Can Methylphenidate Reduce Fall Risk in Community-Living Older Adults? A Double-Blind, Single-Dose Cross-Over Study

Authors

  • Ron Ben-Itzhak MD,

    1. From the *Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Geriatrics, Reuth Medical Center, Tel Aviv, IsraelDepartment of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel§Department of Physical Therapy, Harvard Medical School, Boston, Massachusetts, and Division on Aging, Harvard Medical School, Boston, Massachusetts
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  • Nir Giladi MD,

    1. From the *Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Geriatrics, Reuth Medical Center, Tel Aviv, IsraelDepartment of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel§Department of Physical Therapy, Harvard Medical School, Boston, Massachusetts, and Division on Aging, Harvard Medical School, Boston, Massachusetts
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  • Leor Gruendlinger MS,

    1. From the *Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Geriatrics, Reuth Medical Center, Tel Aviv, IsraelDepartment of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel§Department of Physical Therapy, Harvard Medical School, Boston, Massachusetts, and Division on Aging, Harvard Medical School, Boston, Massachusetts
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  • Jeffrey M. Hausdorff PhD

    1. From the *Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, IsraelDepartment of Geriatrics, Reuth Medical Center, Tel Aviv, IsraelDepartment of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel§Department of Physical Therapy, Harvard Medical School, Boston, Massachusetts, and Division on Aging, Harvard Medical School, Boston, Massachusetts
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  • This work was presented in part at the 59th Annual Meeting of the American Academy of Neurology, Boston, Massachusetts, May 2007, and at the American Geriatrics Society meeting, Seattle, Washington, May 2007.

Address correspondence to Jeffrey M. Hausdorff, PhD, Laboratory for Gait Analysis & Neurodynamics, Movement Disorders Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel. E-mail: jhausdor@tasmc.health.gov.il

Abstract

OBJECTIVES: To test the hypothesis that methylphenidate modifies markers of fall risk in older adults.

DESIGN: Randomized, double-blind, placebo-controlled, single-dose cross-over study.

SETTING: Outpatient movement disorders clinic.

PARTICIPANTS: Twenty-six community-living older adults without dementia (mean age 73.8) with subjective complaints of “memory problems.”

INTERVENTIONS: The study examined the effects of a single dose of 20 mg of methylphenidate (MPH) on cognitive function and gait. Participants were evaluated before and 2 hours after taking MPH or a placebo in sessions 1 to 2 weeks apart.

MEASUREMENTS: The Timed Up and Go and gait variability quantified mobility and fall risk. A computerized neuropsychology battery quantified memory and executive function (EF).

RESULTS: Timed Up and Go times, stride time variability, and measures of EF significantly improved in response to MPH but not in response to the placebo. In contrast, MPH did not significantly affect memory or finger tapping abilities.

CONCLUSION: In older adults, MPH appears to improve certain aspects of EF, mobility, and gait stability. Although additional studies are required to assess clinical utility and efficacy, the present findings suggest that methylphenidate and other drugs that are designed to enhance attention may have a role as a therapeutic option for reducing fall risk in older adults.

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