著者
Etsuo HORIKAWA Toshifumi MATSUI Hiroyuki ARAI Takashi SEKI Koh IWASAKI Hidetada SASAKI
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.44, no.7, pp.717-721, 2005 (Released:2005-08-06)
参考文献数
16
被引用文献数
64 88

Objective Falls are common in patients with Alzheimer’s disease (AD). Identification of the potential risk factors and developing preventive strategies for falls will have a significant impact in maintaining the quality of life in AD.Patients Clinical follow-up of 124 (74.1±6.1 years, range 62-88) mild to moderate AD patients in an outpatient memory clinic.Methods Postural sway, cognitive function, use of neuroleptics, severity of periventricular and deep white matter lesions, and the presence or absence of silent brain infarctions on magnetic resonance imaging were assessed at baseline.Results A total of 104 patients (84%) completed the study. Fall events were confirmed in 42.3% (44/104). After adjustment for age, gender, and cognitive status, a high grade of periventricular white matter lesions (odds ratio 8.7 [95%CI 1.5 to 51.8], p=0.017) and neuroleptic drug use (odds ratio 3.5 [95%CI 1.2 to 10.5], p=0.027) were significantly associated with an increased risk of falls.Conclusion Our results suggest that periventricular white matter lesions and the use of neuroleptics may be related to falls in mild to moderate AD. A comprehensive risk management of brain ischemia as well as the use of the smallest efficacious dose of neuroleptics in the treatment of behavioral and psychiatric symptoms of AD should be recommended to help reduce the risk of unexpected falls.