Falling, stumbling and problems with balance could be the very first indicator of Alzheimer's disease.

That's the word from researchers at the Washington University School of Medicine in St. Louis, Missouri, who found that study participants with brain changes suggestive of early Alzheimer's disease were more likely to fall than those whose brains did not show the same changes.

Until now, falls had only been associated with Alzheimer's in the late stages of dementia.

"If you meet these people on the street, they appear healthy and have no obvious cognitive problems," says lead author Dr. Susan Stark, assistant professor of occupational therapy and neurology. "But they have changes in their brain that look similar to Alzheimer's disease, and they have twice the typical annual rate of falls for their age group."

The study: The team recruited 119 volunteers from studies of aging and health at Washington University's Knight Alzheimer's Disease Research Center. All the participants were 65 or older and cognitively normal. Brain scans showed that 18 participants had high levels of amyloid plaques, a hallmark of Alzheimer's. The other 101 volunteers had normal amyloid levels in the brain.

Participants were given a journal and asked to note any falls. When they did so, the researchers followed up with a questionnaire and a phone interview about the falls. This follow-up allowed researchers to gather information for future analyses that will compare and contrast the nature of the falls.

The results: About one in three adults age 65 or older typically fall each year. But in the 18 participants with high amyloid levels in the brain, two-thirds fell within the first eight months of the study. High levels of amyloid in the brain were the best predictor of an increased risk of falls.

"Falls are a serious health concern for older adults," Stark says. "Our study points to the notion that we may need to consider preclinical Alzheimer's disease as a potential cause."

The study findings were reported at the Alzheimer's Association International Conference on Alzheimer's Disease in Paris.

--From the Editors at Netscape