs (Katz and Shah, 2010)
After adjusting for age, gender, use of psychoactive drugs, cognitive status and total intracranial volume (TIV), the voxel-based morphometric (VBM)-DARTEL analysis by using anatomic toolbox 2.2c identified 17 clusters that positively correlated with falls, which are presented in Table 2; the most
After adjusting for studied potential confounders, that older fallers had larger gray matter volume in striatum, principally in bilateral caudate nucleus, than non-fallers; a correlation retrieved in those with cognitive decline
Summary
Falls in older adults are frequent, with a prevalence reaching 35% after the age of 65 and 50% after 80, and severe as they lead to adverse consequences including fractures, hospitalization, loss of independence, institutionalization and death; with significant health care costs (Katz and Shah, 2010). The brain-level of motor control involves the integration of afferent information in the brain to generate a global motor control message and to produce complex motor responses that are adapted to multiple sensory inputs and environmental constraints (Annweiler et al, 2013). For this reason, older adults with prodromal or severe cognitive impairments exhibit significant gait disorders (Beauchet et al, 2015). Which brain areas are affected among fallers remains yet not elucidated The objective of this cross-sectional analysis was to determine whether the history of falls correlated with focal brain volume reductions in older adults
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
