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Elderly people at risk of falling early asymptomatic Alzheimer’s disease

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Waterfalls are a major cause of fatal injuries in the elderly, with more than 800,000 hospitalizations and about 30,000 deaths each year in the United States. Some risk factors are well known-older age, visual or balance problems, weakness-but an unrecognized factor is early Alzheimer’s disease. Older people in the earliest stages of Alzheimer’s disease are more likely to suffer falls than those without dementia progression before cognitive impairment develops.

Researchers at Washington University in St. Louis School of Medicine have discovered that elderly people without cognitive impairment may have experienced falls and the process of neurodegeneration leading to Alzheimer’s disease may have already begun. The survey results are Journal of Alzheimer’s diseaseElderly people who have experienced falls should be screened for Alzheimer’s disease, suggesting that new strategies may be needed to reduce the risk of falls in people in the early stages of the disease.

“In the world of autumn research, we generally say that if you lose strength and balance, you risk falling,” says Susan Stark, an associate professor of occupational therapy, neurology, and neuroscience. The doctor said. Of social work. “If you lose strength and balance, the recommended treatment is to stay fit and balanced. But if someone falls for another reason, perhaps his or her brain accumulates Alzheimer-related damage. The person may need a completely different treatment because they are starting, but it is not yet known what the treatment is, but using this information, the risk of falls in this population I hope we can come up with new treatment suggestions to alleviate this. “

In 1987, then-University of Washington trainee John C. Morris, MD, said older people with Alzheimer’s disease could suffer more than twice as much trauma as people of the same age without dementia. Was found to be high. Morris is currently a professor of neurology with Harvey A. and Drismae Hacker Friedman, and head of the University’s Charles F. and Joanne Knight Alzheimer’s Disease Research Center.

Since the discovery of Morris more than 30 years ago, scientists have learned that the brains of patients with Alzheimer’s disease have begun to change decades before memory loss and confusion became apparent. First, amyloid protein plaques are formed, and then tau protein tangles are formed. A few Starts shrinking Between the distant parts of the brain begins to collapse. Stark and colleagues have shown that the relationship between Alzheimer’s disease and falls applies even during the silence phase of the illness. People with so-called preclinical Alzheimer’s disease are at increased risk of falls, even though there are no obvious cognitive problems.

To better understand why people without dementia are at risk of falling, Audrey Kelemen, the first author of a graduate student in Stark’s lab, and colleagues tracked 83 people over the age of 65 for a year. Did. All participants were evaluated as cognitively normal by a qualified neurologist at the beginning of the study. Each participant completed a monthly calendar recording falls and performed a brain scan for signs of amyloid and atrophy and signs of poor connectivity.

Researchers have found that the presence of amyloid in the brain alone increases neurodegeneration rather than increasing the risk of people falling. The fallen participant, the hippocampus, focused on memory and had a small brain area that shrank due to Alzheimer’s disease. There were also signs of weakness in their somatomotor network, the network of connections involved in receiving sensory inputs and controlling movement. Researchers have concluded that falls are most likely to occur during the neurodegenerative stage of preclinical Alzheimer’s disease-around five years ago. And confusion arises.

“Since I started working on this project, I started asking patients about falls. I don’t know how often it helped them start to understand what’s happening to individuals,” he said. Chief author Bo M. Ances, MD, Ph.D., Daniel J. Brennan, MD, Professor of Neurology, Professor of Radiology and Biomedical Engineering. Ances treats patients with dementia and other neurological disorders at the University of Washington Medical Campus.

“Even if a person looks very normal, when a person’s mobility is reduced, it can be a sign that something needs further evaluation,” Ances said. “This is actually a” important potential marker, “wait a minute. Let’s take a closer look at this. Is there anything else?”

Researchers have begun further experiments to better understand why changes in the brain in Alzheimer’s disease put people at risk of falling. On the other hand, simple changes could greatly help protect older people from catastrophic waterfalls, Stark said.

“Just making the environment safer can prevent many falls,” Stark said. “Simple changes are effective and do no harm. Make sure the tub is not slippery. Make sure you can easily get up from the toilet. Balance and strength training. Review your prescription and See if a particular drug or combination of drugs is increasing Risk of falls. To make people safer until specific fall prevention treatments for people with preclinical Alzheimer’s disease are available. There are still many things that can be done. ”


Signs and Symptoms of Dementia with Lewy Bodies


For more information:
Audrey Keleman et al., Falls are associated with neurodegenerative changes in the ATN framework for Alzheimer’s disease. Journal of Alzheimer’s disease (2020). DOI: 10.3233 / JAD-200192

Quote: Elderly people at early risk of asymptomatic Alzheimer’s fall (September 15, 2020), September 15, 2020 https://medicalxpress.com/news/2020-09-older-people-early Obtained from -asymptomatic-alzheimer.html

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