Cerebral White Matter Lesions, Gait, and the Risk of Incident Falls

Abstract

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 (nϭ294, 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 (Pϭ0.01) and multiple incident falls (Pϭ0.02). 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 PϽ0.001).

Parkinson's disease motor subtypes and mood

“…A second possible mechanism underpinning an association between axial symptoms and depression is white matter change. White matter damage is a significant predictor of gait problems and falls in the elderly [53] and is also strongly associated with depression and cognitive impairment. [54] In PD, microstructural white matters changes are similarly associated with both axial motor and cognitive symptoms [55] while recent in vivo studies report increased white matter changes in cortico-limbic and medial thalamic areas in depressed patients.…”

White Matter Lesions Are Associated With Hospital Admissions Because of Hip-Fractures and Trauma After Ischemic Stroke

“…6 WMLs of the brain are associated with decreasing mobility, gait instability, and falls. [7][8][9][10] However, the association of the presence of WMLs in long-term follow-up with clinically relevant incidences, as traumatic injuries requiring hospitalization, remains unclear. The aim of this study was to explore the association of WMLs of the brain with hospital admissions because of any trauma and especially hip-fractures in a cohort of patients with ischemic stroke aged 55 to 85 years followed up for 12 years.…”

Silent Infarcts and Cerebral Microbleeds Modify the Associations of White Matter Lesions With Gait and Postural Stability

“…WMLs are associated gait and a greater risk of falls. 11 Although SIs are associated with poorer cognition and dementia, 12 fewer studies have been performed to examine their effects on gait and balance, also showing adverse associations. [13][14][15] There is emerging evidence that MBs may be associated with poorer cognition, but there has been only 1 study on their association with gait.…”