Age-associated striatal dopaminergic denervation and falls in community-dwelling subjects.
Older adults have a high prevalence of gait and balance disturbances and falls. Normal aging is associated with significant striatal dopaminergic denervation, which might be a previously unrecognized additional contributor to geriatric falls. This study investigated the relationship between the severity of age-associated striatal dopaminergic denervation (AASDD) and falls in community-dwelling subjects. Community-dwelling subjects who did not have a clinical diagnosis to explain falls (n = 77: 43 female, 34 male; mean age 61.4 +/- 16.4; range 20-85) completed clinical assessment and brain dopamine transporter (DAT) [(11)C]beta-CFT (2-beta-carbomethoxy-3beta-(4-fluorophenyl) tropane) positron emission tomography imaging followed by 6 months of prospective fall monitoring using diaries. Results showed a significant inverse relationship between striatal DAT activity and age (r = -0.82, p < 0.001). A total of 26 subjects (33.8%) reported at least one fall, with 5 subjects (6.5%) reporting two or more falls. While no significant difference was noted in striatal DAT activity between nonfallers (n = 51) and fallers (n = 26; f = 0.02, not significant), striatal DAT activity was modestly reduced in the small subgroup of recurrent fallers compared with the other subjects (f = 5.07, p < 0.05). Findings indicate that AASDD does not explain isolated self-reported falls in community-dwelling subjects. However, it may be a contributing factor in the small subgroup of subjects with recurrent falls.
Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Geriatric Research, Education, and Clinical Center (GRECC), Ann Arbor, MI, USA. nbohnen@umich.edu
Nicolaas I
NI
Bohnen
Martijn L T M
ML
Muller
Hiroto
H
Kuwabara
Rakié
R
Cham
Gregory M
GM
Constantine
Stephanie A
SA
Studenski
D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D001479:Basal Ganglia / Q000378:metabolism*; D004298:Dopamine / Q000378:metabolism*; D050483:Dopamine Plasma Membrane Transport Proteins / Q000502:physiology*; D005260:Female; D020233:Gait Disorders, Neurologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D055815:Young Adult
D050483:Dopamine Plasma Membrane Transport Proteins; D004298:Dopamine