Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study.
OBJECTIVE
To test the hypothesis that methylphenidate modifies markers of fall risk in older adults.


METHODS
Randomized, double-blind, placebo-controlled, single-dose cross-over study.


METHODS
Outpatient movement disorders clinic.


METHODS
Twenty-six community-living older adults without dementia (mean age 73.8) with subjective complaints of "memory problems."


METHODS
The study examined the effects of a single dose of 20 mg of methylphenidate (MPH) on cognitive function and gait. Participants were evaluated before and 2 hours after taking MPH or a placebo in sessions 1 to 2 weeks apart.


METHODS
The Timed Up and Go and gait variability quantified mobility and fall risk. A computerized neuropsychology battery quantified memory and executive function (EF).


RESULTS
Timed Up and Go times, stride time variability, and measures of EF significantly improved in response to MPH but not in response to the placebo. In contrast, MPH did not significantly affect memory or finger tapping abilities.


CONCLUSIONS
In older adults, MPH appears to improve certain aspects of EF, mobility, and gait stability. Although additional studies are required to assess clinical utility and efficacy, the present findings suggest that methylphenidate and other drugs that are designed to enhance attention may have a role as a therapeutic option for reducing fall risk in older adults.
Ben-Itzhak
Ron
R
Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
Giladi
Nir
N
Gruendlinger
Leor
L
Hausdorff
Jeffrey M
JM
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D001288:Attention / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005684:Gait / Q000187:drug effects*; D020233:Gait Disorders, Neurologic / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009043:Motor Activity / Q000187:drug effects*; D010045:Outpatients; D012307:Risk Factors; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate