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Sub-cortical infarcts and the risk of falls in older people: combined results of TASCOG and Sydney MAS studies

Citation

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 Statement

Copyright 2014 International Journal of Stroke

DOI: doi:10.1111/ijs.12279

Abstract

BACKGROUND: White matter hyperintensities increase the risk of multiple falls in older people, but the effect of sub-cortical infarcts is unknown.

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 745 (standard deviation 67) years, 336 (513%) males. Overall, 114 (174%) had multiple falls. The majority had no sub-cortical infarcts (n = 491, 750%), while 90 had one (137%), 41 had two (63%), and 33 had more than or equal to three sub-cortical infarcts (50%). The risk of multiple falls was elevated in people with more than or equal to three sub-cortical infarcts (adjusted relative risk 189, 95% confidence interval 103, 346) and in the highest quarter of white matter hyperintensity volume (adjusted relative risk 146, 95% confidence interval 100, 213). The effect of sub-cortical infarcts on falls was amplified by poorer vision (P = 003). The effect of white matter hyperintensities was amplified by poorer vision (P = 0008), proprioception (P = 003), and muscle strength (P = 0008). 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 Details

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 Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Health Related to Ageing
Author:Callisaya, ML (Dr Michele Callisaya)
Author:Srikanth, VK (Dr Velandai Srikanth)
ID Code:96973
Year Published:2014
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-11-26
Last Modified:2017-11-03
Downloads:0

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