Brain Diseases and Fall-Related Surgery in Older Persons

Abstract

<b><i>Background:</i></b> It is known that age-related brain symptoms (gait difficulty and dementia) increase the likelihood of fall-related surgery. In contrast, it is not known which types of brain disease underlie such symptoms most. <b><i>Objective:</i></b> The aim of this study was to correlate brain diseases with the types of surgeries performed at our hospital for patients who had fallen. <b><i>Methods:</i></b> This was a retrospective study at a multifaculty university hospital in Japan, with a 12-month recruiting period, a follow-up period of 3.0 ± 2.5 weeks, and ≥1×/week visits. We assembled a neurogeriatric team to diagnose brain diseases with the use of brain imaging to the extent possible and correlated the diagnoses with types of fall-related surgery. <b><i>Results:</i></b> Fall-related surgery was conducted by the orthopedics (OP) and neurosurgery (NS) faculties (total <i>n</i> = 124) at a ratio of about 2 to 1. The underlying brain diseases differed by faculty; for OP, surgery was most commonly performed in patients with a combination of white matter disease (WMD) and Alzheimer’s disease (AD) (79%) followed by dementia with Lewy bodies. In contrast, for NS, the most common surgery was for patients with alcoholism (50%) followed by a combination of WMD and AD. <b><i>Conclusion:</i></b> Fall-related surgery was performed by the OP and NS faculties at a 2 to 1 ratio. The major underlying brain diseases were a combination of WMD and AD (79%) for OP and alcoholism (50%) for NS.