Falls linked to early Alzheimer’s

When a loved one who falls in the bathroom, kitchen or even outside of the home it can be daunting; now new research has helped to explain the act of falling and how it could be linked to something more sinister.

Researchers have found falling may be an early sign of Alzheimer’s disease.

In the study, older people whose brain scans showed signs of amyloid — an early indicator of Alzheimer’s disease — but who were otherwise healthy, had twice the risk of falls as people without brain amyloid.

Susan Stark, an assistant professor of occupational therapy and neurology at Washington University in St. Louis, described the importance of the study.

“To our knowledge, this is the first study to identify a risk of increased falls related to a diagnosis of pre-clinical Alzheimer’s disease. The study suggests higher rates of falls can occur very early in the disease process,” Professor Susan Stark says.

She says the results are consistent with other studies that show mobility problems in people who have very early Alzheimer’s or mild cognitive impairment.

During the eight-month study, Professor Stark and colleagues measured the rates of falls among 125 older adults, some of whom were cognitively healthy and who showed no memory problems day to day, but whose brain scans revealed the presence of amyloid.

Positron emission tomography (PET) scanning — which uses a tracer that lights up areas with amyloid — was used to detect the presence of amyloid.

The participants also contributed samples of cerebrospinal fluid and were asked to keep a journal that tracked how many times they fell.

Forty-eight people experienced at least one fall and those with a positive PET scan image had more than double the risk of falling.

The study was described by Jeffrey Burns, director of the Alzheimer and Memory Program at the University of Kansas School of Medicine, as another “piece to the puzzle” of understanding Alzheimer’s in its early stages, and he said the findings were interesting to experts in the field.

“It’s a small study, but certainly an interesting finding and likely to be of clinical importance down the road if these scans become available,” Mr Burns said.

He added that someone at an increased risk for falls may benefit from bone medication, physical therapy to help with balance and could also be a candidate for early Alzheimer’s drug studies.

According to Mr Burns, the study raises bigger questions about the earliest signs of Alzheimer’s.

“These results apply to cognitively normal individuals who have amyloid in their brains. It’s something we’re just beginning to learn about. What does it mean, what’s the significance when someone has no obvious cognitive problems?” he asked.

“We talk about memory and Alzheimer’s, but that’s not the presenting problem for everybody.”

Researchers say the “take-home message” is if an elderly loved one starts “showing up with bruising and has unexplained falls”, it’s worth a trip to a healthcare provider.

Falls remain the leading cause of long-term disability, premature institutionalisation, and injury-related deaths in the older population.