Brain Diseases and Fall-Related Surgery in Older Persons

Eur Neurol. 2022;85(4):260-264. doi: 10.1159/000521807. Epub 2022 Feb 14.

Abstract

Background: It is known that age-related brain symptoms (gait difficulty and dementia) increase the likelihood of fall-related surgery. In contrast, it is not known which types of brain disease underlie such symptoms most.

Objective: The aim of this study was to correlate brain diseases with the types of surgeries performed at our hospital for patients who had fallen.

Methods: This was a retrospective study at a multifaculty university hospital in Japan, with a 12-month recruiting period, a follow-up period of 3.0 ± 2.5 weeks, and ≥1×/week visits. We assembled a neurogeriatric team to diagnose brain diseases with the use of brain imaging to the extent possible and correlated the diagnoses with types of fall-related surgery.

Results: Fall-related surgery was conducted by the orthopedics (OP) and neurosurgery (NS) faculties (total n = 124) at a ratio of about 2 to 1. The underlying brain diseases differed by faculty; for OP, surgery was most commonly performed in patients with a combination of white matter disease (WMD) and Alzheimer's disease (AD) (79%) followed by dementia with Lewy bodies. In contrast, for NS, the most common surgery was for patients with alcoholism (50%) followed by a combination of WMD and AD.

Conclusion: Fall-related surgery was performed by the OP and NS faculties at a 2 to 1 ratio. The major underlying brain diseases were a combination of WMD and AD (79%) for OP and alcoholism (50%) for NS.

Keywords: Alzheimer’s disease; Dementia with Lewy bodies; Hip fracture; Subdural hematoma; White matter disease.

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Alcoholism*
  • Alzheimer Disease* / diagnosis
  • Brain / diagnostic imaging
  • Brain / surgery
  • Humans
  • Leukoencephalopathies*
  • Lewy Body Disease*
  • Retrospective Studies