Citation

Callisaya ML, Srikanth VK, Lord SR, Close JC, Brodaty H, Sachdev PS, Phan T, Beare R, Trollor J, Wen W, Zheng JJ, Delbaere K. Int. J. Stroke 2014; 9(Suppl A100): 55-60.

Affiliation

Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Melbourne, Australia; Menzies Research Institute, University of Tasmania, Hobart, Australia.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/ijs.12279

PMID

24712920

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 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.

Language: en