Could Falls be a Harbinger Alzheimer’s Disease?

Paris — One of the most striking reports Sunday at the Alzheimer’s Association International Conference demonstrated an increased risk of falls among patients who have biomarker evidence of Alzheimer’s disease in a presymptomatic state.

This work was presented by Susan Stark, PhD, Washington University. Her report focused on non-demented research subjects as judged by assessment on the CDR scale. Although this 3-point scale has proven useful in staging dementia severity, it does not have adequate sensitivity to detect mild cognitive impairments. In these non-demented individuals, those having strong biomarker evidence of Alzheimer’s disease (abnormal CSF markers plus brain amyloid imaging in the top 15 percent of all subjects) had a significantly increased risk of falls relative to those non-demented subjects who did not meet these biomarker criteria.

Based upon the biomarker signature, these individuals could be regarded as being on the cusp of developing clinical signs of Alzheimer’s disease. This suggests that even before the development of dementia, these individuals had an increased risk of falls, which has obvious clinical importance. The work must be regarded as a preliminary finding. Cognitive data were not analyzed or considered, the number of patients meeting the restrictive biomarker endpoints was quite small (18 people), and the data related to signs of Parkinson’s disease were not analyzed. Indeed, no data regarding gait were presented. Nonetheless, this finding emphasized the importance of examination of gait (walking) in patients suspected of having cognitive impairment.

On Monday, Dutch researchers presented data demonstrating a correlation between fear of falling and cognitive impairment among 1,850 elderly Dutch persons, further highlighting the relationship between falls and cognitive difficulties.

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