Keleman Audrey A, Nicosia Jessica, Bollinger Rebecca M, Wisch Julie K, Hassenstab Jason, Morris John C, Ances Beau M, Balota David A, Stark Susan L
Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA.
Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
J Alzheimers Dis Rep. 2023 Jul 14;7(1):739-750. doi: 10.3233/ADR-230002. eCollection 2023.
Individuals with Alzheimer's disease (AD) are more than twice as likely to incur a serious fall as the general population of older adults. Although AD is commonly associated with cognitive changes, impairments in other clinical measures such as strength or functional mobility (i.e., gait and balance) may precede symptomatic cognitive impairment in preclinical AD and lead to increased fall risk.
To examine mechanisms (i.e., functional mobility, cognition, AD biomarkers) associated with increased falls in cognitively normal older adults.
This 1-year study was part of an ongoing longitudinal cohort study. We examined the relationships among falls, clinical measures of functional mobility and cognition, and neuroimaging AD biomarkers in cognitively normal older adults. We also investigated which domain(s) best predicted fall propensity and severity through multiple regression models.
A total of 182 older adults were included (mean age 75 years, 53% female). A total of 227 falls were reported over the year; falls per person ranged from 0-16 with a median of 1. Measures of functional mobility were the best predictors of fall propensity and severity. Cognition and AD biomarkers were associated with each other but not with the fall outcome measures.
These results suggest that, although subtle changes in cognition may be more closely associated with AD neuropathology, functional mobility indicators better predict falls in cognitively normal older adults. This study adds to our understanding of the mechanisms underlying falls in older adults and could lead to the development of targeted fall prevention strategies.
患有阿尔茨海默病（AD）的个体发生严重跌倒的可能性是老年普通人群的两倍多。尽管AD通常与认知变化有关，但在临床前AD中，其他临床指标如力量或功能活动能力（即步态和平衡）的损害可能先于有症状的认知损害，并导致跌倒风险增加。
研究认知正常的老年人跌倒增加相关的机制（即功能活动能力、认知、AD生物标志物）。
这项为期1年的研究是一项正在进行的纵向队列研究的一部分。我们研究了认知正常的老年人跌倒、功能活动能力和认知的临床指标以及神经影像学AD生物标志物之间的关系。我们还通过多元回归模型研究了哪个领域最能预测跌倒倾向和严重程度。
共纳入182名老年人（平均年龄75岁，53%为女性）。一年中共报告了227次跌倒；每人跌倒次数为0至16次，中位数为1次。功能活动能力指标是跌倒倾向和严重程度的最佳预测指标。认知和AD生物标志物相互关联，但与跌倒结局指标无关。
这些结果表明，尽管认知方面的细微变化可能与AD神经病理学更密切相关，但功能活动能力指标能更好地预测认知正常的老年人跌倒。这项研究增进了我们对老年人跌倒潜在机制的理解，并可能导致针对性跌倒预防策略的制定。
