Trouble getting around in old age? Blame your brain

NEW YORK (Reuters Health) - How well people get around and keep their balance in old age is linked to the severity of changes in their brains, new research suggests.

Age-related white matter brain changes, also called leukoaraiosis, are frequently seen in older people and differ in severity, and the new study suggests that they are associated with gait and balance disturbances.

Neurologists, geriatricians and family doctors often send older patients for brain scans to rule out severe brain atrophy (wasting), a tumor, stroke or brain infection because of mild mental difficulties, unsteadiness or depressed mood, and get back white matter changes as the main finding, Dr. Hansjoerg Baezner told Reuters Health.

Baezner, from University of Heidelberg in Mannheim, Germany, and colleagues studied the impact of age-related white matter changes on functional decline in 639 men and women between the ages of 65 and 84 who underwent brain scans as well as walking and balance tests. Of the group, 284 had mild age-related white matter changes, 197 moderate changes, and 158 severe changes.

They found that people with severe white matter changes were twice as likely to score poorly on tests of walking and balance as those with mild white matter changes. They further found that people with severe changes were twice as likely as the mild group to have a history of falls. The moderate group was one-and-a-half times as likely as the mild group to have a history of falls.

"Walking difficulties and falls are major symptoms of people with white matter changes and a significant cause of illness and death in the elderly," Baezner said in a written statement. "Exercise may have the potential to reduce the risk of these problems since exercise is associated with improved walking and balance. We'll be testing whether exercise has such a protective effect in our long-term study of this group."

The researchers say monitoring white matter changes may be useful in the early detection of walking problems, which have been linked to other health problems.

It's not clear why some people's white matter changes are worse than others or what causes the changes; however, studies have shown a link between these changes and insufficiently treated high blood pressure and diabetes.

SOURCE: Neurology March 18, 2008.