Fall and risk of Alzheimer's disease
Elderly people with early asymptomatic Alzheimer's disease are at risk of falls
Anna Yudina, "Scientific Russia"
Even without cognitive problems, people with brain damage associated with Alzheimer's disease have an increased risk of falls, according to a press release from Older people with early, asymptomatic Alzheimer's at risk of falls.
Article by Keleman et al. Falls Associate with Neurodegenerative Changes in the ATN Framework of Alzheimer's Disease is published in the Journal of Alzheimer's Disease.
Falls are the leading cause of fatal injuries in the elderly – they cause more than 800,000 hospitalizations and about 30,000 deaths in the U.S. each year. Some risk factors are well known – old age, problems with vision or balance, muscle weakness – but a little-known factor is early-stage Alzheimer's disease. Older people in the earliest stages of Alzheimer's disease, before cognitive problems arise, are more likely to suffer from a fall than people who do not have dementia yet.
Researchers from Washington University School of Medicine in St. Louis found that in elderly people without cognitive problems who experience a fall, the neurodegeneration process that leads to Alzheimer's dementia could have already begun. The results suggest that older people who have experienced falls should be screened for Alzheimer's disease and that new strategies may be needed to reduce the risk of falls for people in the early stages of the disease.
"In the world of fall research, we usually say that you risk falling if you lose strength and balance," said study co–author Susan Stark, PhD, associate professor of occupational therapy, neurology and social work. – If you lose strength and balance, the recommended treatment is to work on strength and balance. But if someone falls for a different reason, perhaps because the damage associated with Alzheimer's disease has begun to accumulate in his brain, this person may need a completely different treatment. We don't know yet what kind of treatment it might be, but we hope we can use this information to develop new treatment recommendations that will reduce the risk of falls in this population."
In 1987, Dr. John C. Morris, an intern at the University of Washington, found that older people with Alzheimer's dementia are more than twice as likely to suffer from traumatic falls than people of the same age without dementia. Morris is currently an emeritus professor of neurology and directs the Alzheimer's Disease Research Center at the University.
Since Morris' discovery more than three decades ago, scientists have learned that the brains of Alzheimer's patients begin to undergo changes decades before memory loss and confusion become apparent. First, plaques of amyloid proteins are formed, then tangles of tau protein. Some areas of the brain begin to shrink, and communication networks between distant parts of the brain begin to break down. Stark and his colleagues have shown that the link between Alzheimer's disease and falling persists even during the latent phase of the disease: people with so-called preclinical Alzheimer's disease are at increased risk of falling, despite the absence of obvious cognitive problems.
To better understand why people without cognitive symptoms are at risk of falling, first author Audrey Kelemen–a graduate student in Stark's lab–and her colleagues followed 83 people over 65 for a year. A qualified neurologist at the beginning of the study assessed the cognitive abilities of all participants as normal. Each participant filled out monthly calendars in which any falls were recorded, and underwent brain scans for amyloid, as well as for signs of atrophy and communication disorders.
Researchers have found that the presence of amyloid in the brain does not in itself increase the risk of people falling, unlike neurodegeneration. The participants who fell had a smaller hippocampus, an area of the brain dedicated to memory and shrinking in Alzheimer's disease. Their somatomotor networks – networks of connections that are involved in receiving sensory signals and controlling movement– have also shown signs of disintegration. The researchers concluded that the fall is most likely in the neurodegeneration phase of preclinical Alzheimer's disease – in the last five years or so before memory loss and confusion occur.
"Since I started working on this project, I started asking my patients about falls, and I can't tell you how often it helped me start to understand what was going on with this person," said study co–author Bo M. Ansez, MD, MD. Ansez treats patients with dementia and other neurological diseases at the University of Washington Medical Campus.
"When a person's mobility decreases, even if they look normal, it can be a sign that something needs further evaluation," Ansez said. – In fact, this is a really important potential marker that should make us say, "Wait a minute. Let's delve into this in more detail. Is there anything else related to this?""
Researchers have begun further experiments to better understand why brain changes in Alzheimer's disease put people at risk of falling so they can develop recommendations to prevent falls. Meanwhile, according to Stark, simple changes can make a big difference in protecting the elderly from devastating falls.
"You can prevent a lot of falls just by making the environment safer," Stark said. – Simple changes can help and will not hurt: make sure that the tub is not slippery, that you can easily get up from the toilet. Start working with balance and doing strength training. Review your prescriptions and analyze whether the amount of certain medications or combinations of medications increases the risk of falling. Until we have special fall prevention methods for people with preclinical Alzheimer's disease, we can still do a lot to make people's lives safer."
Portal "Eternal youth" http://vechnayamolodost.ru