Objective: to identify clinical, physical activity and mobility measures that differentiate patients with mild cognitive impairment with Lewy bodies (MCI-LB) fallers and non-fallers from cognitively preserved individuals.
Background: The occurrence of falls in those with MCI can be twice that of cognitively intact individuals . The consequences of falls can be more serious in this population and MCI fallers are more likely to be institutionalized than MCI non-fallers . The literature has advanced in understanding falls in MCI patients, however, most of the studies did not determine MCI subtype, concentrating largely on amnestic groups, or focused on those already diagnosed with dementia. Repeated falls are reported as one of the clinical characteristics in dementia with Lewy bodies (DLB), however, little is known regarding the clinical-specific characteristics of fallers and non-fallers in prodromal DLB.
Method: As part of the SUPERB study (22 MCI-LB and 13 healthy controls), MCI patients were classified as fallers (at least one fall; n = 13) or non-fallers (n = 9) based on retrospective report over 12 months. Demographic, disease specific and cognitive measures were collected. In addition, participant’s gait speed was measured through a 4-meters walking test, completed in usual speed whist being timed. Patients were also asked about the frequency of participation in vigorous, moderate, and light physical activities. Variables were compared between groups using ANOVAs and nonparametric tests where appropriate.
Results: MCI-LB fallers walked more slowly (p<0.001) and took part in fewer light physical activities (p<0.001) compared to healthy controls and MCI-LB non-fallers. MCI-LB fallers and non-fallers were similar for all other measures including in vigorous and moderate physical activities.
Conclusion: To the best of our knowledge, this is the first study to examine differences in fall status in those with MCI-LB. Even at early stage of disease, there are characteristics that define fallers among people with MCI-LB, including slower gait speed and reported reduction in physical activity. Although numbers are small, it highlights the importance of falls prevention and management to prevent and delay the consequences of falls in Lewy body disease.
References:  Doi T et al. Cognitive function and falling among older adults with mild cognitive impairment and slow gait. Geriatr Gerontol Int. 2015;15(8):1073-8.
 Montero-Odasso et al. Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual tasking, and risk of falls. Arch Phys Med Rehabil. 2012;93(2):293-299.
To cite this abstract in AMA style:E. Lirani Silva, S. Waite, C. Hamilton, P. Donaghy, J. O'Brien, J. Taylor, J. Lloyd, L. Allan, M. Firbank, A. Thomas, A. Yarnall. Falls in Mild Cognitive Impairment with Lewy bodies (MCI-LB). [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/falls-in-mild-cognitive-impairment-with-lewy-bodies-mci-lb/. Accessed September 25, 2023.
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