Manuel Montero-Odasso1,2,3, Mark Speechley1,3. 1. Gait and Brain Laboratory, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada. 2. Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada. 3. Department of Epidemiology and Biostatistics, Schulich Interfaculty Program in Public Health, University of Western Ontario, London, ON, Canada.
Abstract
OBJECTIVES: To provide an overview of the role of cognition in falls, with potential implications for managing and preventing falls in older adults. DESIGN: Review. SETTING: Observational and interventional studies addressing the role of cognition on falls. PARTICIPANTS: Community-dwelling older adults (65 years and older). MEASUREMENTS: The relationship between gait and cognition in aging and neurodegeneration was reviewed in the medical literature to highlight the role of brain motor control deficits in fall risk. The benefits of dual-task gait assessments as a marker of fall risk were reviewed. Therapeutic approaches for reducing falls by improving certain aspects of cognition were appraised. RESULTS: Low performance in attention and executive function are associated with gait slowing, instability, and future falls. Drug-enhancement of cognition may reduce falls in Parkinson's disease, and cognitive training, dual-task training, and virtual reality modalities are promising to improve mobility in sedentary older adults and in those with cognitive impairment and dementia. CONCLUSION: Falls remain common in older people, with higher prevalence and morbidity in those who are cognitively impaired. Disentangling the mechanism and contribution of cognitive deficits in fall risk may open new treatment approaches. Mounting evidence supports that cognitive therapies help reduce falls.
OBJECTIVES: To provide an overview of the role of cognition in falls, with potential implications for managing and preventing falls in older adults. DESIGN: Review. SETTING: Observational and interventional studies addressing the role of cognition on falls. PARTICIPANTS: Community-dwelling older adults (65 years and older). MEASUREMENTS: The relationship between gait and cognition in aging and neurodegeneration was reviewed in the medical literature to highlight the role of brain motor control deficits in fall risk. The benefits of dual-task gait assessments as a marker of fall risk were reviewed. Therapeutic approaches for reducing falls by improving certain aspects of cognition were appraised. RESULTS: Low performance in attention and executive function are associated with gait slowing, instability, and future falls. Drug-enhancement of cognition may reduce falls in Parkinson's disease, and cognitive training, dual-task training, and virtual reality modalities are promising to improve mobility in sedentary older adults and in those with cognitive impairment and dementia. CONCLUSION: Falls remain common in older people, with higher prevalence and morbidity in those who are cognitively impaired. Disentangling the mechanism and contribution of cognitive deficits in fall risk may open new treatment approaches. Mounting evidence supports that cognitive therapies help reduce falls.
Authors: Jennifer C Davis; Chun Liang Hsu; Cheyenne Ghag; Samantha Y Starkey; Patrizio Jacova; Larry Dian; Naaz Parmar; Kenneth Madden; Teresa Liu-Ambrose Journal: Qual Life Res Date: 2022-07-07 Impact factor: 3.440
Authors: Manuel Montero-Odasso; Nathalie van der Velde; Finbarr C Martin; Mirko Petrovic; Maw Pin Tan; Jesper Ryg; Sara Aguilar-Navarro; Neil B Alexander; Clemens Becker; Hubert Blain; Robbie Bourke; Ian D Cameron; Richard Camicioli; Lindy Clemson; Jacqueline Close; Kim Delbaere; Leilei Duan; Gustavo Duque; Suzanne M Dyer; Ellen Freiberger; David A Ganz; Fernando Gómez; Jeffrey M Hausdorff; David B Hogan; Susan M W Hunter; Jose R Jauregui; Nellie Kamkar; Rose-Anne Kenny; Sarah E Lamb; Nancy K Latham; Lewis A Lipsitz; Teresa Liu-Ambrose; Pip Logan; Stephen R Lord; Louise Mallet; David Marsh; Koen Milisen; Rogelio Moctezuma-Gallegos; Meg E Morris; Alice Nieuwboer; Monica R Perracini; Frederico Pieruccini-Faria; Alison Pighills; Catherine Said; Ervin Sejdic; Catherine Sherrington; Dawn A Skelton; Sabestina Dsouza; Mark Speechley; Susan Stark; Chris Todd; Bruce R Troen; Tischa van der Cammen; Joe Verghese; Ellen Vlaeyen; Jennifer A Watt; Tahir Masud Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782
Authors: Rebecca S Crow; Christian Haudenschild; Matthew C Lohman; Robert M Roth; Meredith Roderka; Travis Masterson; John Brand; Tyler Gooding; Todd A Mackenzie; John A Batsis Journal: J Am Geriatr Soc Date: 2021-02-10 Impact factor: 5.562