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The neurobiology of falls

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Abstract

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.

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Authors and Affiliations

  1. Department of Neurology, Catholic University, Rome, Italy

    Alfonso Fasano & Francesco Bove

  2. Department of Neuroscience, AFaR-Fatebenefratelli Hospital, Rome, Italy

    Alfonso Fasano

  3. Istituto di Neurologia, Policlinico A. Gemelli, 8, 00168, Rome, Italy

    Alfonso Fasano

  4. Advanced Technologies Center, Rehabilitation Hospital, Sehba Medical Center, Tel Hashomer, Israel

    Meir Plotnik

  5. Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel

    Meir Plotnik

  6. Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Meir Plotnik

  7. Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel

    Meir Plotnik

  8. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy

    Alfredo Berardelli

  9. Neuromed Institute (IRCSS), Pozzilli (IS), Italy

    Alfredo Berardelli

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  1. Alfonso Fasano
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  2. Meir Plotnik
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  3. Francesco Bove
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  4. Alfredo Berardelli
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Correspondence to Alfonso Fasano.

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A. Fasano and M. Plotnik equally contributed to the work.

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Fasano, A., Plotnik, M., Bove, F. et al. The neurobiology of falls. Neurol Sci 33, 1215–1223 (2012). https://doi.org/10.1007/s10072-012-1126-6

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