story by Claire Miller
Older adults face various physical and mental challenges as they age, including an increased risk of falling.
This is especially true for individuals with mild cognitive impairments (MCI) – the early stages of cognitive disorders that can lead to dementia – and those diagnosed with Alzheimer’s disease (AD), a type of dementia that affects memory, thinking and behavior, according to the Alzheimer’s Association.
Post-doctoral fellow Caroline Simpkins (Ph.D. ’24), Dean’s Doctoral Research Fellow Sara Mahmoudzadeh Khalili and Associate Professor Feng Yang conducted a meta-analysis of 35 studies on the annual fall risk for older adults with MCI or AD, to determine if the risks differ between these two populations.
After the literature search, they narrowed the studies to include only those that fit the following criteria: 1) They were conducted among adults ages 65 and older with MCI or AD, 2) They tracked the number of falls that study participants had over a 12-month period and 3) They were published in a peer-reviewed journal.
Simpkins, Mahmoudzadeh Khalili and Yang took the results from each study and calculated the annual fall prevalence for older adults with MCI and AD based on the number of people who fell once or more over 12 months and the study’s sample size. The annual number of falls was also compared between the two dementia subgroups.
Their meta-analysis, published in Advances in Geriatric Medicine and Research, found that older adults with AD had a higher risk of falling (43.55 percent) and a higher number of falls per year (1.3) compared to those with MCI (35.26 percent risk of falling and 0.77 falls per year).
Dementia affects walking, balance and mobility, and the studies in this meta-analysis indicate that the “more severe the cognitive impairments, the stronger the correlation between falls and cognitive deficits.”
“This relationship not only explains why people with dementia exhibit a higher fall risk than their cognitively intact peers, but also the greater fall risk among people with AD than those with MCI since AD is a more advanced dementia stage than MCI,” the authors wrote. “Another possible contributor to the positive correlation could be the side effects of taking medications used to treat dementia. The potential side effects include dizziness, postural instability, confusion, difficulty in coordinating body movements and decreased blood pressure, which can all increase the fall risk.”
The results from their meta-analysis could help public officials, researchers and healthcare providers decide how best to support older adults with MCI and AD.
“This information could guide different stakeholders, such as policymakers, to better distribute fall prevention resources among people with AD or MCI,” the authors wrote. “It can also assist researchers and clinicians with developing modalities to assess fall risk, identifying individuals with an elevated fall risk and establishing treatment strategies to lower the fall risk for these populations.”