Older People With Early Alzheimer’s at Risk of Falls

Patients with early stages of Alzheimer’s disease are likely to suffer from a fall, according to a new study. In these patients, the process of neurodegeneration that leads to Alzheimer’s dementia may have begun.

Falls are the leading //cause of fatal injuries in older adults. They cause more than 800,000 hospitalizations and 30,000 deaths in the U.S. annually.

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‘People with a preclinical stage of Alzheimer's disease are at a higher risk of falling though they do not show any apparent cognitive problems. Neurodegeneration and the presence of amyloid were linked to a higher risk of falling.’
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Some risk factors are advanced age, problems with balance or vision, muscle weakness. However, an under-recognized risk factor is early Alzheimer's disease.

The study is published in the Journal of Alzheimer's Disease.

The study suggests that older people who have experienced falls should be screened for Alzheimer's disease. There is also a need for new strategies to reduce the risk of falling for people in the disease's early stages.

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In 1987, John C. Morris, MD, discovered that older people with Alzheimer's dementia are more than twice as likely to suffer a traumatic fall when compared with the people of the same age without dementia.

Since then, scientists have learned that the brains of Alzheimer's patients begin changing years before memory loss and confusion become apparent.

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First, there is the formation of amyloid plaques, then tau protein. Certain brain areas start shrinking, and communication networks between distant parts of the brain begin to decay.

The researchers show that people with preclinical Alzheimer's disease are also at an increased risk of falling though they do not have apparent cognitive problems.

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The researchers followed 83 people over the age of 65 for a year. At the start of the study, participants were assessed as cognitively normal by a qualified neurologist.

Every participant filled out monthly calendars recording any falls. They also underwent brain scans to detect amyloid and signs of impaired connectivity and atrophy.

The researchers found that the presence of amyloid was not solely linked to increased risk of falling. Neurodegeneration also played a role.

Participants who fell had smaller hippocampi, the brain region for memory which shrinks in Alzheimer’s disease.

Participants who fell showed signs that their somatomotor networks were decaying. Somatomotor networks are webs of connections that are involved in receiving sensory inputs and controlling movement .

The researchers concluded that falling is likely to occur in the neurodegeneration phase of preclinical Alzheimer's disease which is the last five years or so before memory loss and confusion arise.

The researchers have begun further experiments in order to understand better why brain changes in Alzheimer's put people at risk of falling. They hope these experiments can help them develop fall-prevention recommendations.

Simple changes could also help protect older people from falling.

"Simple changes could help and can't hurt: making sure the tub isn't slippery; making sure you can get up easily off the toilet; balance and strength training; reviewing your prescriptions to see if certain medications or combinations of medications are increasing the risk of falling. Until we have specific fall-prevention treatments for people with preclinical Alzheimer's, there are still plenty of things we can do to make people safer," Stark said.

Source-Medindia