Fear of Falling as a Behavioral Symptom in Neurocognitive Impaired Patients: Evidence from an Underrepresented Population

Article type: Research Article

Authors: Castelblanco-Toro, Sandra Milena^{a; b; c; *} | Jurado-Delgado, Janeth^d | Meneses-Bernal, Juan Felipe^e | Santacruz-Escudero, José Manuel^{a; c} | Santamaria-García, Hernando^{b; c}

Affiliations: [a] Institute of Aging of the Faculty of Medicine of the Pontificia Universidad Javeriana, Bogotá, Colombia | [b] PhD Neuroscience, Psychiatry Department, Pontificia Universidad Javeriana, Bogotá, Colombia | [c] Intellectus Memory and Cognition Center, San Ignacio University Hospital, Bogotá, Colombia | [d] Universidad del Valle (Univalle), Clínica alta complejidad Santa Bárbara, Palmira, Colombia | [e] Célula de Desarrollo de Producto y redes de valor, SIES Salud IPS, Bogotá, Colombia

Correspondence: [*] Correspondence to: Sandra Milena Castelblanco Toro, MD, and Hernando Santamaria García, MD. PhD, Instituto de Envejecimiento – Administrative Offices: Building, Hospital Universitario San Ignacio/9th floor, Cra. 7 No. 40-62 Bogotá, Colombia. Tel.: +571 320 8320 Ext. 2777; E-mails: smcastelblanco@husi.org.co; nanosanta@gmail.com.

Abstract: Background:Fear of falling (FoF) is a condition associated with falls, multi-morbidity, and functional impairment. To date it remains unknow which clinical, somatic, socio-demographic, behavioral, and emotional factors are associated with FoF and how these factors interact in people with Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Objective:Identify the association of FoF with clinical, socio-demographic, and neuropsychiatric factors in patients with AD and bvFTD. Methods:We evaluated 98 participants, 58 with AD and 40 with bvFTD at mild or moderate stages and assess FoF using the Falls Efficacy Scale-International. Additionally, we analyzed cognitive, physical performance variables, functional impairment, and affective and behavioral symptoms associated with FoF using standardized scales and a regression model analysis. Results:The prevalence of FoF in AD and bvFTD was 51% and 40%, respectively. In the AD group, physical performance [F (3, 53) = 4.318, p = 0.009], the behavioral symptoms model [F (19, 38) = 3.314, p = 0.001], and the anxiety model [F (1, 56) = 13.4, p≤0.01] showed statistically significant values. In addition, the presence of hallucinations assessed with the Neuropsychiatric Inventory and social behavior assessed with the Mild Behavioral Impairment Checklist were significant. In contrast, in the bvFTD group, a homologous group of models was evaluated but we did not find any significant results. Conclusion:FoF in people with AD was related to physical performance, neuropsychiatric symptoms such as apathy and hallucinations, and affective symptoms such as anxiety. However, this pattern was not seen in the bvFTD group, and therefore further studies are required.

Keywords: Alzheimer’s disease, behavioral symptoms, fear of falling, frontotemporal dementia, physical performance

DOI: 10.3233/JAD-230266

Journal: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 1197-1207, 2023