Falls in Older Adults with MCI and Alzheimer’s Disease

Abstract

Falls are very prevalent in older adults with cognitive impairment: older adults with dementia are 2–3 times more likely to fall than older adults without cognitive deficits. Social isolation, impaired mobility, injury and increased mortality represent the major consequences of falls in aging. Although older adults with cognitive impairment share similar risk factors for falls as in older adults with intact cognition, dementia represents an independent risk factor for falls. Gait disorders, cognitive impairment, and depression contribute to the increased prevalence of falls in older adults with mild cognitive impairment (MCI) or Alzheimer’s disease. Various non-pharmacological interventions have been tested in older adults with MCI or dementia to reduce the risk of falls. Physical activity interventions are feasible in older adults with cognitive impairments and may decrease risk of falls. Besides nonpharmacological interventions, identification and removal of inappropriate medications (i.e. psychotropic drugs) are also part of the falls management strategy in older patients with cognitive impairment. The purpose of this chapter is to summarize the recent knowledge about risk factors, clinical assessment and management of falls in older adults with MCI and Alzheimer’s disease and to provide an algorithm for helping clinicians in their falls management strategy.