title: Regional Gray Matter Volumes Are Related to Concern About Falling in Older People: A Voxel-Based Morphometric Study.
abstract: BACKGROUND
  Concern about falling is common in older people. Various related psychological constructs as well as poor balance and slow gait have been associated with decreased gray matter (GM) volume in old age. The current study investigates the association between concern about falling and voxel-wise GM volumes.
  
  
  METHODS
  A total of 281 community-dwelling older people aged 70-90 years underwent structural magnetic resonance imaging. Concern about falling was assessed using Falls Efficacy Scale-International (FES-I). For each participant, voxel-wise GM volumes were generated with voxel-based morphometry and regressed on raw FES-I scores (p < .05 family-wise error corrected on cluster level).
  
  
  RESULTS
  FES-I scores were negatively correlated with total brain volume (r = -.212; p ≤ .001), GM volume (r = -.210; p ≤ .001), and white matter volume (r = -.155; p ≤ .001). Voxel-based morphometry analysis revealed significant negative associations between FES-I and GM volumes of (i) left cerebellum and bilateral inferior occipital gyrus (voxels-in-cluster = 2,981; p < .001) and (ii) bilateral superior frontal gyrus and left supplementary motor area (voxels-in-cluster = 1,900; p = .004). Additional adjustment for vision and physical fall risk did not alter these associations. After adjustment for anxiety, only left cerebellum and bilateral inferior occipital gyrus remained negatively associated with FES-I scores (voxels-in-cluster = 2,426; p < .001). Adjustment for neuroticism removed all associations between FES-I and GM volumes.
  
  
  CONCLUSIONS
  Our study findings show that concern about falling is negatively associated with brain volumes in areas important for emotional control and for motor control, executive functions and visual processing in a large sample of older men and women. Regression analyses suggest that these relationships were primarily accounted for by psychological factors (generalized anxiety and neuroticism) and not by physical fall risk or vision.
authors: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
authors: Carola
authors: C
authors: Tuerk
authors: Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia.
authors: Haobo
authors: H
authors: Zhang
authors: Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia.
authors: Perminder
authors: P
authors: Sachdev
authors: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
authors: Stephen R
authors: SR
authors: Lord
authors: Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia. Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors: Henry
authors: H
authors: Brodaty
authors: Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia.
authors: Wei
authors: W
authors: Wen
authors: Neuroscience Research Australia, University of New South Wales, Sydney, Australia. k.delbaere@neura.edu.au.
authors: Kim
authors: K
authors: Delbaere
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D002531:Cerebellum / Q000473:pathology*; D004644:Emotions / Q000502:physiology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009778:Occipital Lobe / Q000473:pathology*; D009929:Organ Size; D012307:Risk Factors; D013223:Statistics as Topic; D014796:Visual Perception / Q000502:physiology
keywords: Accidental falls; Aged; Brain atrophy; Fear of falling; Magnetic resonance imaging; Neurodegeneration; Personality; Psychological distress.