title: Association Between Falls and Brain Subvolumes: Results from a Cross-Sectional Analysis in Healthy Older Adults.
abstract: Falls are a consequence of gait instability. Cortical and subcortical abnormalities have been associated with gait instability but not yet with falls. This study aims to compare the global and regional brain subvolumes between healthy older fallers and non-fallers. A total of 77 healthy older individuals (23 fallers and 54 non-fallers, 69.8 ± 3.5 years; 45.5 % female) were included in this study using a cross-sectional design. Based on an a priori hypothesis, the following brain subvolumes were quantified from three-dimensional T1-weighted MRI using FreeSurfer software: total white matter abnormalities, total white matter, total cortical and subcortical gray matter, hippocampus, motor cortex, somatosensory cortex, premotor cortex, prefrontal cortex and parietal cortex volumes. Gait performances were also recorded. Age, sex, body mass index, comorbidities, use of psychoactive drugs, far-distance visual acuity, lower-limb proprioception, depressive symptoms and cognitive scores (Mini-Mental State Examination, Frontal Assessment Battery) were used as covariates. Fallers have more frequently depressive symptoms (P = 0.048), a lower far distance visual acuity (P = 0.026) and a higher coefficient of variation of stride time (P = 0.008) compared to non-fallers. There was a trend to greater subvolumes for the somatosensory cortex (P = 0.093) and the hippocampus (P = 0.060) in the falls group. Multiple logistic regressions showed that subvolumes of the somatosensory cortex and the hippocampus (P < 0.042) were increased in fallers compared to non-fallers, even after adjustment for clinical and brain characteristics. The greater subvolumes of the somatosensory cortex and hippocampus reported in fallers compared to non-fallers suggests a possible brain compensatory mechanism involving spatial navigation and integration of sensory information.
authors: Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.|Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.|Centre of Excellence on Aging and Chronic Diseases of McGill Integrated University Health Network, Montreal, QC, Canada. Olivier.beauchet@mcgill.ca.
authors: Olivier
authors: O
authors: Beauchet
authors: Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.|University Memory Clinic of Angers, Angers, France.|UPRES EA 4638, University of Angers, UNAM, Angers, France.
authors: Cyrille P
authors: CP
authors: Launay
authors: Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
authors: John
authors: J
authors: Barden
authors: Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors: Teresa
authors: T
authors: Liu-Ambrose
authors: Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada.
authors: Victoria L
authors: VL
authors: Chester
authors: Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
authors: Tony
authors: T
authors: Szturm
authors: Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QUÉBEC, Canada.
authors: Sébastien
authors: S
authors: Grenier
authors: Research Center on Aging, Institut universitaire de gériatrie de Sherbrooke (IUGS), Sherbrooke, QUÉBEC, Canada.
authors: Guillaume
authors: G
authors: Léonard
authors: Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, QUÉBEC, Canada.|PERFORM Centre and Department of Psychology, Concordia University, Montreal, QC, Canada.
authors: Louis
authors: L
authors: Bherer
authors: Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, Angers, France.|University Memory Clinic of Angers, Angers, France.|UPRES EA 4638, University of Angers, UNAM, Angers, France.
authors: Cédric
authors: C
authors: Annweiler
authors: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Jorunn L
authors: JL
authors: Helbostad
authors: Division of Cognitive & Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
authors: Joe
authors: J
authors: Verghese
authors: Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.
authors: Gilles
authors: G
authors: Allali
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging*; D006624:Hippocampus / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size / Q000502:physiology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging
keywords: Brain volume; Fall; Magnetic resonance imaging; Motor control; Older adults