Author: Henry Manke

More than a quarter of elderly people fall each year, making it the leading cause of fatal and non-fatal injuries among elderly people. Anyone with a loved one who is at high risk of falling can tell you that falling causes constant worry and reduces many of the joys of life. Moreover, if the loved one falls and breaks the hip, too many caregivers can share this often mentioned story of how that fracture became the beginning of the end.

As our population grows and ages, the cost of this common risk will increase exponentially. However, recent breakthroughs in brain health science have shown that we can take relatively low-cost, highly scalable steps to reduce these risks.

Our narrow focus on physical factors is wrong

When we consider the causes of fall risk, we tend to focus on physical factors in the environment, such as trip hazards or unexpected changes in terrain. We may also think of physical factors that affect our health, such as muscle strength, bone density, impaired vision, or drugs that cause dizziness.

Therefore, most plans to reduce the risk of falls involve physical aspects, such as someone coming to the house to eliminate the risk of tripping and adding handrails, perhaps drug reviews, recommendations for treatments to strengthen bone density and muscles, and recommendations for renewing eyeglass prescriptions.

These are good actions! But they did not completely solve this problem. Just before you fell, there was a moment—just a moment—you either regained your footing or fell to the ground. Everything that happened at that moment is in your mind-addressing this risk may be the most important factor in preventing falls.

What happens when you fall…or you don’t

At the moment you go from walking upright to landing, at least one of the three systems that keep you standing is malfunctioning: (1) The “vestibular” or “balance” system uses the hair-like structure in the inner ear-balance Sensors-to monitor the position of your head in space; (2) The musculoskeletal sensory system, which uses posture sensors all over the body to monitor the position of your body in space; (3) The vision of your eyes and brain Space system, which detects changes in the visual scene when you move in space. When you walk, these three systems continuously send information to your brain, so you can make small adjustments to your posture in an instant, allowing you to stay standing and walk confidently.

Now, imagine yourself walking and then suddenly starting to fall. When you start to fall, your head starts to move from its balanced upright position to an angular position-this movement activates your brain’s visual motor system, letting your brain know that something unusual and dangerous is happening sports. At the same time, the balance and posture sensors will activate, sending a message to your brain, indicating that something unusual—possibly bad—is happening.

In most cases, your brain will receive all of this information in an instant and will issue appropriate commands to your body in an instant to adjust your posture, so you can stay standing-but sometimes these instant messages are not processed quickly , Accurate enough…then you go.

For a long time, the processing speed and accuracy of the brain will decrease with age-this will increase the risk of falling, which has long been fully demonstrated. There is also ample evidence that through proper brain training, processing speed and accuracy can be significantly improved, even at an advanced age.

Neuroscientists have learned a lot about the role of the brain in falls

Recently, scientists are interested in whether brain function can explain much of the risk of falls.Facts proved it Do. This is especially true for related cognitive performance Visual processing speed and attention. Research in the early 2000s showed The relationship between visual cognitive ability and personal action ability, Including predicting the risk of falling and Gait problems while walking.

Improved brain function can reduce the risk of falls

Since people with better brain performance have a lower risk of falling, it may make sense to try to improve brain performance to see if it reduces the risk of falling. Researchers at the University of Illinois at Chicago had this idea. They conducted two randomized controlled trials using brain exercises in the commercial BrainHQ application to improve the accuracy and speed of visual processing. The two studies were conducted in very different groups of elderly people.One study involved Mainly white, residents of high-end retirement communities over 70, The other involves African-American, a resident of the Southern District of Chicago, Over 65 years old. In these two studies, the researchers found that brain training significantly improved the standard measures of fall risk and gait, and had a greater impact, and in the latter study, kept users away from the cusp of high fall risk. These studies show that enhancing cognitive function through brain training—helping the brain process information faster and more accurately—helps people stay standing.

Strengthen brain speed and accuracy to reduce the risk of falls

No matter what circumstances cause a fall, it is the moment when the fall begins—when your brain can quickly process information and make adjustments to prevent a fall—that ultimately determines whether you fall. Brain exercises reduce the risk of falls by enhancing the speed and accuracy of instant reactions, thereby targeting the results at that moment. When these studies were conducted in 2013-2015, this was a novel approach.

A new NIH grant

A new grant from the National Institute on Aging (National Institutes of Health) has been awarded to further advance this research. The previous study provided face-to-face brain training sessions (requiring all participants to visit the academic medical center 3 times a week) and balance measurements (to estimate the risk of falling). The new research will be conducted completely remotely using online brain exercises with telemedicine guidance-meaning that people from all over the country can participate. Study participants will receive an Apple Watch® to directly record any falls they actually experience, as well as measuring other aspects of walking and balance.

What the future looks like

The program used under this new grant-online, telemedicine guidance-is meaningful in the COVID era, where telemedicine has become commonplace. But this is also meaningful in the post-COVID era, because the program can be extended to people across the country-urban centers and rural areas-without the need for participants who may be at risk of falling to travel to participate in programs that reduce the risk of falls and improve mobility . We are finally beginning to see the promise of digital health technology-inexpensive, easily accessible and effective-to benefit people through breakthrough technologies.

Henry Mahncke, Ph.D. received his Ph.D. in neuroscience from the laboratory of the University of California, San Francisco. He discovered that the brain remains plastic throughout life. After consulting with McKinsey for a period of time, He was recruited to lead the global team to commercialize plasticity-based training in Posit Science, which created BrainHQ.