Coach’s Corner; “Hey Coach-Jim, Are Dementia & Dangerous Falls Inevitable? Don't Fall for That!”

As a Parkinson's Fitness Therapy provider I watch every week as PwP's (People with Parkinson's) walk in slowly, sometimes with lethargy and honestly, the occasional look of confusion on their faces, and every week, I watch them go from a fear of bumbling, stumbling and falling to floating like a butterfly, and striving to see just how good they can still be...

They're concerned about falling, as all of us now living in Mr. Rogers Senior Citizen Neighborhood should be, but they're not staying kept in their corners by it... They're coming out fighting and swinging back at Falls and Dementia. But what is the relationship between the two, if any?

Falls among older adults are often perceived as minor mishaps, yet research increasingly suggests they can have significant, long-term consequences, particularly concerning cognitive health. A study published in *JAMA Network Open* indicates that older adults who suffer traumatic injuries from falls may face a 20% increased risk of developing dementia, including Alzheimer’s disease, within a year of the fall. This connection between falls and dementia highlights the critical need for fall prevention, especially for those over age 65.

*Note: Fall prevention is one of the BIGGEST benefits from Parkinson’s Fitness Boxing, like provided by our REBOPS for Parkinson’s nonprofit program… jus’sayin’!

The aforementioned study, conducted by Brigham and Women’s Hospital, reviewed data from over two million older adults who had experienced falls causing traumatic injury. Findings showed that more than 10% of these individuals were diagnosed with dementia within a year of their injury. The average age of those studied was 78, and women were more commonly affected. While dementia is typically associated with neurodegenerative diseases, head injuries from falls may directly damage brain cells, potentially increasing the risk of cognitive decline.

Dr. Meredith Bock, a neurologist and Chief Medical Officer at Remo Health, explains the nuances of this link between falls and dementia. Falls can be an early indicator of neurodegeneration, which can be happening in the brain years before dementia is formally diagnosed. Known as the “prodromal” period, this phase may involve changes in mood, cognition, and sensory processing. During this time, falls may increase due to subtle shifts in balance and behavior that signal dementia’s early onset. Repeated falls may also be an independent risk factor, as traumatic brain injuries (TBIs) are established risk factors for dementia.

The Centers for Disease Control and Prevention (CDC) warns that falls are a leading cause of injury-related death among older adults. Injuries from falls, such as fractures and head injuries, not only impact physical health but often lead to significant declines in independence. Dr. Bock urges proactive fall prevention for cognitive and overall health, suggesting that those who experience falls or near-falls should consider cognitive screenings.

Despite these findings, Dr. Bock emphasizes the study’s limitations, as it is challenging to establish causation from association. While falls might signal dementia’s early stages, it’s not certain that falls cause dementia. However, the connection between falls and cognitive decline still underscores the need for preventive measures.

Dr. Bock provides several tips to minimize fall risks. Improving home safety by removing loose rugs, securing cords, and repairing damaged flooring can make a big difference. Lightheadedness, often due to low blood pressure, can also increase fall risk, so she recommends discussing any dizziness with a healthcare provider. Simple solutions like compression socks and hydration may help improve circulation and reduce this risk.

In addition, Dr. Bock advises keeping eyewear prescriptions updated and considering hearing aids if needed, as both vision and hearing affect balance. Regular physical activity is crucial, as it strengthens muscles, improves coordination, and enhances balance, reducing fall risk. Working with a physical therapist can help design a safe exercise plan. For those who have experienced previous falls, assistive devices such as canes or walkers may provide extra stability.

For individuals with dementia, falls present added risks. People with Alzheimer’s and other forms of dementia are more likely to fall, often resulting in serious injuries like hip fractures. These injuries frequently require surgery, which can further impact physical and cognitive health. Even without surgery, a fall may worsen dementia symptoms, diminishing the patient’s quality of life. Fear of falling can lead to reduced activity and increased reliance on caregivers, contributing to further cognitive and physical decline.

Creating a safe environment at home is essential for those with dementia. Ensuring adequate lighting, applying visual contrasts like brightly colored tape on stair edges, and maintaining clutter-free pathways can make a significant difference. Additionally, safe, supportive footwear indoors and outdoors can reduce slipping hazards.

In summary, the study reveals that falls among older adults are not just accidents but potentially indicators or contributors to cognitive decline. While more research is needed to clarify the causative nature of this relationship, the findings underscore the importance of fall prevention and proactive steps to maintain cognitive health in later life. Through home safety measures, medical consultations, and physical activity, older adults can take action to stay steady on their feet and protect their cognitive well-being.

For more details on the sources for this piece, click these links -

https://www.womansworld.com/aging/falls-may-increase-dementia-risk-how-to-prevent-them

https://neuraleffects.com/blog/what-can-make-dementia-worse/#:~:text=Even%20if%20the%20patient%20does,the%20patient%27s%20quality%20of%20life.