TY - JOUR
T1 - The neurobiology of falls
AU - Fasano, Alfonso
AU - Plotnik, Meir
AU - Bove, Francesco
AU - Berardelli, Alfredo
PY - 2012/3/23
Y1 - 2012/3/23
N2 - Falling is a major clinical problem; especially, in elderly population as it often leads to fractures, immobilization, poor quality of life and life-span reduction. Given the growing body of evidences on the physiopathology of balance disorders in humans, in recent years the approach of research on falls has completely changed and new instruments and new definitions have been formulated. Among them, the definition of "idiopathic faller" (i.e. no overt cause for falling in a given subject) represented a milestone in building the "science of falling". This review deals with the new determinants of the neurobiology of falling: (1) the role of motor impairment and particularly of those "mild parkinsonian signs" frequently detectable in elderly subjects, (2) the role of executive and attentive resources when coping with obstacles, (3) the role of vascular lesions in "highest level gait disorder" (a condition tightly connected with senile gait, cautious gait and frailty), (4) the role of the failure of automaticity or inter-limbs coordination/symmetry during walking and such approach would definitely help the development of screening instrument for subjects at risk (still lacking in present days). This translational approach will lead to the development of specific therapeutic interventions.
AB - Falling is a major clinical problem; especially, in elderly population as it often leads to fractures, immobilization, poor quality of life and life-span reduction. Given the growing body of evidences on the physiopathology of balance disorders in humans, in recent years the approach of research on falls has completely changed and new instruments and new definitions have been formulated. Among them, the definition of "idiopathic faller" (i.e. no overt cause for falling in a given subject) represented a milestone in building the "science of falling". This review deals with the new determinants of the neurobiology of falling: (1) the role of motor impairment and particularly of those "mild parkinsonian signs" frequently detectable in elderly subjects, (2) the role of executive and attentive resources when coping with obstacles, (3) the role of vascular lesions in "highest level gait disorder" (a condition tightly connected with senile gait, cautious gait and frailty), (4) the role of the failure of automaticity or inter-limbs coordination/symmetry during walking and such approach would definitely help the development of screening instrument for subjects at risk (still lacking in present days). This translational approach will lead to the development of specific therapeutic interventions.
KW - Automaticity
KW - Cognition
KW - Falls
KW - Freezing of gait
KW - High-level gait disorder
KW - Parkinsonism
KW - Postural instability
UR - http://www.scopus.com/inward/record.url?scp=84883510839&partnerID=8YFLogxK
U2 - 10.1007/s10072-012-1126-6
DO - 10.1007/s10072-012-1126-6
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C2 - 22673818
AN - SCOPUS:84883510839
SN - 1590-1874
VL - 33
SP - 1215
EP - 1223
JO - Neurological Sciences
JF - Neurological Sciences
IS - 6
ER -