title: Neuropathological correlates of falling in the CC75C population-based sample of the older old.
abstract: BACKGROUND
  Previous imaging studies have suggested links between brain pathologies and factors that are associated with falls such as gait, balance and daily function. Possible neuropathological correlates of older people's falls have been suggested based on brain imaging studies, but to date none have been examined in brain tissue.
  
  
  METHODS
  Falls data collected from repeated surveys of a population-based cohort of individuals aged at least 75 years old at baseline were related to neuropathological data collected from post-mortem examination of the study's associated brain donor collection (n=212).
  
  
  RESULTS
  Amongst people without dementia, most cerebrovascular neuropathological features examined, particularly white matter pallor, microinfarcts and microscopic atherosclerosis, were increasingly common across the subgroups categorised by no reports of falling, only one or at least two reports of falling. The overall burden of pathology was greater in those with dementia, but only microinfarcts showed a similar increase with respect to reported falling status.
  
  
  CONCLUSIONS
  Subclinical pathologies sharing a common vascular origin are associated with increased falling amongst people with no dementia, as are microinfarcts in those with dementia. Although further research is needed to address the mechanisms of falls and their neuropathological correlates, the findings from the current study would suggest that if cerebrovascular disease prevention reduces vascular neuropathology changes this may have direct benefits in reducing falls amongst older people with or without dementia.
authors.affiliation: University of Cambridge, Department of Public Health and Primary Care. seh66@medschl.cam.ac.uk
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richardson
authors.forename: Sally
authors.initials: S
authors.lastname: Hunter
authors.forename: Tom
authors.initials: T
authors.lastname: Dening
authors.forename: John H
authors.initials: JH
authors.lastname: Xuereb
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Jane
authors.initials: J
authors.lastname: Fleming
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male