Objectives-Among older adults, falls are a major health concern. A decrease in executive function (EF), common with aging, has been associated with gait instability, reduced mobility and other markers of fall risk. It is not known, however, whether augmenting EF affects gait and fall risk. We tested the hypothesis that methylphenidate modifies markers of fall risk in older adults.Design-Randomized, double-blind, placebo-controlled, single dose crossover study Author Contributions: Indicate authors' role in study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. (See section on "Authorship and Duplicate Publication").RBY contributed to the study design, data collection, interpretation of the results, and wrote the first draft of the manuscript. NG contributed to the study design, data collection, interpretation of the results and revisions of the manuscript. LG contributed to data analysis, interpretation of the results, and revisions of the manuscript. JMH contributed to the study design, data collection, interpretation of the results, and revisions of the manuscript. All authors have seen and approved of the final version of the manuscript.Sponsor's Role: Indicate sponsor's role in the design, methods, subject recruitment, data collections, analysis and preparation of paper.
Conflict of Interest Disclosures:Below is a checklist for all authors to complete and attach to their papers during submission. Setting-Outpatient movement disorders clinic.
Elements of Financial/Personal ConflictsParticipants-Twenty-six non-demented, community-living older adults (mean age: 73.8 years) with subjective complaints of "memory problems."Interventions-The study examined the effects of a single dose of 20 mg of methylphenidate (MPH) on cognitive function and gait. Participants were evaluated before and two hours after taking MPH or a placebo in sessions separated by 1-2 weeks.Measurements-The Timed Up and Go and gait variability quantified mobility and fall risk. A computerized neuropsychology battery quantified memory and EF.Results-Compared to baseline, Timed Up and Go times, stride time variability, and measures of EF significantly improved in response to MPH, but not in response to the placebo. In contrast, memory and finger tapping abilities were not significantly affected by MPH.Conclusions-In older adults, MPH appears to improve certain aspects of EF, mobility and gait stability. Although additional studies are required to assess clinical utility and efficacy, the present findings suggest that methylphenidate and other drugs that are designed to enhance attention may have a role as a therapeutic option for reducing fall risk in older adults.