BACKGROUND: Greater volume of cerebral white matter hyperintensities (WMH) of presumed vascular origin may affect postural control and gait. WMH measured at one time point predicts an increased risk of incident multiple falls. However, it is unknown whether WMH progression increases falls risk. We hypothesized that the progression of WMH would be associated with a greater risk of multiple falls.

METHODS: A population-based sample aged more than 60 years was randomly selected from the electoral roll and followed up 2.5 years apart with two phases of measurement. Magnetic resonance imaging scans from both time points were subjected to automated segmentation to derive WMH volumes. Falls were recorded prospectively over 12 months after the second magnetic resonance imaging measurement. A generalized linear model was used to estimate the relative risk of multiple falls associated with WMH progression adjusted for confounders.

RESULTS: There were 187 people (mean age 70.4, SD 6.5) with a mean follow-up of 2.5 (SD 0.4) years. Over 12 months, 35 (18.7%) participants reported multiple falls. A greater progression of WMH was associated with an increased risk of multiple falls (adjusted relative risk 1.30, 95% confidence interval 1.00-1.70, p = .05) independent of baseline WMH volume, duration of follow-up, age, sex, and total intracranial volume. This association was unchanged when adjusted for medical history, peripheral sensorimotor factors, gait speed, cognition, medications, mood, and magnetic resonance imaging infarcts.

CONCLUSION: Greater WMH progression independently increased the risk of multiple falls. Interventions to slow the progression of WMH may be successful in reducing this risk.

Item Type:	Refereed Article
Keywords:	Falls, Brain aging, Epidemiology, Imaging, White matter hyperintensities
Research Division:	Health Sciences
Research Group:	Epidemiology
Research Field:	Epidemiology not elsewhere classified
Objective Division:	Health
Objective Group:	Specific population health (excl. Indigenous health)
Objective Field:	Health related to ageing
UTAS Author:	Callisaya, ML (Dr Michele Callisaya)
UTAS Author:	Blizzard, L (Professor Leigh Blizzard)
UTAS Author:	Srikanth, VK (Dr Velandai Srikanth)
ID Code:	94522
Year Published:	2014
Web of Science® Times Cited:	32
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2014-09-11
Last Modified:	2017-11-06
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