# Falls predict faster progression to Alzheimer's dementia

## TL;DR

Falls in older adults with preclinical Alzheimer's disease may predict faster progression to dementia, suggesting motor dysfunction is linked to disease development.

## Contribution

This study identifies falls as a potential early marker of Alzheimer's progression, independent of amyloid accumulation.

## Key findings

- Participants with both preclinical AD and falls progressed to dementia most rapidly.
- Those without falls or amyloid burden progressed to dementia least quickly.
- Falls may indicate motor dysfunction intrinsic to Alzheimer's disease progression.

## Abstract

In preclinical Alzheimer's disease (AD), amyloid accumulates in the brain while individuals remain cognitively unimpaired (Clinical Dementia Rating® [CDR] = 0). Differentiating trajectories of healthy aging and preclinical AD is challenging as both are associated with age‐related impairments (e.g., falls).

Longitudinal cohort study. We monitored falls for 1 year among 125 CDR 0 older adults and assessed preclinical AD status (amyloid). We continued to evaluate CDR annually (median 10 years). The cohort was grouped: Preclinical AD−Fall−, Preclinical AD−Fall+, Preclinical AD+Fall−, and Preclinical AD+Fall+. Survival analysis examined time to progression to CDR 1 (mild dementia) by group.

Participants were 74 years (mean) at baseline, 62% female, 96% White. Preclinical AD+Fall+ progressed to CDR 1 most rapidly. Preclinical AD−Fall− progressed least quickly. Preclinical AD+Fall− and Preclinical AD−Fall+ had similar progression rates.

Falls may associate with faster progression of AD dementia, potentially reflecting motor and gait dysfunction intrinsic to disease progression.

Falls predicted faster progression to dementia symptoms.Those without falls or amyloid burden progressed to dementia least quickly.Falls may serve as early markers of motor dysfunction in Alzheimer's disease.

Falls predicted faster progression to dementia symptoms.

Those without falls or amyloid burden progressed to dementia least quickly.

Falls may serve as early markers of motor dysfunction in Alzheimer's disease.