title: Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment.
abstract: BACKGROUND
  The risk of falling is associated with cognitive dysfunction. Older adults with mild cognitive impairment (MCI) exhibit an accelerated reduction of brain volume, and face an increased risk of falling. The current study examined the relationship between baseline physical performance, baseline gray matter volume and falls during a 12-month follow-up period among community-dwelling older adults with MCI.
  
  
  METHODS
  Forty-two older adults with MCI (75.6 years, 43% women) underwent structural magnetic resonance imaging and baseline physical performance assessment, including knee-extension strength, one-legged standing time, and walking speed with normal pace. 'Fallers' were defined as people who had one or more falls during the 12-month follow-up period.
  
  
  RESULTS
  Of the 42 participants, 26.2% (n = 11) experienced at least one fall during the 12-month follow-up period. Fallers exhibited slower walking speed and shorter one-legged standing time compared with non-fallers (both p < .01). One-legged standing time (sec) (standardized odds ratio [95% confidence interval]: 0.89 [0.81, 0.98], p = .02) was associated with a significantly lower rate of falls during the 12-month follow-up after adjusting for age, sex, body mass index, and history of falling in the past year at baseline. Voxel-based morphometry was used to examine differences in baseline gray matter volume between fallers and non-fallers, revealing that fallers exhibited a significantly greater reduction in the bilateral middle frontal gyrus and superior frontal gyrus.
  
  
  CONCLUSIONS
  Poor balance predicts falls over 12 months, and baseline lower gray matter densities in the middle frontal gyrus and superior frontal gyrus were associated with falls in older adults with MCI. Maintaining physical function, especially balance, and brain structural changes through many sorts of prevention strategies in the early stage of cognitive decline may contribute to decreasing the risk of falls in older adults with MCI.
authors.forename: Hyuma
authors.initials: H
authors.lastname: Makizako
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.forename: Hyuntae
authors.initials: H
authors.lastname: Park
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshida
authors.forename: Kazuki
authors.initials: K
authors.lastname: Uemura
authors.forename: Kota
authors.initials: K
authors.lastname: Tsutsumimoto
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology; D060825:Cognitive Dysfunction / Q000150:complications*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
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