Gait and cognitive abnormalities are associated with regional cerebellar atrophy in elderly fallers – A pilot study

Amgad Droby, Mohamed Mounir El Mendili, Nir Giladi, Jeffery M. Hausdorff, Inbal Maidan, Anat Mirelman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives: To investigate cerebellar lobule atrophy patterns in elderly fallers (EFs) and their association with gait and cognitive performance. Background: Cognitive impairments, gait, and balance deficits are major risk factors for falls in older adults, however, their neural fingerprints remain poorly understood. Recent evidence from neuroimaging studies highlight the role of the cerebellum in both sensorimotor and cognitive networks, suggesting that it may contribute to fall risk. Methods: Fourteen EFs (mean age ± SD = 78 ± 1.5 yrs.) and 20 healthy controls (HCs) (mean age ± SD = 69.6 ± 1.3 yrs.) underwent a 3 T MRI scan obtaining 3D T1-weighted images, cognitive, and gait assessments. Cerebellar lobule segmentation was performed, and the obtained cerebellar lobules volumes were adjusted for intracranial volume (ICV). The relationship between lobules volumes, gait, and cognitive performance scores was assessed using hierarchical multiple linear regression adjusted for age and gender. Results: EFs exhibited lower cerebellar volumes in the posterior cerebellum, lobules V, VI, VIIB, VIIIA, VIIIB, and Crus II, and significantly higher volumes in the anterior cerebellum and lobule IV (p = 0.018 and p = 0.046) compared to HCs. In EFs, lobule V, VI, VIIB, VIIIA, VIIIB, and anterior cerebellum volumes were found to be independent predictors of usual walking (UW) gait speed, dual-task (DT) gait speed, mini Best, MOCA, CTTa, and CTTb (p < 0.05). Conclusions: The observed patterns of cerebellar lobule atrophy and their associations with motor and cognitive performance scores suggest that cerebellar atrophy contributes to the pathophysiology of fall risk in EFs.

Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalGait and Posture
StatePublished - 1 Oct 2021
Externally publishedYes


  • Cerebellar atrophy
  • Cognition
  • Elderly fallers
  • Gait
  • MRI

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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