痴呆与跌倒风险

With an increasingly clear picture of why people living with dementia fall more than their cognitively-healthy peers, researchers from the University of Wisconsin School of Medicine and Public Health have identified possible solutions to reduce risk of falls.
 
Professor Jane Mahoney, MD, who’s spent her career studying correlations between falling and dementia, believes drug changes, environmental interventions and physical therapy could mitigate some risk for falls.
Mahoney, who also serves as director of the Wisconsin Alzheimer’s Institute, presented to more than 260 medical professionals at the institute’s 14th annual Alzheimer’s Disease Update Conference in downtown Madison.
 
She highlighted the heightened danger falls present to people living with Alzheimer’s, who are not only more likely to fall, but also more likely to suffer adverse outcomes from falling. For example, fracture rates for Alzheimer’s patients are more than three times the age- and sex-adjusted rates for the general population, Mahoney said.
 
Through research, Mahoney and other scientists have identified many environmental and dual-task-related factors that appear to cause people with dementia to fall more frequently.
 
“Start to think about just plain old walking or maybe more complex walking, when you’re walking and talking, or you’re walking and playing with your iPhone,” Mahoney said. “It takes visual-spatial abilities, working memory, information processing and reaction time.
 
“So, as we think about people with Alzheimer’s disease and think about the decrements that occur, we can begin to understand why risk increases.”
 
Mahoney said more research must be done but suggested health care providers reduce use of psychotropic medications and emphasize muscle strengthening and balance training to reduce the likelihood of falls.
Research suggests basic caregiver environmental interventions, as simple as adding railings or reducing clutter, also have “great potential” to reduce falls, she said.
 
The Alzheimer’s Disease Update Conference, which highlights research and provides an opportunity for continuing education, included presentations and remarks from a variety of other researchers and public figures.
 
With the challenge posed managing agitation resulting from dementia, Constantine Lyketsos, MD, MHS, FAPM, DFAPA, a professor of psychiatry and behavioral sciences at Johns Hopkins University, showed how clinical trials of citalopram have bucked the trend of other risky, largely ineffective prescription drugs by reducing agitation.

Jennifer Manley, PhD, professor of neuropsychology in neurology at Columbia University, shared research on social factors that may lead to racial and ethnic disparities in Alzheimer’s disease and cognitive degeneration, including how a person’s educational environment affects their risk.

UW professor Steven Barczi, MD, FAASM, presented studies showing how people with more severe sleep disturbance, such as sleep apnea, tend to have more rapid cognitive decline.
 
Former Wisconsin Gov. Martin Schreiber described the challenges and the joys of being a caregiver for his wife, Elaine, who has Alzheimer’s.

James Galvin, MD, MPH, professor of clinical biomedical science and associate dean for clinical research at Florida Atlantic University, explored how cultural differences affect Alzheimer’s screening and diagnosis.
Christopher Callahan, MD, professor and director of the Indiana University Center for Aging, discussed how to best design systems of care for adults with Alzheimer’s.

For more information on Alzheimer’s research at UW School of Medicine and Public Health, visit the Wisconsin Alzheimer’s Institute and Wisconsin Alzheimer’s Disease Research Center online.
 

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