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Falls as a Manifestation of Brain Failure: Gait, Cognition, and the Neurobiology of Falls
Pages 3-20
Despite of the enormous efforts of researchers and clinicians to understand the pathophysiology of falls in older adults and establish preventive treatments, there is still a significant gap in our understanding and treating of this challenging syndrome, particularly when we focus in cognitively impaired older adults. Falls in older adults are a very common yet complex medical event, being the fifth leading cause of death and a main cause of insidious disability and nursing home placement in our world aging population. Importantly, falls in the cognitively impaired double the prevalence of the cognitively normal, affecting up of 60% of older adults with low cognition and increasing the risk of injuries. The past decade has witnessed an explosion of new knowledge in the role of cognitive processes into the falls mechanisms. This was also accompanied with clinical trials assessing the effect of improving cognition via pharmacological and non-pharmacologic approaches to prevent falls and related injuries. Unfortunately, this revolution in emerging interventions left a gap between clinician-scientists and researchers at academic centers where the new data had been generated and the practitioners who care for cognitively impaired patients with falls. Most advances are published in specialty journals of geriatric medicine, neurology, and rehabilitation.
The aim of this book is to reduce this gap and to provide practical tools for fall prevention in cognitively impaired populations. The proposed book is designed to present a comprehensive and state-of the-art update that covers the pathophysiology, epidemiology, and clinical presentation of falls in cognitively impaired older adults. We additionally aim to reduce the knowledge gap in the association between cognitive processes and falls for practitioners from a translational perspective: from research evidence to clinical approach. We will address gaps and areas of uncertainty but also we will provide practical evidence-based guidelines for the assessment, approach, and treatment of falls in the cognitively impaired populations.
This book is a unique contribution to the field. Existing textbooks on fall prevention focus in global approaches and only tangentially address the cognitive component of falls and not purposely address special populations and/or settings as residential care and nursing homes. Due to the expected increase of proportion of older adults with cognitive and mobility impairments, this book is also valuable for the whole spectrum of the health care of the elderly. By including a transdisciplinary perspective from geriatric medicine, rehabilitation and physiotherapy medicine, cognitive neurology, and public health, this book will provide a practical and useful resource with wide applicability in falls assessment and prevention.
Falls as a Manifestation of Brain Failure: Gait, Cognition, and the Neurobiology of Falls
Pages 3-20
Dismobility in Aging and the Role of Cognition and Health Consequences of Reduced Mobility
Pages 21-33
Epidemiology and Falls Risk Factors in Cognitively Impaired Older Adults
Pages 35-48
Depression, Fear of Falling, Cognition and Falls
Pages 49-66
Frailty, Cognition, and Falls
Pages 67-83
Comprehensive Falls Assessment: Cognitive Impairment Is a Matter to Consider
Pages 87-106
Gait Variability and Fall Risk in Older Adults: The Role of Cognitive Function
Pages 107-138
Assistive Devices, Falls, and Cognitive Aspects
Pages 139-150
Medication Use and Falls in People with Cognitive Impairment. Assessment and Management Strategies
Pages 151-164
Neurobiology of Falls: Neuroimaging Assessment
Pages 165-188
Falls in Parkinson’s Disease and Lewy Body Dementia
Pages 191-210
Falls in Older Adults with MCI and Alzheimer’s Disease
Pages 211-228
Delirium, Restraint Use and Falls
Pages 229-243
Approaches for Falls Prevention in Hospitals and Nursing Home Settings
Pages 245-259
Evidence, Recommendations, and Current Gaps in Guidelines for Fall Prevention and Treatments
Pages 263-272
Exercise to Prevent Falls in Older Adults with Cognitive Impairment
Pages 273-287
Cognitive Training and Mobility: Implications for Falls Prevention
Pages 289-308
Virtual Reality Training as an Intervention to Reduce Falls
Pages 309-321
Cognitive Enhancers as a Means to Reduce Falls in Older Adults
Pages 323-341
Dual-Task Training in Cognitively Impaired and Intact Older Populations to Reduce Fall Risk: Evidence from Previous Intervention Trials by Using a Systematic Review Approach
Pages 343-372
Noninvasive Brain Stimulation to Reduce Falls in Older Adults
Pages 373-398
Engineering Human Gait and the Potential Role of Wearable Sensors to Monitor Falls
Pages 401-426
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