TY  - JOUR
PY  - 2014//
TI  - Sub-cortical infarcts and the risk of falls in older people: combined results of TASCOG and Sydney MAS studies
JO  - International journal of stroke
A1  - Callisaya, Michele L.
A1  - Srikanth, Velandai K.
A1  - Lord, Stephen R.
A1  - Close, Jacqueline C.
A1  - Brodaty, Henry
A1  - Sachdev, Perminder S.
A1  - Phan, Thanh
A1  - Beare, Richard
A1  - Trollor, Julian
A1  - Wen, Wei
A1  - Zheng, Jacqueline J.
A1  - Delbaere, Kim
SP  - 55
EP  - 60
VL  - 9
IS  - Suppl A100
N2  - 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. <br><br>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. <br><br>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. <br><br>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.<p />  <p>Language: en</p>
LA  - en
SN  - 1747-4930
UR  - http://dx.doi.org/10.1111/ijs.12279
ID  - ref1
ER  -