In the October 2009 issue of the Archives, Johnson and colleagues1 describe a longitudinal study of the transition from healthy aging to Alzheimer disease. When comparing various cognitive domains between stable participants and participants with dementia, they found that visuospatial abilities demonstrated an inflection point 3 years before clinical diagnosis of dementia.1 These findings are potentially profound because visuospatial decline occurred 1 year prior to global cognitive declines and 2 years before declines in verbal and working memory functions.1 This suggests that the current widespread use of episodic memory screening as a clinical method of detecting cognitive decline may, in fact, be inadequate. These findings also have implications when considering fall risk among older adults. Currently, falls are a major health care concern, as 30% of community-dwelling adults older than 65 years experience 1 or more falls each year.2 Additionally, mild cognitive impairment, having dementia, or having a Mini-Mental State Examination score of 24 or less further increases the risk of falling.3
Naslund J. Visuospatial Ability in Relation to Fall Risk and Dementia. Arch Neurol. 2010;67(5):643–644. doi:10.1001/archneurol.2010.71
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