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Brain Diseases and Fall-Related Surgery in Older Persons.

Ryuji Sakakibara1, Ayako Iimura1, Tsuyoshi Ogata1

  • 1Neurogeriatric Team, Sakura Medical Center, Toho University, Sakura, Japan.

European Neurology
|February 14, 2022
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Summary

Brain diseases like white matter disease and Alzheimer's disease are common causes of fall-related surgery in orthopedics, while alcoholism is more frequent in neurosurgery. This study identifies key links between specific brain conditions and surgical interventions following falls.

Keywords:
Alzheimer’s diseaseDementia with Lewy bodiesHip fractureSubdural hematomaWhite matter disease

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Area of Science:

  • Geriatric Medicine
  • Neurology
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • Age-related brain symptoms, including gait difficulty and dementia, are known risk factors for fall-related surgery.
  • The specific types of underlying brain diseases contributing to these fall-related surgeries remain largely unknown.
  • Understanding these links is crucial for targeted prevention and treatment strategies.

Purpose of the Study:

  • To investigate the correlation between specific brain diseases and the types of fall-related surgeries performed.
  • To identify the most prevalent neurological conditions leading to surgical intervention after falls.
  • To differentiate the underlying pathologies based on the surgical specialty involved.

Main Methods:

  • A retrospective study was conducted at a Japanese multifaculty university hospital.
  • A dedicated neurogeriatric team diagnosed brain diseases using neuroimaging.
  • Diagnoses were correlated with surgical procedures performed by orthopedic and neurosurgery departments.

Main Results:

  • Fall-related surgeries were performed by orthopedics (OP) and neurosurgery (NS) at approximately a 2:1 ratio.
  • For orthopedic surgery, the most common underlying conditions were a combination of white matter disease (WMD) and Alzheimer's disease (AD) (79%).
  • For neurosurgery, alcoholism (50%) was the most frequent underlying condition, followed by WMD and AD.

Conclusions:

  • The primary drivers for fall-related surgeries differ between orthopedic and neurosurgical interventions.
  • A combination of white matter disease and Alzheimer's disease is strongly associated with orthopedic fall-related surgeries.
  • Alcoholism is a significant underlying factor for neurosurgical procedures following falls.