Israeli researchers find ADHD drug helps prevent falls in the elderly

A single dose of a popular ADHD drug commonly used in children was found to increase balance while walking in a study of 30 healthy elderly, reducing their risk of falling.

Researchers at Ben-Gurion University of the Negev found that balance and concentration were improved after administering 10 mg of methylphenidate (MPH), the generic name of Ritalin, in a study of 30 elderly adults.

BGU’s Itshak Melzer told The Jewish Star that MPH could be used for treatment “in a few years after completing our studies to see if there are any adverse events.”

In the study, 15 subjects were administered MPH and 15 were given a placebo. Their balance, walking ability and then walking ability combined with a verbal task were tested. Analysis of the data, in one part of the study, indicated “a 57% reduction in the number of step errors in the experimental group with no equivalent improvement in placebo controls.”

The decline in walking ability and balance with age significantly affects the increase in falls in the elderly. Another aspect that may precipitate falls may involve the need to accomplish two actions at the same time such as walking and observing traffic while crossing a street or being distracted while walking.

The subjects in the study were all aged 70 or older, had no sight complications, were able to walk without assistance and were sound physically and mentally, with no neurological disease, psychiatric problems, dementia or cardiac disease.

The amount of the dose of MPH was chosen since it’s been shown to aid walking in Parkinson’s patients and helped mental processing in brain tumor patients and is the beginning dosage in adults with attention deficit or hyperactivity disorder.

Melzer noted that “our findings that MPH improves gait can be explained not just by its effect of attention improvements but also by indications that it has a direct influence on areas of the brain that deal with motor and balance control.”

“Our results add to a growing body of evidence showing that MPH may have a role as a therapeutic option for improving gait and reducing fall risk in older adults, especially in ‘real-life’ situations, where the requirement to walk commonly occurs under more complicated circumstances with cognitive attention focused elsewhere (e.g. watching traffic, talking) and not on performing a specific motor task.”

He noted that the use of more than four medications is a risk factor for falling in the elderly and precautions to prevent falls include “less medication, a home safety check and specific exercises to improve balance.”

Dr. Paula Lester, a gerontologist affiliated with Winthrop-University Hospital in Mineola, said that she has “concerns about stimulants in the elderly, especially those with cognitive dysfunction or cardiac disease as their use is not well studied in those populations.”

MPH stimulates the central nervous system and is used to treat ADHD and narcolepsy (a sudden attack of deep sleep). It increases attention and decreases restlessness in children and adults and can only be obtained with a doctor’s prescription.

In the United States, one third of adults 65 and older fall each year, and falls are the leading cause of death related to injury, according to the Centers for Disease Control and Prevention. Cuts, hip fractures and head traumas result in almost 30 percent of falls by the elderly. Even if they are not injured after they fall, they fear falling again, causing them to limit their activities, leading to loss of physical fitness, restricting their mobility and in turn increasing their risk of falling. In 2009, about 20,400 older adults died from injuries from a fall.

Falls can be prevented with regular exercise focusing on improving balance and leg strength, notes the CDC. Medicines should be reviewed and assessed by a doctor or pharmacist to determine if they or their combinations cause negative effects including dizziness or sleepiness. Vision should be checked, possibly switching to distance only glasses for use when walking. The patient’s home should be evaluated to eliminate tripping hazards, to improve lighting, provide railings on both sides of a staircase and grab bars in the bathroom. To lower the risk of broken bones, patients should have a bone density scan, insure adequate calcium and vitamin D intake and do weight bearing exercises.