Callisaya, ML and Srikanth, VK and Lord, SR and Close, JC and Brodaty, H and Sachdev, PS and Phan, T and Beare, R and Trollor, J and Wen, W and Zheng, JJ and Delbaere, K, Sub-cortical infarcts and the risk of falls in older people: combined results of TASCOG and Sydney MAS studies, International Journal of Stroke, 9, (Suppl A100) pp. 55-60. ISSN 1747-4930 (2014) [Refereed Article]
Copyright 2014 International Journal of Stroke
AIMS: By pooling data from two Australian population-based studies, we aimed to investigate the association between sub-cortical infarcts and multiple falls and whether this relationship, and that of white matter hyperintensities, is mediated or modified by cognitive or sensorimotor factors.
METHODS: Participants underwent structural magnetic resonance imaging and cognitive and sensorimotor assessments. Falls were prospectively measured over 12 months. Sub-cortical infarcts were detected visually. Total white matter hyperintensity volume was quantified using automated segmentation methods. Generalized linear models were used to examine if sub-cortical infarcts and white matter hyperintensities predicted falls.
RESULTS: The mean age of the sample (n = 655) was 74·5 (standard deviation 6·7) years, 336 (51·3%) males. Overall, 114 (17·4%) had multiple falls. The majority had no sub-cortical infarcts (n = 491, 75·0%), while 90 had one (13·7%), 41 had two (6·3%), and 33 had more than or equal to three sub-cortical infarcts (5·0%). The risk of multiple falls was elevated in people with more than or equal to three sub-cortical infarcts (adjusted relative risk 1·89, 95% confidence interval 1·03, 3·46) and in the highest quarter of white matter hyperintensity volume (adjusted relative risk 1·46, 95% confidence interval 1·00, 2·13). The effect of sub-cortical infarcts on falls was amplified by poorer vision (P = 0·03). The effect of white matter hyperintensities was amplified by poorer vision (P = 0·008), proprioception (P = 0·03), and muscle strength (P = 0·008). There was no modifying effect of cognitive function.
CONCLUSIONS: Increasing burdens of sub-cortical infarcts and white matter hyperintensities are associated with a risk of falling. Interventions targeting sensorimotor factors along with strategies to prevent sub-cortical infarcts and white matter hyperintensities may reduce the risk of falls.
|Item Type:||Refereed Article|
|Keywords:||falls, older people, population based, small vessel disease, sub-cortical infarcts, white matter disease|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Geriatrics and Gerontology|
|Objective Group:||Specific Population Health (excl. Indigenous Health)|
|Objective Field:||Health Related to Ageing|
|UTAS Author:||Callisaya, ML (Dr Michele Callisaya)|
|UTAS Author:||Srikanth, VK (Dr Velandai Srikanth)|
|Web of Science® Times Cited:||6|
|Deposited By:||Menzies Institute for Medical Research|
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