Study: Falls Rate Nearly 50% for U.S. Seniors with Dementia; 3 Factors Raise Risk

McKnight’s Long-Term Care | Alicia Lasek
 
Nearly half of American seniors with dementia had one or more falls in the preceding year, according to a new analysis of 2016 data. Three factors were most highly associated with risk, the researchers say.

Data came from the National Health and Aging Trends Study from 2015 and 2016, which examined health and disability trends and outcomes in adults aged 65 years and older in the United States. Fully 45.5% of older adults living with dementia experienced one or more falls in 2016, compared to 31% of older adults without dementia, investigators found.

Impaired vision, living with a spouse versus living alone, and a history of falls within the prior year were strongly linked to greater likelihood of falls, reported the authors, from Drexel University in Philadelphia and Johns Hopkins University in Baltimore.

They also pinpointed key falls risk factors for older adults living without dementia. These included financial hardship, a history of falls, fear of falling, poor lower extremity performance, depressive symptoms and home disrepair.

The study is the first national one to compare risk factors for senior Americans living with dementia to those without dementia, according to the researchers. The results support tailored falls prevention strategies for people with dementia that consider key risk factors during screening, they added.

“Overall, our findings demonstrate the importance of understanding and addressing fall-risk among older adults living with dementia,” said Safiyyah Okoye, PhD, of Drexel. “It confirms that fall-risk is multidimensional and influenced by environmental context in addition to health and function factors.”

Full findings were published in Alzheimer’s & Dementia.

Blood Test for Early Alzheimer’s Detection

One of the first stages of Alzheimer’s disease involves formation of toxic aggregates, called oligomers, of the protein amyloid beta (Aβ). These oligomers can start to form more than a decade before symptoms appear and before other known disease markers form. The ability to detect these oligomers would permit early disease diagnosis. This would make strategies to intervene before irreparable brain damage occurs possible.

An NIH-funded research team led by Valerie Daggett at the University of Washington developed a method to detect toxic Aβ oligomers in patients’ blood. They tested the assay, called the soluble oligomer binding assay (SOBA), on nearly 400 banked human blood plasma samples. Results appeared on December 13, 2022, in the Proceedings of the National Academy of Sciences.

Toxic Aβ oligomers have a structure known as an alpha sheet that isn’t normally found in proteins. Alpha sheets tend to bind to each other. SOBA takes advantage of this distinct structural feature. The researchers designed a synthetic alpha sheet molecule to bind to the alpha sheets in Aβ oligomers. They showed that their designed molecule, called AP193, bound to the subset of Aβ with alpha sheets but not to other, non-toxic forms of Aβ.

Aβ oligomers normally reduce signaling in cultured neurons. Adding AP193 prevented this reduction in signaling. AP193 might thus form the basis for future therapeutic strategies.

When the team applied SOBA using AP193 to a cerebrospinal fluid sample from a person with Alzheimer’s disease, they detected Aβ oligomers. They did not detect oligomers in cerebrospinal fluid from a person who had no cognitive impairment.

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