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Cerebral Vasoreactivity Related to Gait, Possibly Falls, in Elderly

Research suggests improving cerebral endothelial function may be novel fall-prevention strategy

TUESDAY, May 18 (HealthDay News) -- Impaired regulation of cerebral blood flow is associated with slowed gait and may be related to increased falls in the elderly, according to research published in the May 18 issue of the journal Neurology.

Farzaneh A. Sorond, M.D., Ph.D., of Brigham and Women's Hospital in Boston, and colleagues conducted a study of 419 elderly individuals taking part in the MOBILIZE Boston Study to determine the relationship of cerebral blood flow regulation to slow gait and falls. The researchers measured two components of beat-to-beat blood flow velocity in the middle cerebral artery: end-tidal CO2 (to reflect cerebral vasoreactivity), and blood pressure changes during a sit-to-stand protocol (to reflect cerebral autoregulation).

The researchers found that cerebrovascular vasoreactivity was significantly associated with gait speed; those in the lowest quintile of cerebrovascular vasoreactivity had slower gaits than those in the highest quintile. Those in the lowest quintile also had a higher fall rate compared to those in the highest quintile of cerebral vasoreactivity although, in an adjusted analysis, the relationship between cerebral vasoreactivity and rate of falls did not reach significance.

"Given that a number of measures such as statins, angiotensin converting enzyme inhibitors and daily exercise can improve endothelial function, as well as promote endothelial repair mechanisms, our findings suggest a novel strategy for the prevention of falls in elderly people," the authors write.

One of the study authors reports financial relationships with the pharmaceutical industry.

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