1 Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.
2 Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.
3 Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.
4 Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.
5 University Memory Clinic of Angers, Angers, France.
6 UPRES EA 4638, University of Angers, UNAM, Angers, France.
7 Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
8 Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
9 Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada.
10 Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
11 Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QUÉBEC, Canada.
12 Research Center on Aging, Institut universitaire de gériatrie de Sherbrooke (IUGS), Sherbrooke, QUÉBEC, Canada.
13 PERFORM Centre and Department of Psychology, Concordia University, Montreal, QC, Canada.
14 Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
15 Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
16 Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.

Association Between Falls and Brain Subvolumes: Results from a Cross-Sectional Analysis in Healthy Older Adults.

Brain Topogr. 2017 03;30(2):272-280

Authors: Beauchet O, Launay CP, Barden J, Liu-Ambrose T, Chester VL, Szturm T, Grenier S, Léonard G, Bherer L, Annweiler C, Helbostad JL, Verghese J, Allali G, Biomathics and Canadian Gait Consortium

Abstract

Falls are a consequence of gait instability. Cortical and subcortical abnormalities have been associated with gait instability but not yet with falls. This study aims to compare the global and regional brain subvolumes between healthy older fallers and non-fallers. A total of 77 healthy older individuals (23 fallers and 54 non-fallers, 69.8 ± 3.5 years; 45.5 % female) were included in this study using a cross-sectional design. Based on an a priori hypothesis, the following brain subvolumes were quantified from three-dimensional T1-weighted MRI using FreeSurfer software: total white matter abnormalities, total white matter, total cortical and subcortical gray matter, hippocampus, motor cortex, somatosensory cortex, premotor cortex, prefrontal cortex and parietal cortex volumes. Gait performances were also recorded. Age, sex, body mass index, comorbidities, use of psychoactive drugs, far-distance visual acuity, lower-limb proprioception, depressive symptoms and cognitive scores (Mini-Mental State Examination, Frontal Assessment Battery) were used as covariates. Fallers have more frequently depressive symptoms (P = 0.048), a lower far distance visual acuity (P = 0.026) and a higher coefficient of variation of stride time (P = 0.008) compared to non-fallers. There was a trend to greater subvolumes for the somatosensory cortex (P = 0.093) and the hippocampus (P = 0.060) in the falls group. Multiple logistic regressions showed that subvolumes of the somatosensory cortex and the hippocampus (P < 0.042) were increased in fallers compared to non-fallers, even after adjustment for clinical and brain characteristics. The greater subvolumes of the somatosensory cortex and hippocampus reported in fallers compared to non-fallers suggests a possible brain compensatory mechanism involving spatial navigation and integration of sensory information.

PMID: 27785698 [PubMed - indexed for MEDLINE]