title: Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy.
abstract: Older adults with type 2 diabetes have significantly higher incidence of falls than those without type 2 diabetes. The devastating consequences of falls include declines in mobility, activity avoidance, institutionalization and mortality. One of the most commonly identified risk factors associated with falls is impaired balance. Balance impairments and subsequent increased fall risk in older adults with type 2 diabetes are most commonly associated with diabetic peripheral neuropathy (DPN). Consequently, DPN has been the central focus of falls prevention research and interventions for older adults with type 2 diabetes. However, isolated studies have identified adults with type 2 diabetes without overt complications of DPN to also be at increased fall risk. It is known that the ability to maintain balance is a complex skill that requires the integration of multiple sensorimotor and cognitive processes. Emerging evidence suggests that diabetes-related subtle declines in sensory functions (somatosensory, visual and vestibular), metabolic muscle function and executive functions may also contribute to increased fall risk in older adults with type 2 diabetes. Knowledge of these type 2 diabetes-related sensorimotor and cognitive deficits may help to broaden approaches to falls prevention in older adults with type 2 diabetes. Therefore, the purpose of this mini review is to describe the impact of type 2 diabetes on sensorimotor and cognitive systems that may contribute to increased fall risk in older adults with type 2 diabetes.
authors.affiliation: School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hewston
authors.affiliation: School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada. Electronic address: nandinijd@yahoo.com.
authors.forename: Nandini
authors.initials: N
authors.lastname: Deshpande
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000818:Animals; D058070:Asymptomatic Diseases / Q000523:psychology; D000066492:Cognitive Aging / Q000523:psychology; D060825:Cognitive Dysfunction / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000523:psychology; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D004856:Postural Balance; D012307:Risk Factors; D012678:Sensation Disorders / Q000150:complications / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology
keywords: aging; balance; chutes; cognition; falls; musculaire; muscular; processus cognitifs; sensoriel; sensory; vieillissement; équilibre