Donepezil and the Risk of Falls in Seniors With Cognitive Impairment
Status:
Completed
Trial end date:
2019-01-01
Target enrollment:
Participant gender:
Summary
Compared with cognitively normal older adults, those with mild cognitive problems (MCI) have
a two-fold higher rate of falls, sustain more fractures, and have a higher rate of mortality
due to falls. Why older adults with cognitive problems fall more frequently is not completely
understood. What is known, however, is that attention is a necessary cognitive resource for
normal walking and impairments in attention are associated with increased risk of falls in
older adults.
It has been suggested that cholinesterase inhibitors (ChEI), medications used for treatment
of dementia, may improve motor function and walking (gait performance). Since ChEI are known
to improve attention, we hypothesized that ChEI will reduce falls risk in people with MCI by
improving their gait velocity, improving their balance, and reducing their gait variability;
a well-established risk factor for falls.
In the proposed study, we will evaluate the effect of donepezil (ChEI) on gait velocity, gait
variability, and the balance on 140 elderly individuals with MCI (70 intervention and 70
controls). Gait variables will be measured using an electronic walkway, and balance
confidence using a validated scale (Activities-Specific Balance Confidence Scale; ABC) over
four months.
By characterizing and understanding the effects of cognitive enhancers on fall risk in older
adults with cognitive impairments, we will be able to pave the way for a new approach to fall
prevention in this population. We would establish that medications that augment cognitive
function could be a complementary therapeutic option for reducing fall risk in people with
MCI. This may lead to new approaches to prevent and treat fall risk in this population, which
will lead to improve the autonomy and quality of life of seniors in early stage of dementia,
and a decreased burden for the Ontario health care system.