Ritalin may help seniors stay steady on their feet

By Anne Harding

NEW YORK (Reuters Health) - Taking methylphenidate -- familiar as the drug Ritalin used to treat attention-deficit disorder -- could help older people reduce their risk of falling by sharpening their mental function, Israeli researchers report.

After taking one dose of methylphenidate, seniors walked with a more even gait and did better on a standard screening test for fall risk, Dr. Jeffrey M. Hausdorff and colleagues found.

"Our study suggests that it may be possible to reduce the risk of falls in older adults by treating cognitive deficits associated with aging (and/or disease)," Hausdorff, of Tel-Aviv Sourasky Medical Center in Israel, told Reuters Health by email.

"This is consistent with a growing body of literature which suggests that walking is not a simple, automated task," he added. Instead, gait control in older people may involve higher-level cognitive function, in particular executive function (which includes thought processes involved in planning and achieving goals), as well as attention.

Falls are a leading cause of injury and death among older people, and just half of elderly people who are hospitalized after a fall will be alive a year later, Hausdorff and his colleagues note in their report in the Journal of the American Geriatrics Society.

To investigate whether methylphenidate might offer a strategy for fall prevention, the researchers had 26 healthy, independently living seniors complete tests of fall risk and executive function before and after taking a single dose of the drug or an inactive placebo.

After taking the drug, study participants completed the "Timed Up and Go" test significantly more quickly. In the test, a person gets up from a chair, walks for three meters at a normal pace, turns around and walks back, and sits back down. Fall risk rises with the amount of time it takes a person to complete the test.

Study participants also showed less variability in stride time, which is a marker of instability, and performed better on tests of executive function.

"The idea of treating fall risk via a pill is quite intriguing," Hausdorff said. "It is likely, however, that methylphenidate is not a simple panacea. Still, perhaps it can be used with other therapies and interventions to reduce fall risk."

More studies are needed to assess long-term efficacy and safety, "and the cost-benefits need to be carefully weighed before methylphenidate can become one of the routine treatment options for reducing fall risk," the researcher said. He and his colleagues are planning longer-term tests of the drug to gauge whether it does indeed reduce the risk of falls, and are also investigating other "cognitive-based" therapies for fall prevention, he added.

SOURCE: Journal of the American Geriatrics Society, April 2008.