Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1522-1527 , August 2008

Subcortical Vascular Lesions Predict Falls at 12 Months in Elderly Patients Discharged From a Rehabilitation Ward

  • Fabio Guerini, MD

      Affiliations

    • Rehabilitation and Aged Care Unit “Ancelle della Carità” Hospital, Cremona, Italy
    • Geriatric Research Group, Brescia, Italy
  • ,
  • Giovanni B. Frisoni, MD

      Affiliations

    • LENITEM–Laboratory of Epidemiology Neuroimaging & Telemedicine, IRCCS San Giovanni di Dio FBF, Brescia, Italy
  • ,
  • Alessandra Marrè, MD

      Affiliations

    • Rehabilitation and Aged Care Unit “Ancelle della Carità” Hospital, Cremona, Italy
    • Geriatric Research Group, Brescia, Italy
  • ,
  • Renato Turco, MD

      Affiliations

    • Rehabilitation and Aged Care Unit “Ancelle della Carità” Hospital, Cremona, Italy
    • Geriatric Research Group, Brescia, Italy
  • ,
  • Giuseppe Bellelli, MD

      Affiliations

    • Rehabilitation and Aged Care Unit “Ancelle della Carità” Hospital, Cremona, Italy
    • Geriatric Research Group, Brescia, Italy
    • Corresponding Author InformationReprint requests to Giuseppe Bellelli, MD, Rehabilitation and Aged Care Unit, “Ancelle della Carità” Hospital, Via Aselli, Cremona, Italy 1426100
  • ,
  • Marco Trabucchi, MD

      Affiliations

    • Geriatric Research Group, Brescia, Italy
    • “Tor Vergata” University, Rome, Italy.

References 

  1. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–672
  2. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707
  3. Tinetti ME. Clinical practice (Preventing falls in elderly persons). N Engl J Med. 2003;348:42–49
  4. Cesari M, Landi F, Torre S, Onder G, Lattanzio F, Bernabei R. Prevalence and risk factors for falls in an older community-dwelling population. J Gerontol A Biol Sci Med Sci. 2002;57:M722–M726
  5. Kuo HK, Lipsitz LA. Cerebral white matter changes and geriatric syndromes: is there a link?. J Gerontol A Biol Sci Med Sci. 2004;59:818–826
  6. Baloh RW, Ying SH, Jacobson KM. A longitudinal study of gait and balance dysfunction in normal older people. Arch Neurol. 2003;60:835–839
  7. Starr JM, Leaper SA, Murray AD, et al. Brain white matter lesions detected by magnetic resonance imaging are associated with balance and gait speed. J Neurol Neurosurg Psychiatry. 2003;74:94–98
  8. Sachdev PS, Wen W, Christensen H, Jorm AF. White matter hyperintensities are related to physical disability and poor motor function. J Neurol Neurosurg Psychiatry. 2005;76:362–367
  9. Guttmann CR, Benson R, Warfield SK, et al. White matter abnormalities in mobility-impaired older persons. Neurology. 2000;54:1277–1283
  10. Whitman GT, Tang Y, Lyn A, Baloh RW. A prospective study of cerebral white matter abnormalities in older people with gait dysfunction. Neurology. 2001;57:990–994
  11. Longstreth WT, Manolio TA, Arnold A, et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people (The Cardiovascular Health Study). Stroke. 1996;27:1274–1282
  12. de Groot JC, de Leeuw FE, Oudkerk M, Hofman A, Jolles J, Breteler MM. Cerebral white matter lesions and depressive symptoms in elderly adults. Arch Gen Psychiatry. 2000;57:1071–1076
  13. Kerber KA, Enrietto JA, Jacobson KM, Baloh RW. Disequilibrium in older people: a prospective study. Neurology. 1998;51:574–580
  14. Syrjälä P, Luukinen H, Pyhtinen J, Tolonen U. Neurological diseases and accidental falls of the aged. J Neurol. 2003;250:1063–1069
  15. Alexander NB. Gait disorders in older adults. J Am Geriatr Soc. 1996;44:434–451
  16. Liston R, Mickelborough J, Bene J, Tallis R. A new classification of higher level gait disorders in patients with cerebral multi-infarct states. Age Ageing. 2003;32:252–258
  17. Folstein MF, Folstein S, McHugh PR. “Mini-mental state” (A practical method for grading cognitive state of patients for the clinician). J Psychiatr Res. 1975;12:189–198
  18. Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): recent evidence and development of a shorter version. In:  Brink TL editors. Clinical gerontology: a guide to assessment and intervention. New York: Harworth Pr; 1986;p. 165–173
  19. Matthews LE. Using anthropometric parameters to evaluate nutritional status. J Nutr Elderly. 1986;5:67–71
  20. Charlson ME, Pompei P, Ales KL, McKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383
  21. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–186
  22. Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–65
  23. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–126
  24. Geroldi C, Galluzzi S, Testa C, Zanetti O, Frisoni GB. Validation study of a CT-based weighted rating scale for subcortical ischemic vascular disease in patients with mild cognitive deterioration. Eur Neurol. 2003;49:193–209
  25. Guerini F, Frisoni GB, Bellwald C, Bellelli G, Trabucchi M. Subcortical vascular lesions predict functional recovery after rehabilitation in patients with L-Dopa refractory parkinsonism. J Am Geriatr Soc. 2004;52:252–256
  26. Speciale S, Turco R, Magnifico F, Bellelli G, Trabucchi M. Frailty is the main predictor of falls in elderly patients undergoing rehabilitation training. Age Ageing. 2004;33:84–85
  27. Verghese J, Buschke H, Viola L, Hall C, Kulansky G, Lipton R. Validity of divided attention tasks in predicting falls in older individuals: a preliminary study. J Am Geriatr Soc. 2002;50:1572–1576
  28. Rosano C, Kuller LH, Chung H, Arnold AM, Longstreth WT, Newman AB. Subclinical brain magnetic resonance imaging abnormalities predict physical functional decline in high-functioning older adults. J Am Geriatr Soc. 2005;53:649–654
  29. van den Heuvel DM, ten Dam VH, de Craen AJ, et al. Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population. J Neurol Neurosurg Psychiatry. 2006;77:149–153
  30. Wahlund LO, Barkhof F, Fazekas F, et al. A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke. 2001;32:1318–1322
  31. Frisoni GB, Scheltens P, Galluzzi S, et al. Neuroimaging tools to rate regional atrophy, subcortical cerebrovascular disease, and regional cerebral blood flow and metabolism: consensus paper of the EADC. J Neurol Neurosurg Psychiatry. 2003;74:1371–1381

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)00379-1

doi: 10.1016/j.apmr.2008.01.018

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1522-1527 , August 2008