权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Biological and neural mechanisms of falls

跌倒的生物学和神经机制

基本信息

批准号：
9293219
负责人：
JOE VERGHESE
金额：
$ 49.86万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2018-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9293219
关键词：
Address Age Aged, 80 and over Aging Atherosclerosis Attention Bilateral Biological Biological Markers Biology Blood Vessels Clinical Clinical assessments Cognition Cognition Disorders Cognitive Communities Data Effectiveness Effectiveness of Interventions Elderly Enrollment Equilibrium Fall prevention Gait Gait abnormality Health Care Costs High Prevalence Human Image Impairment Incidence Individual Inflammation Inflammatory Inflammatory Response Institutionalization Intervention Isoprostanes Knowledge Lacunar Infarctions Lead Lesion Leukoaraiosis Link Malondialdehyde Measures Mediating Microvascular Dysfunction Modeling Motor Near-Infrared Spectroscopy Oxidative Stress Participant Pathway interactions Peripheral Nerves Pharmaceutical Preparations Physical Function Physical activity Play Prefrontal Cortex Premature Mortality Prevention strategy Preventive Intervention Protocols documentation Reporting Research Risk Risk Factors Role Severities Site Stroke Syndrome Techniques Testing Time Translations United States Vascular Diseases Walking Work base cerebrovascular clinical predictors clinical risk cognitive function cost design disability economic cost equilibration disorder fall risk falls improved innovation macrovascular disease microvascular pathology multidisciplinary neuroimaging neuromechanism new technology public health relevance relating to nervous system success

项目摘要

DESCRIPTION (provided by applicant): One in three community dwelling people over age 65 and one in two over age 80 fall each year. The consequences of falls among older adults are often devastating, resulting in loss of independence, institutionalization and premature mortality. Falls also are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. Although many fall prevention strategies targeted against clinical risk factors have been tested, their success in reducing falls has been modest. Current falls research in aging is mostly focused on clinical predictors of falls and there is a knowledge gap regarding underlying biological and neural mechanisms of falls. Emerging evidence from our and other studies implicates biological derangements in inflammation, oxidative stress, and vascular pathways in the occurrence of disorders of gait, balance, and cognition, which are major risk factors for falls in older adults. We hypothesize that abnormal biological pathways initiate atherosclerosis leading to cerebral vascular damage that increases risk of falls in older adults. We draw together a multidisciplinary team to conduct high-quality research to establish biological and neural mechanisms of falls building on our extensive cognitive and mobility research. We will cross-enroll 530 participants, age 65 and older, from the ongoing Central Control of Mobility in Aging study offering a cost and time efficient strategy to study biological and neural mechanisms of falls. This proposal will employ rigorous clinical assessments, many developed and validated in our other aging studies, to assess fall risk. We propose the following three synergistic aims focusing on our common theme of biological and neural contributions to falls in aging. 1). Determine biological mechanisms (inflammation, oxidative stress, and vascular pathways) contributing to falls. 2). Establish contributions of central microvascular pathology to fall risk using state of the art neuroimaging techniques. 3). Establish the contribution of the prefrontal cortex to falls using an innovative functional near infrared spectroscopy (fNIRS), that enables imaging during walking. While biological risk factors for falls are potentially modifiable, the paucity of data is a critical barrier for translation to clinical interventions. While many fal prevention strategies targeted against clinical risk factors have been tested, their success in reducing falls has been modest in research settings and even less so in the real world. A deeper understanding of underlying biological mechanisms and neural substrates for falls may lead to more efficient risk identification and improve the effectiveness of current interventions for fallsin older adults.

描述（由申请人提供）：65岁以上社区居民每年有三分之一跌倒，80岁以上社区居民每年有两分之一跌倒。老年人跌倒的后果往往是毁灭性的，导致丧失独立性、被收容和过早死亡。