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Brain activation in high-functioning older adults and falls: Prospective cohort study
Joe Verghese1, Cuiling Wang2, Emmeline Ayers2
1From the Departments of Neurology (J.V., E.A., R.H.), Medicine (J.V.), and Epidemiology (C.W.), Albert Einstein College of Medicine; Ferkauf Graduate School of Psychology (R.H.), Yeshiva University, Bronx, NY; and Drexel University School of Biomedical Engineering (M.I.), Philadelphia, PA. joe.verghese@einstein.yu.edu.
Brain activity in the prefrontal cortex during dual-task walking predicts falls in healthy seniors. This finding highlights early neurobiological changes associated with fall risk.
Area of Science:
- Neuroscience
- Gerontology
- Biomedical Engineering
Background:
- Falls are a significant concern for older adults, impacting mobility and independence.
- Identifying predictive markers for falls is crucial for early intervention in high-functioning seniors.
Purpose of the Study:
- To investigate if real-time prefrontal cortex brain activity during walking predicts future falls in high-functioning older adults.
- To assess the role of cognitive-motor dual-tasking in fall prediction.
Main Methods:
- 166 high-functioning older adults (mean age 75) were monitored for falls over 50 months.
- Functional near-infrared spectroscopy (fNIRS) measured prefrontal cortex oxygenated hemoglobin during single and dual-task walking.
- Incident falls were prospectively recorded.
Main Results:
- Higher prefrontal cortex activation during dual-task walking predicted falls (HR 1.32).
- Neither single-task brain activation nor dual-task behavioral performance predicted falls.
- Findings remained significant after adjusting for age, sex, medical history, cognitive status, and frailty.
Conclusions:
- Prefrontal cortex brain activity during cognitively demanding walking is a significant predictor of falls in high-functioning seniors.
- These results suggest that neurobiological changes in brain function may precede the onset of falls, indicating early pathogenesis.
