CT and MRI Findings Link Cerebrovascular Disease to Fall Risks in Seniors

Recent research led by Dr. Úna Clancy of the University of Edinburgh has revealed significant connections between covert brain changes detected through CT and MRI scans and an increased risk of falls in older adults. The study, published on June 27, 2025, in the journal *Stroke*, highlights the potential implications of cerebrovascular disease, which is often undiagnosed yet prevalent among the aging population.

The research team analyzed imaging results from 241,050 patients aged 50 and above who were registered with Kaiser Permanente Southern California. They utilized advanced natural language processing techniques to identify covert brain infarcts and white-matter hyperintensities in imaging reports. These findings are often incidental, meaning they occur without the typical symptoms of stroke but may indicate underlying cerebrovascular disease, which has been associated with dementia, future strokes, and heightened mortality rates.

According to the study, 31.1% of the participants exhibited covert brain infarcts, while 21.2% experienced falls within a three-year follow-up period. The incidence rates of falls per 1,000 person-years were notably higher among those with both covert brain infarcts and white-matter hyperintensities, with rates of 129.3 for CT and 109.9 for MRI.

Dr. Clancy emphasizes the importance of recognizing the full spectrum of clinical manifestations associated with cerebrovascular disease. She stated, "Since cerebrovascular disease is highly prevalent, especially in advancing age, it is crucial to identify as many affected patients as possible to implement management strategies and plan healthcare delivery effectively."

The adjusted hazard ratios for falls were particularly alarming; individuals with detected covert brain infarcts had a 1.13 hazard ratio on CT and 1.17 on MRI for experiencing a fall. Additionally, the risk of falls increased correlatively with the severity of white-matter hyperintensities. For instance, patients with mild white-matter hyperintensities had a 1.37 hazard ratio on CT, escalating to 1.57 for those with moderate to severe hyperintensities.

The implications of these findings are substantial. Falls are a leading cause of emergency healthcare visits among older adults, and understanding the linkage to cerebrovascular disease could facilitate better prognostic assessments and integrated care systems. As stated in the study, "When covert brain infarcts and white-matter hyperintensities are detected, this confers additional prognostic risk for future falls, allowing for more informed clinical decisions and improved patient care."

The research points to a pressing need for healthcare providers to incorporate findings from CT and MRI scans into their assessments of fall risk in elderly patients. This approach may not only enhance patient outcomes but also reduce healthcare costs associated with fall-related injuries.

In conclusion, the study sheds light on the critical relationship between neuroimaging findings and fall risks among older adults, advocating for a more proactive approach in identifying and managing cerebrovascular disease to improve health outcomes in this vulnerable population. The full study can be accessed in the June 2025 issue of *Stroke*.