Age-associated striatal dopaminergic denervation and falls in community-dwelling subjects

J Rehabil Res Dev. 2009;46(8):1045-52. doi: 10.1682/jrrd.2009.03.0030.

Abstract

Older adults have a high prevalence of gait and balance disturbances and falls. Normal aging is associated with significant striatal dopaminergic denervation, which might be a previously unrecognized additional contributor to geriatric falls. This study investigated the relationship between the severity of age-associated striatal dopaminergic denervation (AASDD) and falls in community-dwelling subjects. Community-dwelling subjects who did not have a clinical diagnosis to explain falls (n = 77: 43 female, 34 male; mean age 61.4 +/- 16.4; range 20-85) completed clinical assessment and brain dopamine transporter (DAT) [(11)C]beta-CFT (2-beta-carbomethoxy-3beta-(4-fluorophenyl) tropane) positron emission tomography imaging followed by 6 months of prospective fall monitoring using diaries. Results showed a significant inverse relationship between striatal DAT activity and age (r = -0.82, p < 0.001). A total of 26 subjects (33.8%) reported at least one fall, with 5 subjects (6.5%) reporting two or more falls. While no significant difference was noted in striatal DAT activity between nonfallers (n = 51) and fallers (n = 26; f = 0.02, not significant), striatal DAT activity was modestly reduced in the small subgroup of recurrent fallers compared with the other subjects (f = 5.07, p < 0.05). Findings indicate that AASDD does not explain isolated self-reported falls in community-dwelling subjects. However, it may be a contributing factor in the small subgroup of subjects with recurrent falls.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidental Falls*
  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / metabolism*
  • Basal Ganglia / metabolism*
  • Dopamine / metabolism*
  • Dopamine Plasma Membrane Transport Proteins / physiology*
  • Female
  • Gait Disorders, Neurologic
  • Humans
  • Male
  • Middle Aged
  • Positron-Emission Tomography
  • Young Adult

Substances

  • Dopamine Plasma Membrane Transport Proteins
  • Dopamine