Risk factors for falls in older people with cognitive impairment living in the community: Systematic review and meta-analysis

PurposeThis systematic review aimed to identify risk factors for prospectively ascertained falls, focusing on those that are potentially modifiable (physical and neuropsychological factors), in older people with cognitive impairment living in the community.ResultsA comprehensive search of five databases identified 16 high quality (Newcastle-Ottawa Scale ≥8/9) relevant articles. Meta-analyses were undertaken for five potential fall risk factors. Of these, fallers had significantly poorer balance (standardized mean difference = 0.62, 95 %CI 0.45, 0.79) with low heterogeneity. Global cognition was not significantly associated with faller status in a meta-analysis with low heterogeneity. Meta-analyses of mobility (Timed Up-and-Go), gait speed and depressive symptoms had high heterogeneity and were not statistically significant or were borderline significant (p = 0.05). Sensitivity analyses (removing one study sample’s results that differed markedly from the other included samples) reduced heterogeneity to 0% and revealed fallers had significantly poorer mobility and more depressive symptoms than non-fallers. Fallers also walked significantly slower, but heterogeneity remained high.ConclusionsIn older people with cognitive impairment, fallers presented with balance deficits, poor mobility, slow gait speed and depressive symptoms. Reduced global cognition was not associated with falls. These findings suggest that interventions should target balance impairment and reveal that more high-quality research is needed.     

Impact of gait problems and falls on functioning in independent living persons of 55 years and over: a community survey

In a cross-sectional, population-based study among community-dwelling persons of 55 years and over the incidence of falls, risk indicators for falls, specifically age, and the impact of gait problems, falls and other risk factors on functioning was determined. A randomly age-stratified sample (n = 655) was taken from all independent living persons of 55 years and over (n = 2269) and registered in a primary health care centre. They received a mail questionnaire concerning demographic data, history of falls and injuries due to falls, physical and mental health status, gait problems, functional status, including social activities. The response rate was 62% (n = 405). Of the subjects aged 55 years and of those aged 65 years and over, 25% and 31% respectively fell at least once in the previous year. Half of the people reporting falls fell more than once. Serious injury occurred in 9% of the fallers, with 4% fractures. There is a significant association between falling and age and, even more clearly, between gait problems and age. The main risk factors of single and recurrent falls were female gender, physical health status and gait problems. Logistic regression analysis reveals that the main determinants of falling in general are gait problems and female gender and, of recurrent falling female gender, physical complaints and gait problems. Falls have some negative effect on functioning, i.e. mobility range and social activities, but this is overshadowed by mental status indicators and gait problems.     

Muscular effects in late polio.

New or increased muscular weakness, fatigue and muscle and joint pain with neuropathic electromyography (EMG) changes in a person with a confirmed history of polio constitute the cardinal symptoms of the post-polio syndrome. Unusual tiredness or fatigue is a common complaint in late polio subjects as is intolerance to cold. Fatigue in polio subjects can have several explanations: emotional fatigue, central nervous system fatigue, 'general' fatigue and/or neuromuscular fatigue. Some studies indicate central fatigue, but it is unclear how often and to which degree there will be a central muscular fatigue. Polio patients are known to be deconditioned (reduced function because of low activity level), and aerobic power is reduced. Defects in the neuromuscular transmission may be present but are not seen in all post-polio subjects with reduction in force and increased fatigability. The fatigue experienced by late polio patients is most likely an augmented peripheral muscle fatigue. Possible explanations may be an imperfection in the sarcoplasmatic reticulum with altered calcium release mechanisms (activation) or in sliding filament function (contractile properties). This may be a secondary effect to the enlarged muscle fibres. However, the prolonged subjective feeling of fatigue reported despite unchanged maximal voluntary contraction (MVC) remains unexplained.     

Identification of elderly fallers by muscle strength measures

For efficient prevention of falls among older adults, individuals at a high risk of falling need to be identified. In this study, we searched for muscle strength measures that best identified those individuals who would fall after a gait perturbation and those who recovered their balance. Seventeen healthy older adults performed a range of muscle strength tests. We measured maximum and rate of development of ankle plantar flexion moment, knee extension moment and whole leg push-off force, as well as maximum jump height and hand grip strength. Subsequently, their capacity to regain balance after tripping over an obstacle was determined experimentally. Seven of the participants were classified as fallers based on the tripping outcome. Maximum isometric push-off force in a leg press apparatus was the best measure to identify the fallers, as cross-validation of a discriminant model with this variable resulted in the best classification (86% sensitivity and 90% specificity). Jump height and hand grip strength were strongly correlated to leg press force (r = 0.82 and 0.59, respectively) and can also be used to identify fallers, although with slightly lower specificity. These results indicate that whole leg extension strength is associated with the ability to prevent a fall after a gait perturbation and might be used to identify the elderly at risk of falling.     

Stepping impairment and falls in older adults: A systematic review and meta-analysis of volitional and reactive step tests

ObjectiveTo systematically examine stepping performance as a risk factor for falls. More specifically, we examined (i) if step tests can distinguish fallers from non-fallers and (ii) the type of step test (e.g. volitional vs reactive stepping) that is required to distinguish fallers from non-fallers.Data sourcePubMed, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and reference lists of included articles.Study selection: Cross-sectional and cohort studies that assessed the association between at least one step test and falls in older people (age ≥ 60 and/or mean age of 65).ResultsA meta-analysis of 61 studies (n = 9536) showed stepping performance was significantly worse in fallers compared to non-fallers (Cohen’sd 0.56, 95 % CI 0.48 to 0.64, p < 0.001, I² 66 %). This was the case for both volitional and reactive step tests. Twenty-three studies (n = 3615) were included in a diagnostic meta-analysis that showed that step tests have moderate sensitivity (0.70, 95 % CI 0.62 to 0.77), specificity (0.68, 95 % CI 0.58 to 0.77) and area under the receiver operating characteristics curve (AUC) (0.75, 95 % CI 0.59 to 0.86) in discriminating fallers from non-fallers.Conclusions: This large systematic review demonstrated that both volitional and reactive stepping impairments are significant fall risk factors among older adults. Step tests can identify fallers from non-fallers with moderate accuracy.     

Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms

OBJECTIVE: The aim of this study was to determine illness comorbidity rates for individuals with chronic fatigue syndrome (CFS), fibromyalgia (FM), and multiple chemical sensitivities (MCS). An additional objective was to identify characteristics related to the severity of fatigue, disability, and psychiatric comorbidity in each of these illness groups. METHODS: A random sample of 18,675 residents in Chicago, Illinois, was first interviewed by telephone. A control group and a group of individuals with chronic fatigue accompanied by at least four minor symptoms associated with CFS received medical and psychiatric examinations. RESULTS: Of the 32 individuals with CFS, 40.6% met criteria for MCS and 15.6% met criteria for FM. Individuals with MCS or more than one diagnosis reported more physical fatigue than those with no diagnosis. Individuals with more than one diagnosis also reported greater mental fatigue and were less likely to be working than those with no diagnosis. Individuals with CFS, MCS, FM, or more than one diagnosis reported greater disability than those with no diagnosis. CONCLUSIONS: Rates of coexisting disorders were lower than those reported in prior studies. Discrepancies may be in part attributable to differences in sampling procedures. People with CFS, MCS, or FM endure significant disability in terms of physical, occupational, and social functioning, and those with more than one of these diagnoses also report greater severity of physical and mental fatigue. The findings illustrate differences among the illness groups in the range of functional impairment experienced.     

Disintegration of the motor unit in post-polio syndrome. Part I. Electrophysiological findings in patients after poliomyelitis

CN EMG and SF EMG were performed in 12 patients many years after acute poliomyelitis, without symptoms of post-polio syndrome. In 19 muscles with clinical symptoms and in 11 clinically normal muscles chronic neurogenic changes of a similar degree were observed. Fibre density was increased in both groups of muscles. In muscles with clinical symptoms complexes of single fibres with increased jitter and blocking were more frequent than in muscles without clinical manifestations. It seems that the reinnervation after acute polio is a continuing process and thus complete stabilization and integration of the motor unit cannot be achieved.     

Thoracoabdominal injuries in the elderly: 25 years of experience

BACKGROUND: The present study was conducted to determine the clinical characteristics and outcome of hospitalized elderly patients with thoracic and thoracoabdominal injuries. METHOD: This is a longitudinal, nonblinded study using established standard of care of patients with penetrating and blunt chest trauma. From April 1972 to August 1997, 5,702 patients were hospitalized for chest injuries. Out of these patients, 171 (3%) were aged 65 or above. Of these patients, 96 (56%) had blunt trauma (group 1)--motor vehicle accident in 83 (86%) and falls in 13 (14%). The remaining 75 (44%) patients had penetrating injuries (group 2)--gunshot wounds in 47 (63%) and stab wounds in 28 (37%). RESULTS: Of the blunt trauma patients, 45% (43/96), and 15% (11/75) of the penetrating trauma patients were managed by observation alone; the remainder required surgical procedures. The overall mortality was 10% (17/171), of which mortality among penetrating and blunt trauma to the chest were 12% (9/75) and 8% (8/96), respectively. Of eight deaths due to blunt trauma, six had multiple (four or more) rib fractures. There were no deaths among the 54 patients who were simply observed, and none of them required surgery at a later date. Complication rate among the survivors was 12.3%, with only 0.4% being infectious. CONCLUSIONS: Mortality was highest among the elderly with penetrating chest trauma. Mortality was high because of cardiac and great vessel injuries in group 2, whereas multiple rib fractures and brain injuries were the higher cause of mortality in group-1 patients. Infectious complications were low among the survivors.     

Preventing accidental falls among older people in long stay units

A fall prevention programme for older long-stay patients in a 95 bedded District Hospital was undertaken. Data on falls and resulting injuries for the year prior to the intervention were compared with equivalent data after one year (Year 1) and after two years (Year 2) of the intervention. In the pre-intervention year 25% of patients had at least one fall compared with 20.9% and 17.4% in Year 1 and Year 2 respectively. This difference was not statistically significant. However, there were 21% fewer falls in Year 1 and 49.3% fewer in Year 2 than in the pre-intervention year. This difference was significant in Year 2. In both intervention years there was a significant reduction in the incidence of fracture from 20.5% of falls (pre-intervention) to 2.8% in Year 1 and no fractures occurred in Year 2. Significant reductions in soft tissue injuries occurred in Year 2 but not in Year 1, dropping from 38.5% (pre-intervention) to 36.1% and 15.4% respectively. The percentage of patients uninjured after a fall increased from 41% to 61.1% to 84.6%. This intervention reduced falls and their adverse consequences for older people living in the long stay unit. The effect of the intervention escalated in Year 2. The intervention cost IR4,800 pounds. Fall prevention should be part of the routine care of older people in all types of long stay care.     

Menopause characteristics of women with physical disabilities from poliomyelitis

OBJECTIVE: To describe menopause characteristics of women with physical disabilities from poliomyelitis. METHODS: Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause. RESULTS: The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected. CONCLUSIONS: This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.     

Intrathecal immune response in patients with the post-polio syndrome.

BACKGROUND. The syndrome of progressive muscular atrophy decades after acute paralytic poliomyelitis (post-polio syndrome) is not well understood. The theory that physiologic changes and aging cause the new weakness does not explain the immunologic abnormalities reported in some patients. An alternative explanation is persistent or recurrent poliovirus infection. METHODS. We assessed the intrathecal antibody response to poliovirus and intrathecal production of interleukin-2 and soluble interleukin-2 receptors in 36 patients with the post-polio syndrome and 67 controls (including 13 who had had poliomyelitis but had no new symptoms and 18 with amyotrophic lateral sclerosis). Intrathecal antibody responses to measles, mumps, herpes simplex, and varicella zoster viruses were also determined. RESULTS. Oligoclonal IgM bands specific to poliovirus were detected in the cerebrospinal fluid of 21 of the 36 patients with the post-polio syndrome (58 percent) but in none of the control group (P less than 0.0001). In quantitative studies there was evidence of increased intrathecal synthesis of IgM antibodies to poliovirus only among the patients with the post-polio syndrome; there was no increased synthesis of IgM to measles, mumps, herpes simplex, or varicella zoster viruses. The patients with post-polio syndrome had significantly higher mean (+/- SD) (cerebrospinal fluid levels of interleukin-2 and soluble interleukin-2 receptors than the controls (8.1 +/- 5.3 vs. 1.4 +/- 0.8 U per milliliter and 159.6 +/- 102.9 vs. 10.7 +/- 6.2 U per milliliter, respectively). The intrathecal synthesis of IgM antibodies to poliovirus correlated with the cerebrospinal fluid concentrations of interleukin-2 (P less than 0.0005) and soluble interleukin-2 receptors (P less than 0.001). CONCLUSIONS. An intrathecal immune response against poliovirus is present in many patients with the post-polio syndrome. In some of these patients the recrudescence of muscle weakness may be caused by persistent or recurrent infection of neural cells with the poliovirus.     

Steadiness of quadriceps contractions in young and older adults with and without a history of falling

Decreased steadiness of muscle force may be associated with ageing and could be a cause of falls in older people. We studied this in isometric and anisometric quadriceps contractions in healthy young and older people. The older group contained people with and without a history of medically unexplained falls. Forty-four young (aged 18–40 years) and 78 older (aged > 70 years) subjects participated. In the latter group 34 people had a history of falling (fallers) and 44 did not (non-fallers). Isometric steadiness was measured by the coefficient of variation (CoV) of force at 10, 25 and 50% maximal voluntary force (MVC). Anisometric steadiness was measured by the SD of acceleration during concentric and eccentric contractions against two external loads (1 and 5 kg). There was an overall trend for the younger subjects to be most steady and the fallers the least but the differences were not consistently significant. Isometric steadiness was unaffected by force in all groups. The fallers were less steady (P < 0.001) than both the young and non-fallers, who had similar values. During anisometric contractions, steadiness was similar with both external loads and types of contraction in all groups. During dynamic contractions the older subjects were less steady (P < 0.002). Only eccentric contractions distinguished between the two older groups, with the fallers being less steady by 31% (P = 0.013). These data indicate ageing per se is associated with decreased anisometric, but not isometric, steadiness. Greater unsteadiness during eccentric contractions in the fallers could be an important mechanism of medically unexplained falls.     

Hip fractures among the elderly: causes,consequences and control

This review examines all pertinent literature sources published in the English language between 1966 to the present concerning hip fracture epidemiology, hip fracture injury mechanisms, and hip fracture management strategies. These data reveal hip fractures have several causes, but among these, the impact of falls and muscle weakness, along with low physical activity levels seems to be the most likely explanation for the rising incidence of hip fracture injuries. Related determinants of suboptimal nutrition, drugs that increase fall risk and lower the safety threshold and comorbid conditions of the neuromuscular system may also contribute to hip fracture disability. A number of interventions may help to prevent hip fracture injuries, including, interventions that optimize bone mass and quality, interventions that help prevent falls and falls dampening interventions. Rehabilitation outcomes may be improved by comprehensive interventions, prolonged follow-up strategies and ensuring that all aging adults enjoy optimal health.     

Strength,power output and symmetry of leg muscles: effect of age and history of falling

Risk factors for medically unexplained falls may include reduced muscle power, strength and asymmetry in the lower limbs. Conflicting reports exist about strength and there is little information about power and symmetry. Forty-four healthy young people (29.3 ± 0.6 years), 44 older non-fallers (75.9 ± 0.6 years), and 34 older fallers (76.4 ± 0.8 years) were studied. Isometric, concentric and eccentric strength of the knee and ankle muscles and leg extension power were measured bilaterally. The younger group was stronger in all muscles and types of contraction than both older groups (P < 0.02–0.0001). Strength differences between the older groups occasionally reached significance in individual muscles and types of contraction but overall the fallers had 85% of the strength and 79% of the power of the non-fallers (P < 0.001). Young subjects generated more power than both older groups (P < 0.0001) and the fallers generated less than the non-fallers (P = 0.03). Strength symmetry showed an inconsistent age effect in some muscles and some contraction types. This was similar overall in the two older groups. Both older groups had greater asymmetry in power than the young (P < 0.02–0.004). Power asymmetry tended to be greater in the fallers than the non-fallers but this did not reach significance. These data do not support the suggestion that asymmetry of strength and power are associated with either increasing age or fall history. Power output showed clear differences between age groups and fall status and appears to be the most relevant measurement of fall risk and highlights the cumulative effects on function of small changes in strength in individual muscle groups.     

Effect of asthma on the risk of obstructive sleep apnea syndrome in atopic women.

BACKGROUND: Obstructive sleep apnea syndrome is associated with significant morbidity and remains underdiagnosed in women. Identification of high-risk groups among women is important for early detection and treatment. OBJECTIVE: To describe the prevalence of snoring in young women with atopy and to determine the risk factors for snoring in these individuals. METHODS: The Cincinnati Childhood Allergy and Air Pollution Study is an ongoing prospective birth cohort study of infants with at least 1 atopic parent. Mothers of study participants were evaluated by questionnaire for snoring, respiratory symptoms, and smoking status. Women who snored were compared with those who did not snore. Logistic regression analysis was performed to determine risk factors for snoring. RESULTS: Data were available on 677 women who had at least 1 live birth. Of these 677 women, 546 (81%) were white, 122 (18%) were African American, and 9 (1%) were biracial or Asian. The mean +/- SD age of the cohort at the time of evaluation for snoring was 29.6 +/- 5.6 years. Of the 677 women, 231 (34%) reported snoring at least 1 night per week, and snoring almost always (5-7 nights per week) was reported by 85 (13%). An almost 2-fold risk of snoring was associated with asthma (diagnosis and current symptoms) (odds ratio, 1.8; 95% confidence interval, 1.1-2.8) and African American race (odds ratio, 1.6; 95% confidence interval, 1.04-2.6) after controlling for income level and smoking status. CONCLUSIONS: We found a high prevalence of snoring inyoung women with atopy and a significant association with asthma.     

Sensor technologies aiming at fall prevention in institutionalized old adults: A synthesis of current knowledge

BackgroundFalls are a serious health problem in old adults especially in nursing home residents and hospitalized patients. To prevent elderly from falling, sensors have been increasingly used in intramural care settings. However, there is no clear overview of the current used technologies and their results in fall prevention.ObjectivesThe present study reviews sensor systems that prevent falls in geriatric patients living in an intramural setting and describe fall rates, fall-related injuries, false alarms, and user experience associated with such systems.MethodsWe conducted a systematic search for studies that used sensor technologies with the aim to prevent falls in institutionalized geriatric patients.ResultsA total of 12 studies met the search criteria. Three randomized clinical trials reported no reductions in fall rate but three before–after studies reported significant reductions of 2.4–37 falls per 1000 patient days. Although there was up to 77% reduction in fall-related injuries and there was relatively low, 16%, rate of false alarms, the current data are inconsistent whether current sensor technologies are effective in reducing the number of falls in institutionalized geriatric patients. The occurrence of false alarms (16%) was too high to maintain full attention of the nursing staff. Additionally including the users opinion and demands in developing and introducing sensor systems into intramural care settings seems to be required to make an intervention successful.ConclusionThe evidence is inconsistent whether the current sensor systems can prevent falls and fall-related injuries in institutionalized elderly. Further research should focus more comprehensively on user requirements and effective ways using intelligent alarms.     

Sticks and stones may break my bones, but names will make me feel sick: the psychosocial, somatic, and scholastic consequences of peer harassment.

This study examined associations among peer victimization, psychosocial problems, physical symptoms, and school functioning across the 1st year in middle school. An ethnically diverse sample of urban 6th graders (N=1,526) reported on their perceptions of peer victimization, psychosocial adjustment, and physical symptoms during fall and spring. Objective measures of school functioning (i.e., grade point average and absences) were also collected. In Model 1, peer victimization in the fall was associated with spring psychosocial maladjustment and physical symptoms, which in turn predicted poor spring school functioning. Model 2 suggested that psychosocial difficulties increase the risk of victimization, although physical symptoms did not predict victimization. No sex or ethnic group (African American, Asian, European American, and Latino) differences were found in the model structure or the strength of the path coefficients for either model, suggesting that the process is the same for boys and girls and students from different ethnic groups.     

Do people use methods or tricks to fall asleep? A comparison between people with and without chronic insomnia

The present study estimated the frequency of using methods or tricks to fall asleep in the general Norwegian population. Further, people with chronic insomnia were compared with people without chronic insomnia. A representative sample of 1028 participants aged 18 years or older completed a web-based survey. The response rate was 33.5%. Insomnia symptoms were assessed with the validated Bergen Insomnia Scale, and chronic insomnia based on ICSD-3/DSM-5 criteria. Data were analysed with chi-square tests and logistic regression with adjustment for sex, age, education, and circadian preference. The results showed that 34.3% reported using a method or a trick to fall asleep, with relaxation exercises/breathing exercises being the most common. More females (39.5%) compared with males (29.1%) reported the use of a method/trick to fall asleep with an adjusted odds ratio (aOR) of 1.44. Chronic insomnia was reported by 24.9%, and clearly associated with higher use of such methods/tricks (53.7%; aOR = 3.49). Among the participants without chronic insomnia, 28.1% reported using methods/tricks to fall asleep. In conclusion, most people do not use methods or tricks to fall asleep, but chronic insomnia was associated with a higher frequency of such use. Still, since methods/tricks were also used by some participants without chronic insomnia, this may suggest that, for some people, this strategy may be effective or at least does not seem to disrupt the sleep onset process.     

A systematic review of one-legged balance performance and falls risk in community-dwelling adults

ObjectiveThe aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls.MethodsMedline, EMBASE, CINAHL and Web of Science were systematically searched (to January 2021) to identify peer-reviewed, English language journal articles examining the association between one-legged balance performance and falls in community-dwelling adults.ResultsOf 4310 records screened, 55 papers were included (n = 36954 participants). There was considerable heterogeneity between studies including differences in study characteristics, ascertainment of balance and falls, and analytical approaches. A meta-analysis of the time that individuals could maintain the one-legged balance position indicated that fallers had worse balance times than non-fallers (standardised mean difference: −0.29 (95%CI:−0.38,−0.20) in cross-sectional analyses; −0.19 (−0.28, −0.09) in longitudinal analyses), although there was no difference in the pooled median difference. Due to between-study heterogeneity, regression estimates between balance and fall outcomes could not be synthesised. Where assessed, prognostic accuracy indicators suggested that one-legged balance was a poor discriminator of fall risk; for example, 5 of 7 studies demonstrated poor prognostic accuracy (Area Under the Curve <0.6), with most studies demonstrating poor sensitivity.ConclusionsThis systematic review identified 55 papers that examined associations between balance and fall risk, the majority in older aged adults. However, the evidence was commonly of low quality and results were inconsistent. This contradicts previous perceptions of one-legged balance as a useful fall risk tool and highlights crucial gaps that must be addressed in order to translate such assessments to clinical settings.     

Association Between Falls and Brain Subvolumes: Results from a Cross-Sectional Analysis in Healthy Older Adults

Falls are a consequence of gait instability. Cortical and subcortical abnormalities have been associated with gait instability but not yet with falls. This study aims to compare the global and regional brain subvolumes between healthy older fallers and non-fallers. A total of 77 healthy older individuals (23 fallers and 54 non-fallers, 69.8 ± 3.5 years; 45.5 % female) were included in this study using a cross-sectional design. Based on an a priori hypothesis, the following brain subvolumes were quantified from three-dimensional T₁-weighted MRI using FreeSurfer software: total white matter abnormalities, total white matter, total cortical and subcortical gray matter, hippocampus, motor cortex, somatosensory cortex, premotor cortex, prefrontal cortex and parietal cortex volumes. Gait performances were also recorded. Age, sex, body mass index, comorbidities, use of psychoactive drugs, far-distance visual acuity, lower-limb proprioception, depressive symptoms and cognitive scores (Mini-Mental State Examination, Frontal Assessment Battery) were used as covariates. Fallers have more frequently depressive symptoms (P = 0.048), a lower far distance visual acuity (P = 0.026) and a higher coefficient of variation of stride time (P = 0.008) compared to non-fallers. There was a trend to greater subvolumes for the somatosensory cortex (P = 0.093) and the hippocampus (P = 0.060) in the falls group. Multiple logistic regressions showed that subvolumes of the somatosensory cortex and the hippocampus (P < 0.042) were increased in fallers compared to non-fallers, even after adjustment for clinical and brain characteristics. The greater subvolumes of the somatosensory cortex and hippocampus reported in fallers compared to non-fallers suggests a possible brain compensatory mechanism involving spatial navigation and integration of sensory information.