title: Impact of white matter lesions on physical functioning and fall risk in older people: a systematic review.
abstract: OBJECTIVE
  White matter lesions (WMLs) are common findings on neuroimaging in older people. This review systematically evaluates the published literature on the associations between WMLs and balance, gait, mobility, and falls in older people.
  
  
  METHODS
  Studies were identified with searches of the MEDLINE databases. Articles reporting associations between WMLs and balance, gait, mobility, and falls in older people in cross-sectional and longitudinal studies were included.
  
  
  RESULTS
  Thirty-one articles reporting data from 19 studies met the inclusion criteria. There were consistent findings from both cross-sectional and longitudinal studies indicating greater WML volumes are associated with impaired balance, slower gait, and reduced mobility. Most studies addressing regional WML distributions have reported that WMHs in the frontal lobe and periventricular regions show the strongest relationships with balance, gait, and mobility impairments. In relation to falls, a threshold effect was apparent in that only those with severe WML volumes were found to be at increased risk of falling.
  
  
  CONCLUSIONS
  The findings of this systematic review indicate that WMLs are common and are significantly associated with impaired balance, gait, mobility, and falls in older people. In many studies, however, impaired mobility and increased fall risk are only evident in people who have the most severe degree of WMLs.
authors.affiliation: Neuroscience Research Australia, Barker Street, Randwick, NSW, 2031, Australia.
authors.forename: Jacqueline J J
authors.initials: JJ
authors.lastname: Zheng
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D006801:Humans; D056784:Leukoencephalopathies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D012306:Risk