This hypothesis is substantiated by recent neuroimaging evidence demonstrating neural differences between fallers and non-fallers. It is well-known that both physical and cognitive abilities have neural concomitants, suggesting that altered functional brain responses may play a prominent role in falls risk. More specifically, the executive cognitive processes of response inhibition, as measured by the Stroop Color-Word test ( Lord and Fitzpatrick, 2001 Liu-Ambrose et al., 2008a), and set-shifting, as measured by the Trail Making test ( Corrigan and Hinkeldey, 1987), appear to be most relevant to falls. Within the multiple domains of cognitive function, impaired executive functioning – the ability to concentrate, to attend selectively, to plan and strategize – is associated with falls ( Lundin-Olsson et al., 1997 Rapport et al., 1998 Anstey et al., 2006). Physical risk factors include mobility and balance issues, which can be assessed using multiple physiological components ( Lord et al., 2003).Ĭognitive dysfunction is also a key falls risk factor ( Tinetti et al., 1988). Broadly, falls risk factors can be divided into two distinct categories: (1) physical risk factors, or (2) cognitive risk factors.
Experts consider falls to be non-random events ( Grimley-Evans, 1990) and reliable risk factors for falls have been identified. Of particular note, the medial frontal gyrus – a region implicated in motor planning – demonstrated hypo-activation in fallers, providing evidence that the prefrontal cortex might play a central role in falls risk in older adults.įalls are a common geriatric syndrome, with approximately 30% of community dwelling seniors experiencing one or more per year. We found that fallers exhibited a smaller difference in functional activation between congruent and incongruent trials relative to non-fallers, as well as an overall reduction in level of blood-oxygen-level dependent response.
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We examined the hemodynamic response of congruent and incongruent trials separately in order to separate the relative contribution of each trial type as a function of falls history. All participants completed the Flanker task during functional magnetic resonance imaging (fMRI). In this study, community-dwelling adults aged 65–75 years were divided into two groups based on their recent history of falls (fallers versus non-fallers). Falls are a common geriatric condition, and while impaired cognitive function has been identified as a key risk factor, the neural correlates that contribute to reduced executive functioning and falls currently remain unknown.
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