@article{ref1,
title="Brain activation in high-functioning older adults and falls: prospective cohort study",
journal="Neurology",
year="2016",
author="Verghese, Joe and Wang, Cuiling and Ayers, Emmeline and Izzetoglu, Meltem and Holtzer, Roee",
volume="88",
number="2",
pages="191-197",
abstract="OBJECTIVE: To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. <br><br>METHOD: We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet). Incident falls were prospectively assessed over a 50-month study period. <br><br>RESULTS: Over a mean follow-up of 33.9 ± 11.9 months, 116 falls occurred. Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls (hazard ratio adjusted for age, sex, education, medical illnesses and general mental status 1.32, 95% confidence interval 1.03-1.70). Neither behavioral outcomes (velocity or letter rate) on the dual task nor brain activation patterns on the single tasks (normal walk or talk alone) predicted falls in this high-functioning sample. The results remained robust after accounting for multiple confounders and for cognitive status, slow gait, previous falls, and frailty. <br><br>CONCLUSIONS: Prefrontal brain activity levels while performing a cognitively demanding walking condition predicted falls in high-functioning seniors. These findings implicate neurobiological processes early in the pathogenesis of falls.<br><br>© 2016 American Academy of Neurology.<p /> <p>Language: en</p>",
language="en",
issn="0028-3878",
doi="10.1212/WNL.0000000000003421",
url="http://dx.doi.org/10.1212/WNL.0000000000003421"
}