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Cerebral White Matter Lesions, Gait, and the Risk of Incident Falls A Prospective Population-Based Study


Srikanth, V and Beare, R and Blizzard, L and Phan, T and Stapleton, J and Chen, J and Callisaya, M and Martin, K and Reutens, D, Cerebral White Matter Lesions, Gait, and the Risk of Incident Falls A Prospective Population-Based Study, Stroke, 40, (1) pp. 175-180. ISSN 0039-2499 (2009) [Refereed Article]

DOI: doi:10.1161/STROKEAHA.108.524355


Background and Purpose—The association between cerebral white matter lesions (WMLs) and the risk of falls in older people is uncertain, with no supporting prospective evidence. We aimed to determine the risk of incident falls associated with WML volume, and the interactions between WML volume, gait, and other sensorimotor factors leading to falls. Methods—We conducted a prospective, population-based study (n=294, mean age 72.3 years, independently mobile).Volumetric MRI, computerized gait measures, and sensorimotor measures of falls risk were obtained at baseline. Incident falls were recorded prospectively over a 12-month period. Using regression modeling, we estimated the risk of incident falls associated with baseline WML volume. Results—Increasing baseline WML volume was independently associated with any incident fall (P=0.01) and multiple incident falls (P=0.02). The risk of incident falls was doubled in people with lesion volumes in the highest quintile of its distribution compared with the lowest (adjusted relative risk, 2.32; 95% CI, 1.28 – 4.14). Greater lesion volume was also associated with poorer gait and greater gait variability (both P<0.001). The effect of WML volume on the risk of falls was magnified in people with poorer quadriceps muscle strength (P=0.03) and greater gait variability (P=0.001). Conclusions—These data provide the first prospective evidence to our knowledge demonstrating that WMLs are strong risk factors for falls in the general older population. WMLs present potential therapeutic targets for interventional trials in falls prevention.

Item Details

Item Type:Refereed Article
Keywords:falls; gait; population-based; prospective studies; white matter lesions
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Srikanth, V (Dr Velandai Srikanth)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Callisaya, M (Dr Michele Callisaya)
ID Code:53146
Year Published:2009
Web of Science® Times Cited:168
Deposited By:Menzies Institute for Medical Research
Deposited On:2008-11-04
Last Modified:2011-07-27

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