When it comes to people with Alzheimer’s disease, falls are a serious concern. They fall at twice the rate of healthy older adults, which frequently results in injury, nursing home placement, and premature death.

Alzheimer’s disease is a degenerative neurological disease that causes memory loss and other mental skills to deteriorate. There is no cure, and while drugs and management measures can temporarily alleviate symptoms, falls are linked to significant disability in patients.

The goal of the new study was to learn more about the causes of the high fall rate and to come up with specific strategies to minimize it.

Between March 2018 and January 2020, the research team recruited 48 participants with mild or moderate Alzheimer’s disease who were seen at the Johns Hopkins Memory and Alzheimer’s Treatment Center and the Johns Hopkins Alzheimer’s Disease Research Center. The average age of the participants was 65, with 27 of them being male. Over a two-year period, the team investigated the link between vestibular dysfunction and falls in the patient sample.

Even in physically healthy individuals, damage to the vestibular system, which consists of a set of canals and bone structures deep within the inner ear, is a common cause of dizziness, vertigo, and balance problems. These problems are more common in older people, thus concentrating on this system as a source of risk in Alzheimer’s patients made sense, according to the researchers.

To stimulate and replicate vestibular function, the authors used devices that can measure reactions to eye and head movement. Individuals with impaired vestibular function on these tests were 50% more likely to fall over time than those with normal vestibular function. According to the authors, loss of vestibular function causes higher sway, which causes unstable balance, which leads to more falls.

“We call the vestibular system the sixth hidden sense because it functions almost at a subconscious level. It’s always ‘on’ and operates normally to keep us oriented as we move through space, sensing what’s up and what’s down and around us,” explains the lead author. “The system automatically feeds that information to the brain as other sensory organs such as the eyes or ears do. But unlike closing one’s eyes or plugging one’s ears, people cannot willfully control it. So, when its impaired, people experience vertigo, a disorienting, inability to navigate the world.”

Most Alzheimer’s studies, according to to the authors, have concentrated on minimizing or avoiding memory loss and other cognitive impairment, but they believe that paying more attention to the vestibular system could enhance people with Alzheimer’s quality of life.

“Vestibular impairment is treatable with balance exercises performed under the care of a physical therapist,” they add. “That could enhance the quality of life for both patients and caregivers.”

A clinical investigation to test the usefulness of vestibular therapy in avoiding falls in Alzheimer’s patients is currently underway, according to the research team.

Source: 10.3233/JAD-215366

Image Credit: Getty

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